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KMID : 0605619990060020253
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Journal of Korean Society of Biological Psychiatry
1999 Volume.6 No. 2 p.253 ~ p.258
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A Case of Fluoxetine-induced Mania & Suicidal Ideation in Obsessive-Compulsive Disorder
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1이승환/1Seung Hwan Lee
2이민수/2Min Soo Lee
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Abstract
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The fluoxetine is one of the most frequently prescribed drugs for the treatment of
depression and obsessive-compulsive disorder(OCD). This has been know as one of the
most safest medication. But since the advent of this drug, there have been several
reports of side effects-the mania and suicidal ideation-encountered during
coadministration of fluoxetine with or without other psychotropic drugs.
We experienced a case of 20 years old male OCD patient who developed into abrupt
manic state and also was preoccupied with intense suicidal ideation following fluoxetine
use. He was a only child in his family and his father had a history of alcoholism about
15 years ago. Our patient's obsessive-compulsive symptoms have been occured since
puberty. His OCD symptoms and anxiety were aggravated since joining the army.
Beside these facts, we could not find any other psychiatric history such as depressive
disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and
increased to 40mg at second week. About 3 weeks after the treatment, he developed
sudden manic symptom and more aggravated suicidal ideation without any OCD
symptoms. He felt vitalized and energetic without having enough sleep and food. These
symptoms were ceased over two weeks by stopping medication.
Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation
is unclear. But somehow the fluoxetine has effects on serotonin receptor and
serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can
induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the
serotonin unbalanced patients.
We think this would be the first report to remark on fluoxetine's suicidal and manic
side effects in Korea. So here we present the case with the summary of reviewed
articles
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KEYWORD
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