Emerging mania following escitalopram withdrawal in a patient with unipolar depression managed with its reintroduction

Discontinuation or withdrawal symptoms have been documented for all major classes of antide- pressants, especially the selective serotonin reuptake inhibitors (SSRIs). It has been reported that an antidepressant withdrawal syndrome may induce manic states in patients treated for major depression, even in the absence of a history of bipolar disorder. We report the case of a young woman with unipolar depression who developed a manic state after abrupt discontinuation of lowdose escitalopram. This manic state remitted when escitalopram was reintroduced within a week after the interruption of treatment.