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Interaction of Fluoxetine and Caffeine in a Patient With Substance-Induced Mania - PubMed

6 hours ago
  • #mania
  • #caffeine
  • #fluoxetine
  • A 42-year-old male with no prior psychiatric history developed acute mania symptoms after starting fluoxetine and accidentally taking double the prescribed dose.
  • The patient exhibited classic manic symptoms including elevated mood, grandiosity, pressured speech, and decreased need for sleep.
  • Laboratory tests were normal except for cannabis detected in urine drug screening.
  • The manic episode may have been triggered by excessive fluoxetine combined with high caffeine intake, with fluoxetine potentially inhibiting CYP1A2 and increasing caffeine levels.
  • Treatment involved discontinuing fluoxetine and administering valproate and haloperidol, leading to symptom improvement.
  • The case highlights the importance of assessing stimulant use and medication dosing in new-onset manic symptoms.