{"formatVersion":"1.1","id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/can-antidepressants-cause-mania","path":"/library/can-antidepressants-cause-mania","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/can-antidepressants-cause-mania","title":"Antidepressants and the Risk of Mania","family":"Library detail","description":"Although it's rare, antidepressant use could trigger manic episodes in certain individuals. Learn more about antidepressant-induced-mania here.","language":"en-US","access":{"audience":"custom-shared-preview","indexable":true},"provenance":{"sourceUrl":"https://www.mentalhealth.com/library/can-antidepressants-cause-mania","wordpressId":"627","contentCompleteness":"complete","dateScope":"original-source"},"authors":[{"@type":"Person","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid#person","name":"Leila Khurshid, Pharm.D.","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid"}],"reviewer":{"@type":"Person","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/morgan-blair#person","name":"Morgan Blair","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/morgan-blair"},"dates":{"datePublished":"2023-09-29T12:42:06Z","dateModified":"2025-09-02T09:14:58Z","lastReviewed":"2023-09-29"},"content":{"html":"<nav class=\"breadcrumbs\" aria-label=\"Breadcrumb\"><ol><li><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/\">Home</a></li><li><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/library\">Library</a></li><li><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/medications\">Medications</a></li><li><span aria-current=\"page\">Antidepressants and the Risk of Mania</span></li></ol></nav><div class=\"article-page article-standard\" data-library-standard><div class=\"article-main-grid\"><header class=\"article-heading\"><h1>Antidepressants and the Risk of Mania</h1><p class=\"article-inline-credits\"><span>Written by <a class=\"article-credit-person\" href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid\"><img src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3060.webp\" alt=\"\" width=\"22\" height=\"22\" loading=\"lazy\">Leila Khurshid, Pharm.D.</a></span><span>Medically reviewed by <a class=\"article-credit-person\" href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/morgan-blair\"><img src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3070.jpg\" alt=\"\" width=\"22\" height=\"22\" loading=\"lazy\">Morgan Blair</a></span></p><div class=\"article-dates\"><span>Published on <time datetime=\"2023-09-29T12:42:06Z\">September 29, 2023</time></span><span aria-hidden=\"true\"> · </span><span>Updated on <time datetime=\"2025-09-02T09:14:58Z\">September 2, 2025</time></span></div></header><div class=\"article-jumpbar\"></div><div class=\"article-layout\"><div class=\"article-reading\"><article class=\"prose\" id=\"article-content\"><div class=\"article-intro\" data-source-field=\"hero\"><p>Feeling unreasonably invigorated, chockful of energy, and invincible are not symptoms usually experienced by people prescribed antidepressants. However, it may be a result of your antidepressants triggering a manic or hypomanic episode.</p></div><figure class=\"article-feature\"><img src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/editorial-247/3540.webp\" alt=\"A healthcare professional writes notes beside a medicine bottle.\" width=\"1200\" height=\"630\" loading=\"eager\" decoding=\"async\"></figure><section class=\"article-takeaways\" aria-labelledby=\"key-takeaways\"><h2 id=\"key-takeaways\">Key takeaways</h2><ul><li>Antidepressants can trigger manic or hypomanic episodes in some people, with risk varying by medication and individual vulnerability.</li><li>Medication-associated mania does not establish that antidepressants cause bipolar disorder.</li><li>Monitoring mood changes and discussing risk factors with a prescriber can help guide safer treatment.</li></ul></section><h2 id=\"can-antidepressants-cause-manic-episodes\">Can antidepressants cause manic episodes?</h2><p><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/antidepressants\" class=\"article-inline-link\">Antidepressants</a> can dysregulate your mood leading to both hypomanic and manic episodes, a phenomenon known as antidepressant associated hypomania (AAH). <sup><a href=\"#review-antidepressant-associated-hypomania-those-diagnosed-unipolar-depressionrisk-facto\" aria-label=\"Reference 1\" class=\"article-inline-link article-citation\">[1]</a></sup> There is ambiguity about whether antidepressants are the outright cause of mania or hypomania in patients with major depressive disorder, or whether they trigger undiagnosed bipolar disorder. <sup><a href=\"#do-antidepressants-increase-risk-mania-bipolar-disorder-people-depression\" aria-label=\"Reference 2\" class=\"article-inline-link article-citation\">[2]</a></sup>\n</p><p>While not all individuals with bipolar disorder will experience mania in response to antidepressants, there is evidence suggesting a connection between certain types of antidepressants and the onset of manic symptoms. <sup><a href=\"#review-antidepressant-associated-hypomania-those-diagnosed-unipolar-depressionrisk-facto\" aria-label=\"Reference 1\" class=\"article-inline-link article-citation\">[1]</a></sup></p><p>Although AAH is most associated with bipolar depression, it has also been seen in unipolar depression and anxiety disorders. <sup><a href=\"#review-antidepressant-associated-hypomania-those-diagnosed-unipolar-depressionrisk-facto\" aria-label=\"Reference 1\" class=\"article-inline-link article-citation\">[1]</a></sup></p><p>\nWomen, younger people, and those with a family history of bipolar disease are most susceptible to AAH. <sup><a href=\"#review-antidepressant-associated-hypomania-those-diagnosed-unipolar-depressionrisk-facto\" aria-label=\"Reference 1\" class=\"article-inline-link article-citation\">[1]</a></sup> It is possible that younger people appear more likely to experience AAH as the peak age for contracting bipolar disorder is between 15 and 19 years of age. <sup><a href=\"#www-nice-org-uk\" class=\"article-inline-link article-citation\" aria-label=\"Reference 3\">[3]</a></sup>\n</p><span id=\"what-are-mania-and-hypomania-mania-is-an-elevated-mood-state-characterized-by-intense-euphoria-high-energy-levels-and-a-heightened-sense-of-self-confidence-it-is-most-exhibited-by-people-with-bipolar-disorder-during-a-manic-episode-individuals-may-experience\" class=\"section-anchor-alias\" data-section-alias=\"what-are-mania-and-hypomania\" aria-hidden=\"true\"></span><h2 id=\"what-are-mania-and-hypomania\">What are mania and hypomania?</h2><p>\nMania is an elevated mood state characterized by intense euphoria, high energy levels, and a heightened sense of self-confidence. It is most exhibited by people with bipolar disorder. During a manic episode, individuals may experience:\n</p><ul>\n    <li><strong><strong>High energy: </strong></strong>People in a manic state often feel highly energetic, restless, and have a reduced need for sleep.</li>\n    <li><strong><strong>Better mood: </strong></strong>They might feel an intense and persistent sense of happiness, excitement, or elation.</li>\n    <li><strong><strong>Rapid thoughts and speech - </strong></strong>Mania can lead to racing thoughts and fast-paced speech, making it difficult to focus.</li>\n    <li><strong><strong>Increased goal-directed activity: </strong></strong>Individuals may engage in impulsive or risky behaviors, such as overspending, reckless driving, or engaging in sexual promiscuity.</li>\n    <li><strong><strong>Decreased need for sleep: </strong></strong>Some people in a manic state may require very little sleep without feeling fatigued.</li>\n    <li><strong><strong>Grandiosity: </strong></strong>A sense of inflated self-esteem and belief in one's extraordinary abilities or talents might be present.</li>\n    <li><strong><strong>Irritability: </strong></strong>Mania can also manifest as irritability or agitation, leading to conflicts with others.</li>\n    <li><strong><strong>Lack of insight: </strong></strong>People in a manic state often have a reduced ability to recognize the consequences of their actions or the severity of their condition.</li>\n</ul><p>\nHypomania is a less severe form of mania, characterized by similar symptoms but to a milder degree. While the symptoms of hypomania are noticeable, they don't usually lead to severe disruptions in daily functioning or require hospitalization.\n</p><span id=\"preventing-antidepressant-associated-mania-to-mitigate-the-potential-risks-associated-with-antidepressants-and-mania-doctors-and-patients-must-foster-an-open-honest-channel-of-communication-the-following-steps-could-help-minimize-the-risk-of-inducing-mania-during-antidepressant-treatment\" class=\"section-anchor-alias\" data-section-alias=\"preventing-antidepressant-associated-mania\" aria-hidden=\"true\"></span><h2 id=\"preventing-antidepressant-associated-mania\">Preventing antidepressant-associated mania</h2><p>\nTo mitigate the potential risks associated with antidepressants and mania, doctors and patients must foster an open, honest channel of communication. The following steps could help minimize the risk of inducing mania during antidepressant treatment.\n</p><ul>\n    <li><strong><strong>Thorough assessment: </strong></strong>A comprehensive assessment of the patient's psychiatric history is crucial before prescribing antidepressants. This includes evaluating for any prior manic or hypomanic episodes.</li>\n    <li><strong><strong>Family history: </strong></strong>Ascertaining whether a patient has a family history of bipolar disorder can be helpful in recommending whether they embark on a course of antidepressants.</li>\n    <li><strong><strong>Regular monitoring: </strong></strong>Close monitoring of the patient's mood, behavior, and symptoms during antidepressant treatment can help detect any early signs of mania. Regular follow-up appointments allow for timely intervention if necessary.</li>\n    <li><strong><strong>Combination therapy: </strong></strong>In some cases, a combination of mood stabilizers and antidepressants might be considered to manage depressive symptoms while minimizing the risk of inducing mania.</li>\n    <li><strong><strong>Patient education: </strong></strong>Patients should be informed about the potential risks and benefits of antidepressant treatment, allowing them to make informed decisions and actively participate in their treatment plan.</li>\n</ul><span id=\"do-antidepressants-cause-bipolar-there-is-no-evidence-suggesting-that-antidepressants-cause-bipolar-disease-in-patients-however-the-administering-of-antidepressants-to-people-with-bipolar-can-give-two-causes-for-concern\" class=\"section-anchor-alias\" data-section-alias=\"do-antidepressants-cause-bipolar\" aria-hidden=\"true\"></span><h2 id=\"do-antidepressants-cause-bipolar\">Do antidepressants cause bipolar?</h2><p>\nThere is no evidence suggesting that antidepressants cause bipolar disease in patients.  However, the administering of antidepressants to people with bipolar can give two causes for concern. <sup><a href=\"#antidepressants-bipolar-depression-enduring-controversy\" aria-label=\"Reference 4\" class=\"article-inline-link article-citation\">[4]</a></sup>\n</p><p>Firstly, antidepressants may precipitate manic or hypomanic episodes in patients with bipolar disease. They may also trigger a manic episode in a patient with major depressive disorder who hasn’t yet received a bipolar diagnosis. <sup><a href=\"#antidepressants-bipolar-depression-enduring-controversy\" aria-label=\"Reference 4\" class=\"article-inline-link article-citation\">[4]</a></sup></p><p>Secondly, antidepressants may exacerbate the course of the illness, prolonging symptoms in patients with bipolar for months or, even, years. <sup><a href=\"#antidepressants-bipolar-depression-enduring-controversy\" aria-label=\"Reference 4\" class=\"article-inline-link article-citation\">[4]</a></sup></p><p>\nThat said, antidepressants are prescribed to up to 50% of patients with bipolar depression, despite the potential risk of inducing mania. <sup><a href=\"#review-evidence-use-antidepressants-bipolar-depression\" aria-label=\"Reference 5\" class=\"article-inline-link article-citation\">[5]</a></sup> If you have bipolar disorder or depression, it is essential to weigh up the risks and benefits of starting a course of antidepressants with your healthcare provider.\n</p><span id=\"which-antidepressants-are-most-likely-to-cause-mania-research-indicates-that-tricyclics-an-older-class-of-antidepressants-are-more-likely-to-cause-manic-episodes-than-other-antidepressants\" class=\"section-anchor-alias\" data-section-alias=\"which-antidepressants-are-most-likely-to-cause-mania\" aria-hidden=\"true\"></span><h2 id=\"which-antidepressants-are-most-likely-to-cause-mania\">Which antidepressants are most likely to cause mania?</h2><p>\nResearch indicates that tricyclics, an older class of antidepressants, are more likely to cause manic episodes than other antidepressants. <sup><a href=\"#antidepressants-bipolar-depression-enduring-controversy\" aria-label=\"Reference 4\" class=\"article-inline-link article-citation\">[4]</a></sup>\n</p><p>A 2004 study found that tricyclic antidepressants triggered manic episodes in 10% of participants, compared with a rate of 3.2% for all other antidepressants combined. <sup><a href=\"#review-evidence-use-antidepressants-bipolar-depression\" aria-label=\"Reference 5\" class=\"article-inline-link article-citation\">[5]</a></sup></p><p>\nTricyclic antidepressants include but are not limited to doxepin, amitriptyline, clomipramine, and imipramine.\n</p><span id=\"final-thoughts-it-is-important-to-note-that-the-risk-of-inducing-manic-or-hypomanic-episodes-varies-among-individuals-and-is-influenced-by-factors-such-as-genetic-predisposition-family-history-of-bipolar-disorder-and-overall-mental-health-status\" class=\"section-anchor-alias\" data-section-alias=\"final-thoughts\" aria-hidden=\"true\"></span><h2 id=\"final-thoughts\">Final thoughts</h2><p>\nIt is important to note that the risk of inducing manic or hypomanic episodes varies among individuals and is influenced by factors such as genetic predisposition, family history of bipolar disorder, and overall mental health status.\n</p><p>If you have been diagnosed with major depressive disorder and are taking antidepressants, experiencing bouts of mania is irregular. You may have undiagnosed bipolar disorder, or these manic episodes may be medication induced.</p><p>If you have bipolar disorder, you may experience antidepressant induced mania, or AAH, at any time during your antidepressant course.</p><p>It is essential to work closely with your doctor during your course of antidepressants. Be honest and open about your symptoms and they may be able to provide an alternate medical solution, such as mood stabilizers.</p></article><div class=\"article-endmatter\"><section class=\"article-sources\" id=\"references\" data-source-references=\"\" data-reference-list=\"\" data-reference-style=\"author-date-numbered\"><h2 id=\"references-2\">References</h2><ol>\n    <li id=\"review-antidepressant-associated-hypomania-those-diagnosed-unipolar-depressionrisk-facto\" data-reference-number=\"1\">Gill, N., Bayes, A., &amp; Parker, G. (2020). A Review of Antidepressant-Associated Hypomania in Those Diagnosed with Unipolar Depression—Risk Factors, Conceptual Models, and Management. Current Psychiatry Reports, 22(4). <a href=\"https://doi.org/10.1007/s11920-020-01143-6\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">A Review of Antidepressant-Associated Hypomania in Those Diagnosed with Unipolar…</a></li>\n    <li id=\"do-antidepressants-increase-risk-mania-bipolar-disorder-people-depression\" data-reference-number=\"2\">Patel, R., Reiss, P., Shetty, H., Broadbent, M., Stewart, R., McGuire, P., &amp; Taylor, M. (2015). Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study: Table 1. BMJ Open, 5(12), e008341. <a href=\"https://doi.org/10.1136/bmjopen-2015-008341\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Do antidepressants increase the risk of mania and bipolar disorder in people with…</a></li>\n    <li id=\"www-nice-org-uk\" data-reference-number=\"3\">Introduction | Bipolar disorder: assessment and management | Guidance | NICE. (n.d.). Www.nice.org.uk. https://www.nice.org.uk/guidance/cg185/chapter/Introduction</li>\n    <li id=\"antidepressants-bipolar-depression-enduring-controversy\" data-reference-number=\"4\">Gitlin, M. J. (2018). Antidepressants in bipolar depression: an enduring controversy. International Journal of Bipolar Disorders, 6(1). <a href=\"https://doi.org/10.1186/s40345-018-0133-9\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Antidepressants in bipolar depression</a></li>\n    <li id=\"review-evidence-use-antidepressants-bipolar-depression\" data-reference-number=\"5\">McInerney, S. J., &amp; Kennedy, S. H. (2014). Review of Evidence for Use of Antidepressants in Bipolar Depression. The Primary Care Companion for CNS Disorders. <a href=\"https://doi.org/10.4088/pcc.14r01653\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Review of Evidence for Use of Antidepressants in Bipolar Depression</a></li>\n</ol></section><section class=\"article-medical article-panel\"><h2 id=\"medical-content\">Medical Content</h2><p><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/clinical-affairs\">The Clinical Affairs Team</a> at MentalHealth.com is a dedicated group of medical professionals with diverse and extensive clinical experience. They actively contribute to the development of content, products, and services, and meticulously review all medical material before publication to ensure accuracy and alignment with current research and conversations in mental health. For more information, please visit the <a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/publishing/editorial-policy\">Editorial Policy</a>.</p></section><section class=\"article-about article-panel\"><h2 id=\"about-mentalhealth-com\">About MentalHealth.com</h2><p>MentalHealth.com helps people understand themselves, build healthier relationships, and access the right care. We bring together mental health education, diagnostics, and care management to support well-being throughout every phase of life.</p><div class=\"article-contributors\"><section class=\"article-bio\"><img src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3060.webp\" alt=\"\" width=\"64\" height=\"64\" loading=\"lazy\"><div><p class=\"article-bio-role\">Author</p><h3 id=\"leila-khurshid-pharm-d\"><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid\">Leila Khurshid, Pharm.D.</a></h3><p class=\"article-bio-credentials\">Pharm.D., BCPS</p><p>Leila Khursid is a medical reviewer with a Doctor of Pharmacy degree and completed a PGY1 Pharmacy Residency from St. Mark's Hospital.</p><dl><div><dt>Published</dt><dd><time datetime=\"2023-09-29T12:42:06Z\">September 29, 2023</time></dd></div><div><dt>Updated</dt><dd><time datetime=\"2025-09-02T09:14:58Z\">September 2, 2025</time></dd></div></dl></div></section><section class=\"article-bio\"><img src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3070.jpg\" alt=\"\" width=\"64\" height=\"64\" loading=\"lazy\"><div><p class=\"article-bio-role\">Medical Reviewer</p><h3 id=\"morgan-blair\"><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/morgan-blair\">Morgan Blair</a></h3><p class=\"article-bio-credentials\">MA, LPCC</p><p>Morgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University.</p><dl><div><dt>Reviewed</dt><dd><time datetime=\"2023-09-29\">September 29, 2023</time></dd></div></dl></div></section></div></section><section class=\"article-expert article-expert-mobile\" aria-label=\"Subject matter expert\" data-expert-kind=\"related\"><p class=\"article-bio-role\">Subject matter expert</p><div class=\"article-expert-identity\"><img src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3060.webp\" alt=\"\" width=\"64\" height=\"64\" loading=\"lazy\"><h2><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid\">Leila Khurshid, Pharm.D.</a></h2></div><p class=\"article-expert-focus\">Clinical pharmacy and medication</p><a class=\"profile-experience-link experience-button\" href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid\">View experience</a></section><section class=\"article-topic-community article-topic-community-mobile\" aria-label=\"Related communities\"><img class=\"topic-community-banner\" src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/library/editorial-13316.webp\" alt=\"\" width=\"48\" height=\"48\" loading=\"lazy\"><p class=\"topic-community-label\">Related communities</p><h2>Bipolar Disorder</h2><p>Connect around experiences of bipolar disorder, relationships, and everyday life.</p><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/community/bipolar-disorder\">Explore community</a></section></div></div><aside class=\"article-sidebar\" tabindex=\"0\" data-bounded-rail=\"\" aria-label=\"Article navigation and related information\"><details class=\"article-contents\" open data-section-preview=\"3\" data-expanded=\"false\" data-scrolled-past=\"false\"><summary><strong>Table of contents</strong><span aria-hidden=\"true\"></span><small data-current-section=\"\">Choose a section</small></summary><nav aria-label=\"Article contents\"><ol id=\"article-section-list\"><li><a href=\"#can-antidepressants-cause-manic-episodes\" title=\"Can antidepressants cause manic episodes?\" aria-label=\"Can antidepressants cause manic episodes?\">Can antidepressants cause manic episodes?</a></li><li><a href=\"#what-are-mania-and-hypomania\" title=\"What are mania and hypomania?\" aria-label=\"What are mania and hypomania?\">What are mania and hypomania?</a></li><li><a href=\"#preventing-antidepressant-associated-mania\" title=\"Preventing antidepressant-associated mania\" aria-label=\"Preventing antidepressant-associated mania\">Preventing antidepressant-associated mania</a></li><li><a href=\"#do-antidepressants-cause-bipolar\" title=\"Do antidepressants cause bipolar?\" aria-label=\"Do antidepressants cause bipolar?\">Do antidepressants cause bipolar?</a></li><li><a href=\"#which-antidepressants-are-most-likely-to-cause-mania\" title=\"Which antidepressants are most likely to cause mania?\" aria-label=\"Which antidepressants are most likely to cause mania?\">Which antidepressants are most likely to cause mania?</a></li><li><a href=\"#final-thoughts\" title=\"Final thoughts\" aria-label=\"Final thoughts\">Final thoughts</a></li></ol><button type=\"button\" class=\"article-sections-toggle\" data-sections-toggle aria-controls=\"article-section-list\" aria-expanded=\"false\">View more</button></nav></details><section class=\"article-expert\" aria-label=\"Subject matter expert\" data-expert-kind=\"related\"><p class=\"article-bio-role\">Subject matter expert</p><div class=\"article-expert-identity\"><img src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3060.webp\" alt=\"\" width=\"64\" height=\"64\" loading=\"lazy\"><h2><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid\">Leila Khurshid, Pharm.D.</a></h2></div><p class=\"article-expert-focus\">Clinical pharmacy and medication</p><a class=\"profile-experience-link experience-button\" href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid\">View experience</a></section><section class=\"article-topic-community\" aria-label=\"Related communities\"><img class=\"topic-community-banner\" src=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/library/editorial-13316.webp\" alt=\"\" width=\"48\" height=\"48\" loading=\"lazy\"><p class=\"topic-community-label\">Related communities</p><h2>Bipolar Disorder</h2><p>Connect around experiences of bipolar disorder, relationships, and everyday life.</p><a href=\"https://mentalhealth-v2.workspace-454808.chatgpt.site/community/bipolar-disorder\">Explore community</a></section></aside></div></div></div>","text":"HomeLibraryMedicationsAntidepressants and the Risk of ManiaAntidepressants and the Risk of ManiaWritten by Leila Khurshid, Pharm.D.Medically reviewed by Morgan BlairPublished on September 29, 2023 · Updated on September 2, 2025Feeling unreasonably invigorated, chockful of energy, and invincible are not symptoms usually experienced by people prescribed antidepressants. However, it may be a result of your antidepressants triggering a manic or hypomanic episode.Key takeawaysAntidepressants can trigger manic or hypomanic episodes in some people, with risk varying by medication and individual vulnerability.Medication-associated mania does not establish that antidepressants cause bipolar disorder.Monitoring mood changes and discussing risk factors with a prescriber can help guide safer treatment.Can antidepressants cause manic episodes?Antidepressants can dysregulate your mood leading to both hypomanic and manic episodes, a phenomenon known as antidepressant associated hypomania (AAH). [1] There is ambiguity about whether antidepressants are the outright cause of mania or hypomania in patients with major depressive disorder, or whether they trigger undiagnosed bipolar disorder. [2] While not all individuals with bipolar disorder will experience mania in response to antidepressants, there is evidence suggesting a connection between certain types of antidepressants and the onset of manic symptoms. [1]Although AAH is most associated with bipolar depression, it has also been seen in unipolar depression and anxiety disorders. [1] Women, younger people, and those with a family history of bipolar disease are most susceptible to AAH. [1] It is possible that younger people appear more likely to experience AAH as the peak age for contracting bipolar disorder is between 15 and 19 years of age. [3] What are mania and hypomania? Mania is an elevated mood state characterized by intense euphoria, high energy levels, and a heightened sense of self-confidence. It is most exhibited by people with bipolar disorder. During a manic episode, individuals may experience: High energy: People in a manic state often feel highly energetic, restless, and have a reduced need for sleep. Better mood: They might feel an intense and persistent sense of happiness, excitement, or elation. Rapid thoughts and speech - Mania can lead to racing thoughts and fast-paced speech, making it difficult to focus. Increased goal-directed activity: Individuals may engage in impulsive or risky behaviors, such as overspending, reckless driving, or engaging in sexual promiscuity. Decreased need for sleep: Some people in a manic state may require very little sleep without feeling fatigued. Grandiosity: A sense of inflated self-esteem and belief in one's extraordinary abilities or talents might be present. Irritability: Mania can also manifest as irritability or agitation, leading to conflicts with others. Lack of insight: People in a manic state often have a reduced ability to recognize the consequences of their actions or the severity of their condition. Hypomania is a less severe form of mania, characterized by similar symptoms but to a milder degree. While the symptoms of hypomania are noticeable, they don't usually lead to severe disruptions in daily functioning or require hospitalization. Preventing antidepressant-associated mania To mitigate the potential risks associated with antidepressants and mania, doctors and patients must foster an open, honest channel of communication. The following steps could help minimize the risk of inducing mania during antidepressant treatment. Thorough assessment: A comprehensive assessment of the patient's psychiatric history is crucial before prescribing antidepressants. This includes evaluating for any prior manic or hypomanic episodes. Family history: Ascertaining whether a patient has a family history of bipolar disorder can be helpful in recommending whether they embark on a course of antidepressants. Regular monitoring: Close monitoring of the patient's mood, behavior, and symptoms during antidepressant treatment can help detect any early signs of mania. Regular follow-up appointments allow for timely intervention if necessary. Combination therapy: In some cases, a combination of mood stabilizers and antidepressants might be considered to manage depressive symptoms while minimizing the risk of inducing mania. Patient education: Patients should be informed about the potential risks and benefits of antidepressant treatment, allowing them to make informed decisions and actively participate in their treatment plan. Do antidepressants cause bipolar? There is no evidence suggesting that antidepressants cause bipolar disease in patients. However, the administering of antidepressants to people with bipolar can give two causes for concern. [4] Firstly, antidepressants may precipitate manic or hypomanic episodes in patients with bipolar disease. They may also trigger a manic episode in a patient with major depressive disorder who hasn’t yet received a bipolar diagnosis. [4]Secondly, antidepressants may exacerbate the course of the illness, prolonging symptoms in patients with bipolar for months or, even, years. [4] That said, antidepressants are prescribed to up to 50% of patients with bipolar depression, despite the potential risk of inducing mania. [5] If you have bipolar disorder or depression, it is essential to weigh up the risks and benefits of starting a course of antidepressants with your healthcare provider. Which antidepressants are most likely to cause mania? Research indicates that tricyclics, an older class of antidepressants, are more likely to cause manic episodes than other antidepressants. [4] A 2004 study found that tricyclic antidepressants triggered manic episodes in 10% of participants, compared with a rate of 3.2% for all other antidepressants combined. [5] Tricyclic antidepressants include but are not limited to doxepin, amitriptyline, clomipramine, and imipramine. Final thoughts It is important to note that the risk of inducing manic or hypomanic episodes varies among individuals and is influenced by factors such as genetic predisposition, family history of bipolar disorder, and overall mental health status. If you have been diagnosed with major depressive disorder and are taking antidepressants, experiencing bouts of mania is irregular. You may have undiagnosed bipolar disorder, or these manic episodes may be medication induced.If you have bipolar disorder, you may experience antidepressant induced mania, or AAH, at any time during your antidepressant course.It is essential to work closely with your doctor during your course of antidepressants. Be honest and open about your symptoms and they may be able to provide an alternate medical solution, such as mood stabilizers.References Gill, N., Bayes, A., & Parker, G. (2020). A Review of Antidepressant-Associated Hypomania in Those Diagnosed with Unipolar Depression—Risk Factors, Conceptual Models, and Management. Current Psychiatry Reports, 22(4). A Review of Antidepressant-Associated Hypomania in Those Diagnosed with Unipolar… Patel, R., Reiss, P., Shetty, H., Broadbent, M., Stewart, R., McGuire, P., & Taylor, M. (2015). Do antidepressants increase the risk of mania and bipolar disorder in people with depression? A retrospective electronic case register cohort study: Table 1. BMJ Open, 5(12), e008341. Do antidepressants increase the risk of mania and bipolar disorder in people with… Introduction | Bipolar disorder: assessment and management | Guidance | NICE. (n.d.). Www.nice.org.uk. https://www.nice.org.uk/guidance/cg185/chapter/Introduction Gitlin, M. J. (2018). Antidepressants in bipolar depression: an enduring controversy. International Journal of Bipolar Disorders, 6(1). Antidepressants in bipolar depression McInerney, S. J., & Kennedy, S. H. (2014). Review of Evidence for Use of Antidepressants in Bipolar Depression. The Primary Care Companion for CNS Disorders. Review of Evidence for Use of Antidepressants in Bipolar Depression Medical ContentThe Clinical Affairs Team at MentalHealth.com is a dedicated group of medical professionals with diverse and extensive clinical experience. They actively contribute to the development of content, products, and services, and meticulously review all medical material before publication to ensure accuracy and alignment with current research and conversations in mental health. For more information, please visit the Editorial Policy.About MentalHealth.comMentalHealth.com helps people understand themselves, build healthier relationships, and access the right care. We bring together mental health education, diagnostics, and care management to support well-being throughout every phase of life.AuthorLeila Khurshid, Pharm.D.Pharm.D., BCPSLeila Khursid is a medical reviewer with a Doctor of Pharmacy degree and completed a PGY1 Pharmacy Residency from St. Mark's Hospital.PublishedSeptember 29, 2023UpdatedSeptember 2, 2025Medical ReviewerMorgan BlairMA, LPCCMorgan Blair is a licensed therapist, writer and medical reviewer, holding a master’s degree in clinical mental health counseling from Northwestern University.ReviewedSeptember 29, 2023Subject matter expertLeila Khurshid, Pharm.D.Clinical pharmacy and medicationView experienceRelated communitiesBipolar DisorderConnect around experiences of bipolar disorder, relationships, and everyday life.Explore communityTable of contentsChoose a sectionCan antidepressants cause manic episodes?What are mania and hypomania?Preventing antidepressant-associated maniaDo antidepressants cause bipolar?Which antidepressants are most likely to cause mania?Final thoughtsView moreSubject matter expertLeila Khurshid, Pharm.D.Clinical pharmacy and medicationView experienceRelated communitiesBipolar DisorderConnect around experiences of bipolar disorder, relationships, and everyday life.Explore community","wordCount":1354},"schema":{"@context":"https://schema.org","@graph":[{"@type":"Organization","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/#organization","name":"MentalHealth.com","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/"},{"@type":"WebSite","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/#website","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/","name":"MentalHealth.com","inLanguage":"en-US","publisher":{"@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/#organization"}},{"@type":"BreadcrumbList","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/can-antidepressants-cause-mania#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://mentalhealth-v2.workspace-454808.chatgpt.site/"},{"@type":"ListItem","position":2,"name":"Library","item":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library"},{"@type":"ListItem","position":3,"name":"Medications","item":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/medications"},{"@type":"ListItem","position":4,"name":"Antidepressants and the Risk of Mania","item":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/can-antidepressants-cause-mania"}]},{"@type":"ImageObject","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/can-antidepressants-cause-mania#primaryimage","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/editorial-247/3540.webp","contentUrl":"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/editorial-247/3540.webp","width":1200,"height":630,"encodingFormat":"image/webp","caption":"A healthcare professional writes notes beside a medicine bottle."},{"@type":"Person","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid#person","name":"Leila Khurshid, Pharm.D.","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/leila-khurshid","jobTitle":"Pharm.D., BCPS","image":"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3060.webp","sameAs":["https://www.linkedin.com/in/leila-khurshid-pharmd-bcps/"]},{"@type":"Person","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/morgan-blair#person","name":"Morgan Blair","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/people/morgan-blair","jobTitle":"MA, LPCC","image":"https://mentalhealth-v2.workspace-454808.chatgpt.site/assets/wordpress/3070.jpg","sameAs":["https://www.linkedin.com/in/morgan-blair-5627aa88/"]},{"@type":"Article","@id":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/can-antidepressants-cause-mania#article","url":"https://mentalhealth-v2.workspace-454808.chatgpt.site/library/can-antidepressants-cause-mania","headline":"Antidepressants and the Risk of Mania","description":"Although it's rare, antidepressant use could trigger manic episodes in certain individuals. 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However, it may be a result of your antidepressants triggering a manic or hypomanic episode.","text":"Feeling unreasonably invigorated, chockful of energy, and invincible are not symptoms usually experienced by people prescribed antidepressants. 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