Am J Psychiatry 1988; 145:804-808
Copyright © 1988 by American Psychiatric Association
Possible role of antidepressants in precipitating mania and hypomania in recurrent depression
DJ Kupfer, LL Carpenter and E Frank
Department of Psychiatry, University of Pittsburgh School of Medicine, PA.
This prospective study examined the incidence of mania or hypomania in 230
patients with recurrent depression treated with imipramine. Overall, only
six individuals (2.6%) developed hypomania, representing 0.9% of those in
the acute phase and 2.5% of those in the continuation phase of drug
treatment. Patients with a history of bipolar II depression (N = 33) did
not have a greater incidence of hypomania than those with unipolar
depression (N = 197). Younger patients did not switch to hypomania more
rapidly than older ones, and women were not more likely to switch than men.
Systematic assessment of mania, stringent diagnostic criteria, and the
recurrent nature of the sample may account for this low incidence of
hypomania compared to that reported by other investigators.
