Development of mania in close association with tricyclic antidepressant administration in children. A report of two cases

Two depressed children with a strong family history of affective disorder developed manic episodes shortly after starting treatment with low dose antidepressant therapy. In one of these cases manic symptoms appeared on each of the three occasions that tricyclic medication was started or increased in dosage. There are few reports of manic switching in young people and none that describe such a close temporal association between the administration of antidepressants and the development of mania. Children with a family history of affective disorder may be more susceptible to manic switching.