ANTIDEPRESSANTS AND MANIA - TO STOP OR NOT TO STOP

The clinical problem of whether to stop antidepressants when patients develop mania is looked at in the light of existing practice and advic e both in the UK and in the USA. It is concluded that practice is base d more on an empirical than a scientific basis. The literature on the subject is reviewed with especial reference to the questions of whethe r antidepressants actually cause mania, whether they interfere with th e treatment of mania, whether discontinuing them stops mania and wheth er withdrawal of antidepressants causes mania. Finally a case notes st udy conducted by one of the authors is summarized and recommendations for further research are made.