Mirtazapine-Induced Mania: A Case Report

Detalhes bibliográficos
Autor(a) principal: Freitas, Catarina
Data de Publicação: 2019
Outros Autores: Barranha, Rui, Abreu, Tânia, von Doellinger, Orlando
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916
Resumo: Manic and hypomanic states associated with antidepressant treatments are relatively common; however, when specifically considering mirtazapine, those side effects are infrequent. The authors report a clinical case regarding a manic episode with dysphoric features in a patient with no personal or family previous psychiatric history. It began two weeks after starting treatment with mirtazapine up to 30 mg/day. This episode was treated discontinuing mirtazapine and initiating olanzapine (10 mg), with symptomatic remission. Mirtazapine has a specific pharmacodynamics, blocking not only post-synaptic serotonergic receptors but also α2-presynaptic adrenergic receptors. Taking this into consideration, it was hypothesized that this case could be attributed to a noradrenergic syndrome, characterized by dysphoria, irritability, insomnia and psychomotor agitation.
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spelling Mirtazapine-Induced Mania: A Case ReportMania Induzida por Mirtazapina: Um Caso ClínicoAntidepressive AgentsTricyclic/adverse effectsBipolar Disorder/chemically inducedMirtazapine/adverse effectsAntidepressivos Tricíclicos/efeitos adversosMirtazapina/efeitos adversosPerturbação Bipolar/induzida quimicamenteManic and hypomanic states associated with antidepressant treatments are relatively common; however, when specifically considering mirtazapine, those side effects are infrequent. The authors report a clinical case regarding a manic episode with dysphoric features in a patient with no personal or family previous psychiatric history. It began two weeks after starting treatment with mirtazapine up to 30 mg/day. This episode was treated discontinuing mirtazapine and initiating olanzapine (10 mg), with symptomatic remission. Mirtazapine has a specific pharmacodynamics, blocking not only post-synaptic serotonergic receptors but also α2-presynaptic adrenergic receptors. Taking this into consideration, it was hypothesized that this case could be attributed to a noradrenergic syndrome, characterized by dysphoria, irritability, insomnia and psychomotor agitation.O desenvolvimento de estados maníacos e hipomaníacos associado ao uso de antidepressivos é relativamente comum. Contudo, no caso da mirtazapina, este é um efeito secundário raro. Os autores descrevem um caso clínico de um episódio maníaco de características disfóricas, num doente sem antecedentes psiquiátricos pessoais ou familiares, com instalação duas semanas após início de tratamento com mirtazapina até 30 mg/dia. Uma vez suspensa a mirtazapina e iniciada olanzapina (10 mg) verificou-se remissão sintomática. A mirtazapina apresenta uma farmacodinâmica particular, sendo antagonista não só de recetores serotoninérgicos póssinápticos, mas também de recetores adrenérgicos pré-sinápticos α2. Neste sentido, colocou-se a hipótese de se tratar de uma síndrome noradrenérgica, caracterizada por disforia, irritabilidade, insónia e agitação psicomotora.Ordem dos Médicos2019-10-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916oai:ojs.www.actamedicaportuguesa.com:article/9916Acta Médica Portuguesa; Vol. 32 No. 10 (2019): October; 671-673Acta Médica Portuguesa; Vol. 32 N.º 10 (2019): Outubro; 671-6731646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/5681https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/10665https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/10666https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/11419Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessFreitas, CatarinaBarranha, RuiAbreu, Tâniavon Doellinger, Orlando2022-12-20T11:05:50Zoai:ojs.www.actamedicaportuguesa.com:article/9916Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:46.320589Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Mirtazapine-Induced Mania: A Case Report
Mania Induzida por Mirtazapina: Um Caso Clínico
title Mirtazapine-Induced Mania: A Case Report
spellingShingle Mirtazapine-Induced Mania: A Case Report
Freitas, Catarina
Antidepressive Agents
Tricyclic/adverse effects
Bipolar Disorder/chemically induced
Mirtazapine/adverse effects
Antidepressivos Tricíclicos/efeitos adversos
Mirtazapina/efeitos adversos
Perturbação Bipolar/induzida quimicamente
title_short Mirtazapine-Induced Mania: A Case Report
title_full Mirtazapine-Induced Mania: A Case Report
title_fullStr Mirtazapine-Induced Mania: A Case Report
title_full_unstemmed Mirtazapine-Induced Mania: A Case Report
title_sort Mirtazapine-Induced Mania: A Case Report
author Freitas, Catarina
author_facet Freitas, Catarina
Barranha, Rui
Abreu, Tânia
von Doellinger, Orlando
author_role author
author2 Barranha, Rui
Abreu, Tânia
von Doellinger, Orlando
author2_role author
author
author
dc.contributor.author.fl_str_mv Freitas, Catarina
Barranha, Rui
Abreu, Tânia
von Doellinger, Orlando
dc.subject.por.fl_str_mv Antidepressive Agents
Tricyclic/adverse effects
Bipolar Disorder/chemically induced
Mirtazapine/adverse effects
Antidepressivos Tricíclicos/efeitos adversos
Mirtazapina/efeitos adversos
Perturbação Bipolar/induzida quimicamente
topic Antidepressive Agents
Tricyclic/adverse effects
Bipolar Disorder/chemically induced
Mirtazapine/adverse effects
Antidepressivos Tricíclicos/efeitos adversos
Mirtazapina/efeitos adversos
Perturbação Bipolar/induzida quimicamente
description Manic and hypomanic states associated with antidepressant treatments are relatively common; however, when specifically considering mirtazapine, those side effects are infrequent. The authors report a clinical case regarding a manic episode with dysphoric features in a patient with no personal or family previous psychiatric history. It began two weeks after starting treatment with mirtazapine up to 30 mg/day. This episode was treated discontinuing mirtazapine and initiating olanzapine (10 mg), with symptomatic remission. Mirtazapine has a specific pharmacodynamics, blocking not only post-synaptic serotonergic receptors but also α2-presynaptic adrenergic receptors. Taking this into consideration, it was hypothesized that this case could be attributed to a noradrenergic syndrome, characterized by dysphoria, irritability, insomnia and psychomotor agitation.
publishDate 2019
dc.date.none.fl_str_mv 2019-10-01
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916
oai:ojs.www.actamedicaportuguesa.com:article/9916
url https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916
identifier_str_mv oai:ojs.www.actamedicaportuguesa.com:article/9916
dc.language.iso.fl_str_mv por
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dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/5681
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/10665
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/10666
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9916/11419
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 32 No. 10 (2019): October; 671-673
Acta Médica Portuguesa; Vol. 32 N.º 10 (2019): Outubro; 671-673
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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