Indian Journal of Private Psychiatry

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VOLUME 18 , ISSUE 1 ( January-June, 2024 ) > List of Articles


Mania Induced by a Low Dose of Citalopram: A Case Report

Jaafar Omer Ahmed, Koyar Sherko M Salih, Makwan Mohammed Abdulkareem

Keywords : Antidepressant-induced mania, Bipolar depression, Case report, Citalopram, Selective serotonin uptake inhibitors

Citation Information : Ahmed JO, Salih KS, Abdulkareem MM. Mania Induced by a Low Dose of Citalopram: A Case Report. Ind J Priv Psychiatry 2024; 18 (1):51-54.

DOI: 10.5005/jp-journals-10067-0160

License: CC BY-NC 4.0

Published Online: 03-01-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Antidepressant-induced mania is commonly observed in contemporary clinical practice. The problem in patients with unipolar depression has been evident since the introduction of the first antidepressants. Selective serotonin reuptake inhibitors (SSRIs), as new drugs, are one of those drugs that may lead to treatment-induced mania. The risk of inducing mania in bipolar patients with citalopram is comparable to the documented risk with other SSRIs. This case study elucidates the crucial factors for distinguishing key depressive episodes between bipolar and unipolar depression and provides recommendations regarding the use of antidepressants in high-risk patients. Case presentation: A 24-year-old Kurdish woman developed mania after self-administering a low dose of Citalopram for depression. Diana Azad (DA) is a 24-year-old single female. She was referred to the Mental Health Treatment Center by the police under a judicial order for psychiatric assessment and treatment. DA was irritable, aggressive, and restless. She showed disruptive behavior, including screaming in the wards and showing her will to leave the hospital. She was diagnosed with bipolar disorder I, a manic episode, and was admitted to the hospital with her mother's companion. Rapid tranquilizers were given at the start, and then mood stabilizers and antipsychotics were prescribed. Conclusion: We advocate the idea that caution must be taken in treating depression with citalopram in young populations, even in the absence of a family history of affective illness.

  1. Goldberg JF, Truman CJ. Antidepressant-induced mania: An overview of current controversies. Bipolar Disord 2003;5(6):407–420. DOI:
  2. Yamaguchi Y, Kimoto S, Nagahama T, et al. Dosage-related nature of escitalopram treatment-emergent mania/hypomania: A case series. Neuropsychiatr Dis Treat 2018;14:2099–2104. DOI: 10.2147/NDT.S168078.
  3. Bezchlibnyk-Butler K, Aleksic I, Kennedy SH. Citalopram-A review of pharmacological and clinical effects. J Psychiatry Neurosci 2000;25(3):241–254. PMID: 10863884.
  4. Benvenuti A, Rucci P, Miniati M, et al. Treatment-emergent mania/hypomania in unipolar patients. Bipolar Disord 2008;10(6):726–732. DOI: 10.1111/j.1399-5618.2008.00613.x.
  5. Ghaemi SN, Hsu DJ, Soldani F, et al. Antidepressants in bipolar disorder: The case for caution. Bipolar Disord 2003;5(6):421–433. DOI:
  6. Pravin D, Srinath S, Girimaji S, et al. Citalopram and mania. J Am Acad Child Adolesc Psychiatry 2004;43(7):791. DOI: 10.1097/01.chi.0000128831.13997.e3.
  7. Kul M, Kilincaslan A, Yumru M, et al. Escitalopram-associated mania in a child. J Child Adolesc Psychopharmacol 2008;18(1):119–120. DOI:
  8. Kapur MK, Zalpuri I, Tran S, et al. Treating depression in the context of mania or mania risk in youth. Curr Treat Options Psychiatry 2020;7(3):400–415. DOI: 225-9.
  9. Potter DR. Major depression disorder in adults: A review of antidepressants. Int J Caring Sci 2019;12(3):1936–1942. Available from:
  10. Bryois C, Ferrero F. Mania induced by citalopram. Archives of General Psychiatry6 1994;51(8):664–665. DOI:
  11. Parker S, Nagarsekar B. Escitalopram induced mania. Indian J Psychiatry 2007;49(2):121–122. DOI:
  12. Shoval G, Nahshoni E, Gothelf D, et al. Effectiveness and safety of citalopram in hospitalized adolescents with major depression: A preliminary, 8-week, fixed-dose, open-label, prospective study. Clin Neuropharmacol 2011;34(5):182–185. DOI: 10.1097/WNF.0b013e31822cb863.
  13. Prapotnik M, Di Pauli J, Vetter Z, et al. Antidepressant-associated mania with escitalopram. European Psychiatry 2004;19(7):455–456. DOI: 10.1016/j.eurpsy.2004.06.032.
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