Past Issues
Varenicline-induced Manic Episode
in a Bipolar I Disorder Patient
Stone Yang, M.D, Mu-En Liu, M.D.
Objective: Since varenicline was approved for smoking cessation in 2006,
but case reports associated with psychiatric adverse effects have been published,
especially with regard to depression, but not manic episodes. Case report: We describe
a 52-year-old ethnic Taiwanese male with a history of bipolar I disorder. He
had received regular treatment in the clinic and psychiatric nursing home for one
and half years. He developed mixed mood and psychotic disturbances after an
eight-day varenicline treatment. After withdrawal of varenicline treatment 15 days,
his mood stabilized. He was discharged 23 days later and received regular clinical
follow-up. Conclusion: This case, history suggests that preventive measures with
closed observation are needed if a bipolar patient quits smoking with varenicline.
Further study should be identifi ed that varenicline-induced manic episode is due to
imbalance between cholinergic, adrenergic or dopaminergic tone.
but case reports associated with psychiatric adverse effects have been published,
especially with regard to depression, but not manic episodes. Case report: We describe
a 52-year-old ethnic Taiwanese male with a history of bipolar I disorder. He
had received regular treatment in the clinic and psychiatric nursing home for one
and half years. He developed mixed mood and psychotic disturbances after an
eight-day varenicline treatment. After withdrawal of varenicline treatment 15 days,
his mood stabilized. He was discharged 23 days later and received regular clinical
follow-up. Conclusion: This case, history suggests that preventive measures with
closed observation are needed if a bipolar patient quits smoking with varenicline.
Further study should be identifi ed that varenicline-induced manic episode is due to
imbalance between cholinergic, adrenergic or dopaminergic tone.
| Key Word | varenicline, manic episode, bipolar disorder, smoking cessation |
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