Seven patients who had been maintained on tricyclic antidepressants
developed signs of hypomania or mania shortly (two-seven days) after drug
withdrawal. Three patients responded promptly to treatment with
neuroleptics. One patient receiving lithium and three others who received
no further drug treatment experienced more gradual resolution of symptoms.
Tricyclic withdrawal is accompanied by changes in the turnover rate of
individual neurotransmitters as well as by shifts in the equilibrium
between various transmitter systems. These events may be accompanied by
alterations in mood. Although relapse to depression is more common,
hypomania or mania may also occur.