Mania associated with
fluoxetine treatment in adolescents.
Venkataraman S, Naylor MW, King
University of Michigan Department of Psychiatry, Ann Arbor
Fluoxetine, a selective serotonin reuptake inhibitor, is
gaining increased acceptance in the treatment of adolescent depression.
Generally safe and well tolerated by adults, fluoxetine has been reported to
induce mania. The cases of five depressed adolescents, 14-16 years of age, who
developed mania during pharmacotherapy with fluoxetine, are reported here.
Apparent risk factors for the development of mania or hypomania during
fluoxetine pharmacotherapy in this population were the combination of
attention-deficit hyperactivity disorder and affective instability; major
depression with psychotic features; a family history of affective disorder,
especially bipolar disorder; and a diagnosis of bipolar disorder. Further study
is needed to determine the optimal dosage and to identify risk factors that
increase individual vulnerability to fluoxetine induced mania in