” This may also occur with TCAs and some nonpharmacological therapies such as sleep deprivation or electroconvulsive therapy. Bupropion is thought to be less dangerous in this respect, but this needs confirmation. Overall, as many as about one fifth of bipolar I patients develop iatrogenic hypomania or mania during treatment for a depressive episode. However, the exact relation between ADs and the “iatrogenic switch” is controversial, because bipolar mood disorders have such a high rate of recurrence anyway. There is also a minor form of AD-induced Inhibitors,research,lifescience,medical euphoria that would not qualify for hypomauia or mania according to the judgement of most clinicians, in which, for example, the patient

comes to the consultation saying that he or she feels really well and has no more problems. This wonderful improvement GS-9973 ic50 should alert the clinician to a possible loss of empathy or neglect of justified preoccupations. Indeed, Inhibitors,research,lifescience,medical such patients may stop worrying about their children’s education, blithely stating that they are not gifted enough to continue studies, or may fail to undertake the necessary steps to address a difficult professional situation. One patient, known previously to

be much preoccupied about environmental issues, found that global warming was no longer a matter of concern to him. Such “subsyndromic” forms of mania may be either an Inhibitors,research,lifescience,medical adverse drug reaction seen with the newer ADs, or a behavioral change resulting from patients enjoying a psychological balance they had Inhibitors,research,lifescience,medical been unable to achieve for years or even decades. The differential diagnosis can be difficult, A minority of activists in the United States contend that the effects of the SSRIs, in particular fluoxetine, on the mental state of patients are similar to those experienced by Sigmund Freud when he started taking cocaine,

or those induced by the amphetamines, when their supposed merits in the treatment of depression Inhibitors,research,lifescience,medical or fatigue were much vaunted 50 years ago. A detailed literature search carried out by us disclosed no evidence of addictive potential with either the old or the recent ADs, with the possible exception of the nonselective irreversible monoamine oxidase inhibitors (MAOIs) or the dopaminergic antidepressants, for which a very low risk may exist in some predisposed subjects. ADs, Pfizer Licensed Compound Library in vitro therefore, do not appear to be addictive: for example, drug addicts who are capable of recognizing psychostimulants or benzodiazepines, fail to discriminate between sertraline and placebo.6 The rare cases of addiction to ADs concern subjects who were previously addicted to many other substances. Furthermore, recent ADs have been prescribed to psychostimulant addicts and other addicts, with a somewhat debatable rate of success, but certainly without the occurrence of massive and frequent addiction.