A case of hypomania during nicotine cessation treatment with bupropion

Mania possibly linked with bupropion for smoking cessation: A case report

Bupropion is an antidepressant thought to have a reduced risk of inducing mood switching as compared to other antidepressants. Minimal information is available on the induction of mood shifts when used for smoking cessation. This case describes a 38-year-old female who experienced mania following initiation of bupropion for smoking cessation. After completion of a thorough literature search, this appears to be the first case report describing mania induced by bupropion that was refractory to medications and was resolved with electroconvulsive therapy. This case highlights the need for clinicians to perform thorough histories of patients to avoid missing psychiatric history prior to starting bupropion as well as monitor for changes in mood or behavior after initiation of therapy.

Dyskinesia in an unmedicated adolescent with a 5-year history of tobacco use: a case report

Background

Tobacco use among mentally ill patients is approximately two to three times higher than that in the general population. Withdrawal from tobacco is a common occurrence and many authors have described various symptoms of nicotine withdrawal. Dyskinesia, however, has not been reported as one of the symptoms of nicotine withdrawal in adolescents without any psychopathology or medical illness.

Case presentation

We report a case of a 17-year-old Motswana boy of the Tswana ethnic group with primary school education and a 5-year history of tobacco use who developed dyskinesia approximately 48 hours after cessation of tobacco and had some relief with nicotine gum.

Conclusion

In addition to the documented symptoms of nicotine withdrawal, clinicians should look out for dyskinesia, which may be one of the rare symptoms of withdrawal in chronic tobacco users.

Mirtazapine withdrawal-induced mania

Antidepressant withdrawal mania is not a commonly reported occurrence. To date, there is only one published report of hypomanic episode on withdrawal of mirtazapine. A case is presented herein of a patient who experienced manic episode on withdrawal of mirtazapine.