Hypomania induced by aripiprazole in a patient with treatment-resistant depression
DOI:
https://doi.org/10.25118/2763-9037.2024.v14.1340Keywords:
aripiprazole, drug-related side effects and adverse reactions, depressive disorder treatment-resistant, maniaAbstract
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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