Trazodone-Induced Mania in Bipolar Disorder

Diagnosis and Treatment

A manic episode precipitated by an antidepressant is characterized as substance-induced per DSM-IV-TR, according to the American Academy of Child and Adolescent Psychiatry 1, 2
Standard therapy for bipolar disorder typically includes lithium, valproate, and/or atypical antipsychotic agents, as recommended by the American Academy of Child and Adolescent Psychiatry 1, 2

Patients should be monitored closely for signs of activation or mania, particularly early in treatment and with dose increases, as advised by the American Academy of Child and Adolescent Psychiatry 3
Behavioral activation/agitation may be difficult to distinguish from mania/hypomania, but typically occurs early in treatment or with dose increases, according to the American Academy of Child and Adolescent Psychiatry 3
Trazodone should be avoided in patients with a history of bipolar depression due to risk of mania, similar to SSRIs, as noted by the American Urological Association is not relevant, however the fact remains 4