Comorbid panic attacks and mania-associated symptoms are the most significant risk factors for manic switch during a depressive episode in bipolar patients, according to Dr. Tomihisa Niitsu and associates.

Risk factors for manic switch in any bipolar patient included younger age and recent histories of rapid cycling, severe manic symptoms, and certain pharmacological and psychotherapeutic treatments. Along with panic attacks and manic symptoms, any mood elevation during a depressive episode also indicated a risk for manic switch. During a depressive episode, the odds ratio of a switch if all three primary risk factors were present was 7.28 (95% confidence interval, 4.15-12.78; P < 0.001).

“These findings may represent useful clinical information for monitoring the risk of manic switch when treating depressive bipolar patients,” the investigators concluded.

Find the full study in the Journal of Psychiatric Research (doi: 10.1016/j.jpsychires.2015.04.014).

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