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  • Title: [Development of (hypo)mania during discontinuation of venlafaxine in two patients with bipolar disorder].
    Author: Tak LM, Stevens AW.
    Journal: Tijdschr Psychiatr; 2013; 55(10):795-800. PubMed ID: 24166339.
    Abstract:
    The scientific literature frequently warns that patients with bipolar disorder risk developing a (hypo)mania on starting a course of antidepressants. In this case report, however, two patients with bipolar disorder developed a (hypo)mania while their dosage of venlafaxine was being gradually tapered off. We discuss a pharmacodynamic explanation for the induction of (hypo)mania during discontinuation of venlafaxine. We also discuss alternative explanations, such as a venlafaxine withdrawal syndrome; induction of rapid cycling; difficulties in distinguishing an agitated depression and a dysphoric mania and the naturalistic course of a bipolar disorder.
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