Homicide attempt due to medication induced mania

Bipolar disorders are a group of mental disorders characterized by fluctuations in mood, with depressive symptoms generally dominating the course of disorder. Research on the efficacy of serotonergic antidepressants in bipolar depression is controversial and as a result, treatment of depressive symptoms in bipolar disorder is difficult. A particularly difficult situation arises when bipolar disorder is unrecognized and the depressive state is treated as major depressive disorder with the use of serotonergic antidepressants, which can result in the phenomenon of antidepressant induced mania (AIM). In this report, we present a case of antidepressant induced mania (AIM) with homicidal ideation after initiation of serotonergic antidepressants. Here, we discuss the importance of monitoring for bipolar disorder after prescribing serotonergic antidepressant therapy as well as medico-legal considerations.