In their report on age effects on risk of antidepressant treatment–associated mania, Martin et al1 found that children, adolescents, and young adults treated for depressive or anxiety disorders showed an increased risk of new-onset mania at ages 15 to 25 years. Rates of “conversion” to bipolar disorder (new mania) were lowest in children aged 5 to 9 years and similarly intermediate in those aged 10 to 14 years and 25 to 29 years. They also found a nearly 2-fold greater overall risk of mania with tricyclic antidepressants (TCAs) (hazard ratio vs no antidepressant exposure, 3.9) than with serotonin reuptake inhibitors (SRIs) (hazard ratio, 2.1).
Risk (percentage of patients with depressive or anxiety disorders) of developing mania vs age during treatment with tricyclic antidepressants (TCAs), serotonin reuptake inhibitors (SRIs), any antidepressant (ADD), or no ADD. Data are adapted from Martin et al,1 with standard errors.
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