Manic shift can be caused by the use of atypical antipsychotics. Hypomanic/manic episodes caused by olanzapine, risperidone, quetiapine, ziprasidone, amisulpride, aripiprazole, zotepine, perospirone, and paliperidone have been frequently described in the literature. The proposed causes of mania/hypomania switching are due to blockages of 5HT2A and D2 receptors, enhancement of 5HT1A receptors, and dopamine release in the prefrontal/frontal regions. There have been no hypomanic/manic episodes described during clozapine use up to the present. A manic shift observed during clozapine use in a 30-year-old woman with schizoaffective disorder depressive type without any history of manic or mixed episodes was presented below.
Key words: Atypical antipsychotic, clozapine, manic episode, schizoaffective disorder
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