The chronic dysphoric irritable state is a common consequence, but not very known, of the long-term antidepressants prescription for bipolar patients.

of our study was to illustrate this clinical entity, through the study of a clinical case.

Our study focused on the case of Mrs LA, 36 years old and with a history of a major depressive episode treated with tricyclic antidepressant. The evolution when taking antidepressant, was marked by a persistent irritability, dysphoric mood and sleep disorders.

These symptoms have been attributed to a personality disorder after eliminating organic causes. Increasing antidepressant doses induced to an exacerbation of the characterological symptomatology. A mood stabilizer was added in combination with low doses of antidepressants, but without finding premorbid functioning. After stopping a treatment of five months, Mrs. LA, showed an acute manic episode requiring hospitalization. Thus the diagnosis was of bipolar disorder type I. The long-term evolution when taking mood stabilizer alone was marked by the disappearance of characterological disorder and return to premorbid functioning.

Taking antidepressants in the case of bipolar individuals may induce a turning to mania, mixed episodes, rapid cycling or a the chronic dysphoric irritable state, recently described in the literature.