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Risk of manic switch with antidepressants use in patients with bipolar disorder in a Nigerian neuropsychiatric hospital

Background: Depressive disorders are common among those with bipolar affective disorder (BAD) and may necessitate the use of antidepressants. This has been suggested to precipitate manic episodes in some patients. Objectives: This study aims to determine the prevalence of and factors associated wit...

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Published: 2018
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LEADER 00000njm a2000000a 4500
001 oai:repository.ui.edu.ng:123456789/12737
042 |a dc 
720 |a Fela-Thomas, A.L.  |e author 
720 |a Olotu, O.S  |e author 
720 |a Esan, O.B.  |e author 
260 |c 2018 
520 |a Background: Depressive disorders are common among those with bipolar affective disorder (BAD) and may necessitate the use of antidepressants. This has been suggested to precipitate manic episodes in some patients. Objectives: This study aims to determine the prevalence of and factors associated with manic switch in patients with BAD being treated with antidepressants. Methods: Case notes of patients who were treated at a Nigerian neuropsychiatric hospital for a BAD from 2004 to 2015 were reviewed. BAD diagnosis was made using ICD-10 criteria. Treatment for bipolar depression included monotherapy (i.e. antidepressants, antipsychotics or mood stabilisers) or combination therapy (mood stabiliser with an antidepressant or a combination of mood stabilisers, antipsychotics and antidepressants). The primary outcome measure was a switch to mania or hypomania within 12 weeks of commencing an antidepressant. Results: Manic or hypomanic switch (MS) was observed in 109 (44.3%) of the participants. Female gender, younger age, number of previous episodes and a past history of psychiatric hospitalisation were all significantly associated with a risk of MS. There was no significant difference in the rate of MS in either those treated with adjunct antidepressants therapy with a mood stabiliser or an antipsychotic or those placed on a combination of antidepressants, antipsychotics and mood-stabilising agents. Conclusion: A large proportion of patients with BAD on antidepressants experience medication-induced manic or hypomanic switch. 
024 8 |a 2078-6786 
024 8 |a 1608-9685 
024 8 |a ui_art_fela_thomas_risk_2018. 
024 8 |a South African Journal of Psychiatry, 24(1), pp. 1-6 
024 8 |a https://repository.ui.edu.ng/handle/123456789/12737 
653 |a Manic switch 
653 |a Antidepressants 
653 |a bipolar disorder 
653 |a Nigerian neuropsychiatric hospital 
245 0 0 |a Risk of manic switch with antidepressants use in patients with bipolar disorder in a Nigerian neuropsychiatric hospital