Bipolar Research Today is a free monthly online journal that collates and summarizes the latest research about Bipolar, including details on bipolar disorder, symptoms, treatment, depression, medication.

Agitated dysphoria after late-onset loss of response to antidepressants: a case report.

Phelps JR

Samaritan Professional Bldg., 3517 Samaritan Drive, Corvallis, OR 97330, USA. jp@co-psych.com

BACKGROUND: Antidepressants can sometimes cause agitation, particularly in patients with bipolar disorder, but concern about such effects is generally limited to the first weeks and months of treatment. METHOD: Demonstration of the occurrence of agitated dysphoria after loss of response to an antidepressant following continuous administration through 7 years of euthymia; with a worsening on dose increase; and recurrence of agitation on re-exposure 1 year later; in a patient whose previous dysthymia and recurrent depressions had no recognizable manic or hypomanic features. RESULTS: Only when the antidepressant was removed, twice, was treatment an atypical antipsychotic and lithium effective. CONCLUSION: An antidepressant which has been effective for as long as 7 years may still carry risk of inducing agitated dysphoria, even in apparently unipolar depression. In some patients, clinical vigilance for antidepressant-induced dysphoria may be warranted for extended periods of time.

Published 6 June 2005 in J Affect Disord, 86(2): 277-80.
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