Low-dose manic switch and high-dose antimanic effect and extrapyramidal symptoms by aripiprazole in a single bipolar patient.

A case report of an adult female patient with bipolar depression who developed mania after short-term administration of low-dose aripiprazole (2 mg daily) is reported. Later, the author rechallenged with high-dose aripiprazole (22 mg) for treating mania, but there was no manic switch, unlike when using low-dose aripiprazole. A 1-month follow-up revealed no further symptoms of mania or depression, except dyskinesia and sialorrhea. Clinicians should therefore carefully and vigilantly monitor for both the induction of mania and extrapyramidal symptoms according to the aripiprazole dose.