Mania Precipitated by Opioid Withdrawal: A Retrospective Study
Article first published online: 15 MAY 2013
Copyright © American Academy of Addiction Psychiatry
The American Journal on Addictions
Volume 22, Issue 4, pages 338–343, JulyߝAugust 2013
How to Cite
Shariat, S. V., Hosseinifard, Z., Taban, M. and Shabani, A. (2013), Mania Precipitated by Opioid Withdrawal: A Retrospective Study. The American Journal on Addictions, 22: 338–343. doi: 10.1111/j.1521-0391.2013.12033.x
- Issue published online: 24 JUN 2013
- Article first published online: 15 MAY 2013
- Manuscript Accepted: 27 OCT 2011
- Manuscript Revised: 1 APR 2011
- Manuscript Received: 5 MAR 2011
Little evidence is available on the occurrence of mania following opioid withdrawal. This is the first report on clinical and demographic characteristics of mania precipitated by opioid withdrawal in a relatively large sample.
In this study, we assessed the files of the patients admitted to a large referral psychiatric hospital during a 3-year period with a presentation of manic episode shortly after opioid withdrawal. Forty-five relevant cases (one woman) were found, including 28 patients with their first manic episode, and 17 patients with a previous history of bipolar disorder.
Most of the identified cases had a long history (mean = 11.8 years) of opium dependence (24 cases used only opium and 16 cases opium and other opioids) and had recently experienced an intense withdrawal (25 cases). These associations were present in both first-episode patients and those with recurrent episodes.
Emergence of mania following opioid withdrawal could be partly explained by mood stabilizing effects of opioids. Other than the type of opioid, it seems that the duration of use and withdrawal method might play a role. Caution should be used while detoxifying patients with a long history of opioid use. (Am J Addict 2013;22:338–343)