Pharmacopsychiatry 2007; 40(2): 86-87
DOI: 10.1055/s-2007-970140
Letter

© Georg Thieme Verlag KG Stuttgart · New York

Bipolar Switching after Carbamazepine Withdrawal

C. Lange-Asschenfeldt 1 , I. Blaeser 1 , T. Supprian 1
  • 1Department of Psychiatry and Psychotherapy, Division of Geriatric Psychiatry, Heinrich Heine University, Düsseldorf, Germany
Further Information

Publication History

received 5. 9. 2006

accepted 8. 1. 2007

Publication Date:
19 April 2007 (online)

Introduction

Anticonvulsants such as the dibenzazepine derivative carbamazepine (CBZ) are effective alternatives to lithium in phase prophylaxis of bipolar disorder, particularly in the elderly [1], and in case of medical comorbidity [5]. It is well established that lithium withdrawal may precipitate recurrence of manic symptoms in bipolar patients [2]. However, rebound-affective episodes in such patients upon discontinuation of CBZ have not been recognized till to date. Here we describe a case of mania induced in a bipolar depressive patient following cessation of long-term CBZ treatment.

References

  • 1 Akiskal HS, Fuller MA, Hirschfeld RM, Keck Jr PE, Ketter TA, Weisler RH. Reassessing carbamazepine in the treatment of bipolar patients: clinical implications of new data.  CNS Spectr. 2005;  10 ((6 Suppl 5)) 1-13
  • 2 Cavanagh J, Smyth R, Goodwin GM. Relapse into mania or depression following lithium discontinuation: a 7-year follow-up.  Acta Psychiatr Scand. 2004;  109 91-95
  • 3 Jess GE, Smith DJ, MacKenzie C, Crawford C. Carbamazepine and rebound mania.  Am J Psychiatry. 2004;  161 2132-2133
  • 4 Macritichie KAN, Hunt NJ. Does “rebound mania” occur after stopping carbamazepine? A pilot study.  J Psychopharmacol. 2000;  14 266-268
  • 5 Mouaffak F, Gourevitch R, Baup N, Loo H, Olie JP. Interrelations between lithium therapy, auto-immune thyroiditis and TSH. A case report.  Pharmacopsychiatry. 2006;  39 77-78
  • 6 Scull D, Trimble MR. Mania precipitated by carbamazepine withdrawal.  Br J Psychiatry. 1995;  167 698

Correspondence

C. Lange-Asschenfeldt

Department of Psychiatry and Psychotherapy

Division of Geriatric Psychiatry

Heinrich Heine University

Bergische Landstr. 2

40629 Düsseldorf

Phone: + 49/211/922 42 15

Fax: + 49/211/922 42 13

Email: christian.lange-asschenfeldt@lvr.de

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