Background
Antidepressant-induced mania (AIM) has been described in bipolar disorder (BD) and
has been associated with the short-allele of the serotonin transporter gene (5-HTT).
We wished to investigate the frequency of and risk factors for AIM in pediatric patients
with or at high risk for BD.
Methods
Fifty-two children and adolescents (30 with BD and 22 with subthreshold manic symptoms,
15.1 ± 3.4 years old), all with a parent with BD, were interviewed with their parents
for manic/depressive symptoms occurring before and after past antidepressant treatment.
The 47 subjects with serotonin reuptake inhibitor (SSRI) exposure were genotyped for
the 5-HTT polymorphism.
Results
Fifty percent of subjects were AIM+ and 25.5% had new onset of suicidal ideation.
The AIM+ and AIM− groups did not differ significantly in relation to allele (p = .36)
or genotype (p = .53) frequencies of the 5-HTT polymorphism. The AIM+ subjects were
more likely to have more comorbidities (3.2 vs. 2.4; p = .02) and be BD type I (p
= .04) than AIM− subjects.
Conclusions
Youth with or at high risk for BD may be particularly vulnerable to SSRI AIM and thus
should be monitored if given SSRIs. In this preliminary study, we did not find that
the 5-HTT polymorphism significantly influenced vulnerability to AIM.
Key Words
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Article info
Publication history
Published online: August 30, 2006
Accepted:
June 8,
2006
Received in revised form:
May 2,
2006
Received:
November 3,
2005
Identification
Copyright
© 2006 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
