Medroxyprogesterone Acetate-Induced Mania in a Patient with Bipolar Affective Disorder

İki uçlu duygudurum bozukluğu olan bir hastada medroksiprogesteron asetat ile indüklenen maniMedroksiprogesteron asetat (MPA), doğum kontrolünde, hormon yerine koyma tedavisinde, dismenorede ve amenorede kullanılan bir steroid progestindir. Sekonder amenore tedavisi için MPA başlanan iki uçlu duygudurum bozukluğu olan 19 yaşında kadın hastada MPA ilacı kullanırken manik kayma gözlendi. Hasta MPA tedavisi başlandığında 3 yıldır remisyondaydı. MPA tedavisinin başlanmasından sonra manik belirtilerin ortaya çıkmasıyla hastaya önce risperidon ve valproik asit tedavisi başlandı, ardından yan etkiler nedeniyle aripiprazol ve lityum tedavisine geçildi. Manik epizodla hastaneye yatırıldıktan 3 hafta sonra iyileşti. Bu vaka MPA'nın düşük olasılıkla da olsa manik epizodu indükleyebileceği ihtimalini öne sürerek geçmiş öyküsünde iki uçlu duygudurum bozukluğu olan hastalarda hormon tedavisi başlarken risklerin dikkate alınması gerekliliğini vurgulamaktadır

İki uçlu duygudurum bozukluğu olan bir hastada medroksiprogesteron asetat ile indüklenen mani

Medroxyprogesterone acetate-induced mania in a patient with bipolar affective disorder Medroxyprogesterone acetate (MPA) is a steroidal progestin which is used as a contraceptive, in hormone replacement therapy, dysmenorrhea and amenorrhea. A 19-year-old female with bipolar affective disorder who was started on MPA for the treatment of secondary amenorrhea developed manic episodes while taking MPA pills. She was in remission for three years when MPA was commenced. As manic symptoms emerged following the onset of MPA treatment, risperidone and valproic acid was administered, which was then switched to aripiprazole and lithium treatment because of side effects. The manic episode resolved three weeks after hospital admission. This case report highlights the risk of commencing hormone pills in patients with personal history of affective disorders because of the possibility of MPA-induced manic episode

___

  • 1. Schindler AE, Campagnoli C, Druckmann R, Huber J, Pasqualini JR, Schweppe KW, Thijssen JH. Classification and pharmacology of progestins. Maturitas 2008; 61:171-180. [CrossRef]
  • 2. Warren MP, Shantha S. Uses of progesterone in clinical practice. Int J Fertil Womens Med 1999; 44:96-103.
  • 3. Sabioni P, Baretta IP, Ninomiya EM, Gustafson L, Rodrigues AL, Andreatini R. The antimanic-like effect of tamoxifen: behavioural comparison with other PKC-inhibiting and antiestrogenic drugs. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1927- 1931. [CrossRef]
  • 4. Sitruk-Ware R. Progestogens in hormonal replacement therapy: new molecules, risks, and benefits. Menopause 2002; 9:6-15. [CrossRef]
  • 5. Gupta N, O’Brien R, Jacobsen LJ, Davis A, Zuckerman A, Supran S, Kulig J. Mood changes in adolescents using depotmedroxyprogesterone acetate for contraception: a prospective study. J Pediatr Adolesc Gynecol 2001; 14:71-76. [CrossRef]
  • 6. Pazol K, Wilson ME, Wallen K. Medroxyprogesterone acetate antagonizes the effects of estrogen treatment on social and sexual behavior in female macaques. J Clin Endocrinol Metab 2004; 89:2998-3006. [CrossRef]
  • 7. Kulkarni J, Garland KA, Scaffidi A, Headey B, Anderson R, de Castella A, Fitzgerald P, Davis SR. A pilot study of hormone modulation as a new treatment for mania in women with bipolar affective disorder. Psychoneuroendocrinology 2006; 31:543-547. [CrossRef]
  • 8. Kulkarni J, Berk M, Wang W, Mu L, Scarr E, Van Rheenen TE, Worsley R, Gurvich C, Gavrilidis E, de Castella A, Fitzgerald P, Davis SR. A four week randomised control trial of adjunctive medroxyprogesterone and tamoxifen in women with mania. Psychoneuroendocrinology 2014; 43:52-61. [CrossRef]
  • 9. Izci F, Calli SK, Sever Y. Medroxyprogesterone acetate-induced manic episode in a patient with bipolar affective disorder-I. The Journal of Neurobehavioral Sciences 2015; 2:87-88. [CrossRef]
  • 10. Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978; 133:429-435. [CrossRef]
  • 11. Peuskens J, Pani L, Detraux J, De Hert M. The effects of novel and newly approved antipsychotics on serum prolactin levels: a comprehensive review. CNS Drugs 2014; 28:421-453. [CrossRef]
  • 12. Alpak G, Unal A, Bulbul F, Aksoy I, Demir B, Savas HA. Hyperprolactinemia due to paliperidone palmitate and treatment with aripiprazole. Bulletin of Clinical Psychopharmacology 2014; 24:253-256. [CrossRef]
  • 13. Cretu JB, Culver JL, Goffin KC, Shah S, Ketter TA. Sleep, residual mood symptoms, and time to relapse in recovered patients with bipolar disorder. J Affect Disord 2016; 190:162-166. [CrossRef]
  • 14. Cagnacci A, Arangino S, Baldassari F, Alessandrini C, Landi S, Volpe A. A comparison of the central effects of different progestins used in hormone replacement therapy. Maturitas 2004; 48:456-462. [CrossRef]
  • 15. Bjorn I, Bixo M, Nojd KS, Collberg P, Nyberg S, SundstromPoromaa I, Backstrom T. The impact of different doses of medroxyprogesterone acetate on mood symptoms in sequential hormonal therapy. Gynecol Endocrinol 2002; 16:1-8. [CrossRef]
  • 16. Bjorn I, Bixo M, Nojd KS, Nyberg S, Backstrom T. Negative mood changes during hormone replacement therapy: a comparison between two progestogens. Am J Obstet Gynecol 2000; 183:1419-1426. [CrossRef]
  • 17. Rogines-Velo MP, Heberle AE, Joffe H. Effect of medroxyprogesterone on depressive symptoms in depressed and non-depressed perimenopausal and postmenopausal women following discontinuation of transdermal estradiol therapy. Menopause 2012; 19:471-475. [CrossRef]
Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi-Cover
  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984
  • Yayıncı: Kare Yayıncılık
Sayıdaki Diğer Makaleler

Bir üniversite hastanesine başvuran organ nakli verici adaylarının psikiyatrik değerlendirmeleri, anksiyete, depresyon ve yaşam kalitesi düzeyleri

Filiz İZCİ, Ebru FINDIKLI, Serkan ZİNCİR, Akif CAMKURT, Ozlem KİZİLKURT, Ferzan GİYNAS, SEVDA KORKMAZ, Emin Barış AKIN

Evaluation of Hypothalamo- Pituitary-Adrenal Axis Activity by Using Dexamethasone Suppression Test in Patients with Panic Disorder and Generalized Anxiety Disorder

Yunus HACIMUSALAR, ERTUĞRUL EŞEL

Validity and Reliability of the Turkish Version of DSM-5 “Severity of Acute Stress Symptoms—Child Age 11–17” Form

Sermin Yalin SAPMAZ, Handan Özek ERKURAN, DİLEK ERGİN, NESRİN ŞEN CELASİN, DUYGU KARAARSLAN, Masum OZTURK, Ertuğrul KÖROĞLU, ÖMER AYDEMİR

Co-Occurrence of Autism Spectrum Disorder and Very Early Onset Schizophrenia: a Case Report

Duygu KABA, Pinar URAN, Ayla SOYKAN AYSEV

Gamma-hydroxybutyrate (GHB): an Emerging Substance of Abuse

ÜRÜN ÖZER ÇERİ, Mert BATMAZ, Ibrahim AKBAS

Which Psychiatric Symptoms of the Mother are Related with Preschool Child’s Emotional and Behavioral Problems?

Selma TURAL HESAPÇIOĞLU, MEHMET FATİH CEYLAN, BETÜL ÇELİK ERDOĞAN, Gozde KANDEMİR, ESRA ÇÖP

Evidence Based Criteria for the Antidepressant Choice

Alessandro SERRETTİ

Medroxyprogesterone Acetate-Induced Mania in a Patient with Bipolar Affective Disorder

Memduha AYDIN, Bilge Cetin ILHAN, Abdulbaki AKYİLDİZ, İbrahim EREN

Hypomanic Episode in CADASIL Syndrome

Meliha Zengin EROĞLU, Ebru ŞAHAN

Sentetik kannabinoid kullanımı olan bir olguda pregabalin bağımlılığı

Gültürk KÖROĞLU