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Although the details are debated, it seems clear that antidepressants can induce hypomania or mania in patients with bipolar disorder (see e.g., Journal Watch Psychiatry Oct 23 2006). To examine whether antidepressant-induced mania or hypomania occurs in unipolar depression, researchers in Japan retrospectively reviewed charts of 282 inpatients with apparent unipolar depression and with fewer than three previous episodes.
Thirty-seven patients (13%) developed a mood switch: 34 to DSM-IV hypomania, 2 to mania, and 1 to a “mixed episode.” Nine patients switched within a week of starting antidepressant medication, 21 switched within 2–3 weeks; and 7 switched within 4–7 weeks. Antidepressants were the tricyclic antidepressant amoxapine (24 patie…