ArticleClinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology2026
Dose-related Manic Switch with Psychotic Features Following Bupropion Titration: A Case Report.
Article in Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Bupropion is an antidepressant commonly considered to have a relatively low risk of inducing manic switch in the treatment of bipolar depression. However, in certain cases-particularly at higher doses and in the presence of psychotic features-manic switching may occur. In this report, we present a male patient with bipolar I disorder who developed a psychotic manic episode following an increase in bupropion XL dose from 150 mg to 300 mg/day while receiving lithium treatment. This case highlights that, despite its reputation as a relatively safe antidepressant in bipolar depression, bupropion may precipitate dose-related manic and psychotic switches. Based on the clinical findings observed in this patient, cautious dose titration beyond 150 mg/day may be considered in individuals with bipolar disorder with psychotic features, with particular attention to close clinical monitoring following any dose escalation.
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