Reactions 1016 - 28 Aug 2004

Citalopram

Mania: 4 case reportsFour patients, aged 6–15 years, developed mania after they

started receiving citalopram.A 6-year-old boy with severe depression started receiving

citalopram 20 mg/day and, 7 days later, developed maniawithout psychotic symptoms. He immediately improved uponcitalopram discontinuation, but only achieved completeremission with lithium treatment.

A 15-year-old boy who had moderate depression and asuicide attempt started receiving citalopram, titrated to30 mg/day and, 4 weeks later, developed mania withoutpsychotic symptoms. On presentation 3 weeks later,citalopram was discontinued and he immediately improved,although lithium treatment was required for completeremission.

A 14-year-old girl with obsessive-compulsive disorder whohad previously developed mania on fluoxetine treatment,started receiving citalopram 10 mg/day in addition to lithiumand risperidone and, 1 week later, developed hypomania.Citalopram treatment was stopped but was subsequentlyrestarted at 10 mg/day and her hypomania continued.However, over the next week she became euthymic withoutadditional intervention and treatment with citalopram, lithiumand risperidone was continued with no residual symptoms

A 15-year-old boy with severe depression, catatonia andsocial phobia started receiving citalopram 20 mg/day,escitalopram and olanzapine and, 13 days later, developedmania that lasted 1 week. Citalopram, escitalopram andolanzapine were discontinued. [Patient outcome not clearlystated.]

Author comment: "In all the children, the manicsymptoms temporally correlated with the use of citalopram.All improved to an extent on stopping citalopram."Pravin D, et al. Citalopram and mania. Journal of the American Academy of Childand Adolescent Psychiatry 43: 791, No. 7, Jul 2004 - India 800987132

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Reactions 28 Aug 2004 No. 10160114-9954/10/1016-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved