Induction of mania in depression by paroxetine.

Introduction: An investigation of the proportion of patients who have experienced mania with antidepressant treatment and their characteristics would seem to be of clinical use.

Aims: The purpose of this clinical study was to examine the predictors of induction of mania in depression patients as a result of paroxetine treatment.

Method: A retrospective cohort analysis was carried out among depression patients treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000 and 2001. Some 79 patients were identified who were receiving paroxetine to treat depression. A variety of clinical factors including gender, the type of depression, frequency of episodes, family history, age and daily dose were examined as possible predictors of induction of mania by paroxetine.

Results: Seven (8.86%) of the 79 paroxetine-treated patients developed mania. A Cox proportional hazards analysis showed the type of depression and the history of family psychiatric illness to be independent predictive factors of the induction of mania by paroxetine treatment.

Conclusions: The rate of mania induction of paroxetine is not substantially different from that found for conventional antidepressants. The type of depression and the history of family psychiatric illness may be considered as predictors of mania induction in depression patients taking paroxetine treatment.