Low Risk for Switch to Mania during Treatment with Sleep Promoting Antidepressants.
نویسندگان
چکیده
INTRODUCTION Sleep-promoting antidepressants are of interest because they are used not only as antidepressants, but also to promote sleep. METHODS We reviewed case reports describing the switch to mania during treatment with trazodone, mirtazapine, or agomelatine. RESULTS Trazodone, mirtazapine, and agomelatine may induce manic symptoms. However, the risk of switching is related, first of all, to doses recommended for antidepressant treatment, administered without mood-stabilizer co-therapy. Low doses of these antidepressants, used for their hypnotic or sedative effects, were observed to cause mania only in patients with other risk factors for switching. There is no evidence for trazodone or mirtazapine and only sparse evidence for agomelatine, claiming that treatment with these antidepressants is related to an increased risk of switching to mania when administered in combination with a mood stabilizer. DISCUSSION These findings suggest that low doses of trazodone and mirtazapine are safe in bipolar disorder, and should still be considered important alternatives to hypnotics when long-term pharmacological treatment of insomnia is necessary. It seems that these antidepressants and agomelatine can also be used safely in antidepressant doses when combined with a mood stabilizer.
منابع مشابه
Fan the flame: trazodone-induced mania in a unipolar depressed patient with stable sertraline treatment
Depressed patients often complain of sleep disturbance. Routine antidepressive strategies sometimes fail to deal with this intractable issue. Indeed, the supplementation of sleep promoting antidepressants (eg, trazodone, mirtazapine, and agomelatine) is prevalent in clinical practice. However, the combination of different antidepressants may increase the affective lability. Herein, we document ...
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ورودعنوان ژورنال:
- Pharmacopsychiatry
دوره 48 3 شماره
صفحات -
تاریخ انتشار 2015