Fluoxetine Induced Hypomanic Shift in a Bulimic Patient: Case Report

Abstract

Use of antidepressant doses of fluoxetine for mood and anxiety disorders is known to cause manic or hypomanic shifts. Fluoxetine should be used at higher doses for pharmacological treatment of bulimia nervosa (BN) than those used for an antidepressant effect. High doses of fluoxetine increase the possibility of manic or hypomanic shifts. In cases of comorbidity of BN and mood disorder, fluoxetine treatment is becomes more risky in terms of the occurrence of a manic shift. During the use of fluoxetine 60 mg by a patient with BN, who had no history of bipolar disorder or family history of bipolarity, a hypomanic shift occurred. A BN patient being treated with an antidepressant, who experienced a manic shift risk and comorbid mood disorder which may cause resistance to treatment, are discussed in this case.