Hypomania induced by aripiprazole in a patient with treatment-resistant depression

Authors

  • Dennison Carreiro Monteiro Professor Assistente, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil https://orcid.org/0000-0002-3672-9894
  • João Cortez de Oliveira Graduando, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil https://orcid.org/0009-0008-9660-0938
  • Thamires da Silva Sampaio Medrado Graduanda, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil https://orcid.org/0000-0003-3260-4936
  • Víctor Câmara Gusmão Cardoso Graduando, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil https://orcid.org/0009-0008-5937-3393
  • Vitor Gama Vieira de Araújo Régis Graduando, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil

DOI:

https://doi.org/10.25118/2763-9037.2024.v14.1340

Keywords:

aripiprazole, drug-related side effects and adverse reactions, depressive disorder treatment-resistant, mania

Abstract

Introduction: Aripiprazole is classified as a third-generation atypical antipsychotic, widely used in psychotic disorders, manic/hypomanic episodes, and treatment-resistant major depressive disorder. Its action is exerted through partial agonism at dopaminergic D2 and serotonergic 5-HT1A receptors, as well as antagonism at 5-HT2A receptors, with mania/hypomania induction being a rare event. Case Presentation: This report describes the case of a 63-year-old woman with persistent depressive disorder, who developed a hypomanic episode shortly after starting low-dose aripiprazole (5 mg on alternate days) for antidepressant augmentation. Method: Case report. CAAE: 82055624.7.0000.5192 Parecer N. 7.062.61 Discussion: The prescription of aripiprazole in reduced doses has a predominantly "stimulating" effect, potentially triggering hypomanic/manic symptoms. It is observed that symptoms can begin early, with no evidence of a relationship between the prescribed medication amount and the onset, intensity, or duration of mood changes. The actual prevalence of these events may be underestimated, often confused with akathisia, complicating diagnosis. Conclusions: The need for caution and vigilance regarding potential mood changes is highlighted when prescribing low doses of aripiprazole to patients with treatment-resistant depressive disorder.

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Author Biographies

Dennison Carreiro Monteiro, Professor Assistente, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil

João Cortez de Oliveira, Graduando, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil

Medical student, Faculty of Medical Sciences, University of Pernambuco

Thamires da Silva Sampaio Medrado, Graduanda, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil

Medical student, Faculty of Medical Sciences, University of Pernambuco

Víctor Câmara Gusmão Cardoso, Graduando, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil

Medical student, Faculty of Medical Sciences, University of Pernambuco

Vitor Gama Vieira de Araújo Régis, Graduando, Medicina, Faculdade de Ciências Médicas da Universidade de Pernambuco, FCM/UPE, Recife, PE, Brasil

Medical student, Faculty of Medical Sciences, University of Pernambuco

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Published

2024-11-15

How to Cite

1.
Monteiro DC, Oliveira JC de, Medrado T da SS, Cardoso VCG, Régis VGV de A. Hypomania induced by aripiprazole in a patient with treatment-resistant depression. Debates em Psiquiatria [Internet]. 2024 Nov. 15 [cited 2025 Apr. 3];14:1-9. Available from: https://revistardp.org.br/revista/article/view/1340

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