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Titolo:
Treatment of bipolar depression with twice-weekly fluoxetine: Management of antidepressant-induced mania
Autore:
Megna, JL; Devitt, PJ;
Indirizzi:
SUNY Upstate Med Univ, Dept Psychiat, Syracuse, NY 13210 USA SUNY Upstate Med Univ Syracuse NY USA 13210 chiat, Syracuse, NY 13210 USA SUNY Upstate Med Univ, Dept Med, Syracuse, NY USA SUNY Upstate Med Univ Syracuse NY USA d Univ, Dept Med, Syracuse, NY USA Hutchings Psychiat Ctr, Syracuse, NY USA Hutchings Psychiat Ctr Syracuse NY USA gs Psychiat Ctr, Syracuse, NY USA Cent New York Psychiat Ctr, Marcy, NY USA Cent New York Psychiat Ctr Marcy NY USA York Psychiat Ctr, Marcy, NY USA
Titolo Testata:
ANNALS OF PHARMACOTHERAPY
fascicolo: 1, volume: 35, anno: 2001,
pagine: 45 - 47
SICI:
1060-0280(200101)35:1<45:TOBDWT>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLASMA-CONCENTRATIONS; DISORDER;
Keywords:
bipolar depression; fluoxetine; mania;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Megna, JL SUNY Upstate Med Univ, Dept Psychiat, 750 E Adams St, Syracuse, NY 13210 USA SUNY Upstate Med Univ 750 E Adams St Syracuse NY USA 13210 0 USA
Citazione:
J.L. Megna e P.J. Devitt, "Treatment of bipolar depression with twice-weekly fluoxetine: Management of antidepressant-induced mania", ANN PHARMAC, 35(1), 2001, pp. 45-47

Abstract

OBJECTIVE: To report a case of treatment of bipolar depression and management of antidepressant-induced mania with a low-dose fluoxetine regimen. CASE SUMMARY: A 59-year-old white woman was admitted involuntarily to a New York State psychiatric center with a diagnosis of bipolar (type 1) disorder, mixed, with psychotic features. Initial treatment with lithium, olanzapine, and clonazepam produced a remission of manic and psychotic symptoms. However, the patient remained clinically depressed. Addition of oral fluoxetine 10 mg every morning to her medication regimen was followed 22 days later by the development of a manic state. Reduction of the fluoxetine dosage to 10 mg twice weekly was associated with the attainment of euthymia in 18 days. Thirteen days after the fluoxetine dosage reduction, the patient's fluoxetine blood concentration was 20 mug/L and the norfluoxetine concentratiopn was reported as 53 mug/L. DISCUSSION: To our knowledge, this is the first published case that describes the association between a low-dose fluoxetine regimen and the evolutionof a bipolar affective state from depression to euthymia via manic switching. The temporal synchrony of this switching with initial implementation offluoxetine 10 mg every morning, followed by a dose reduction to 10 mg twice weekly, suggests that bipolar depressed patients are extremely sensitive to low doses of antidepressants and to incremental these doses. However, italso suggests that they can respond clinically to such treatment Furthermore, our laboratory data indicate that antidepressant blood concentrations may play a contributory role in maintaining the balance between euthymia in these patients. CONCLUSION:Manic switching is always a concern when treating a bipolar depressed patient. Utilization of a low-dose antidepressant drug regimen may be a clinically prudent approach in such an individual.

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Documento generato il 26/01/20 alle ore 09:58:28