14th February 2025

Epidemiology and aetiology of bipolar disorder

Risk factors for bipolar disorder

It is more common in those with a family history of bipolar disorder or a personal history of depressive illness (especially in childhood or adolescence). As with many mental illnesses, adverse life events and concurrent alcohol or substance misuse increase the risk.

Medication-induced mania

Medications can cause or increase the risk of mania or hypomania, both in patients with established bipolar disorder and those who are yet to experience their first mood episode. Antidepressants are the most typical cause; TCAs and SNRIs, e.g. venlafaxine, are particularly culpable. SSRIs and bupropion are less likely to cause mania but it is still seen.

Other psychotropic medication causes include benzodiazepines (a paradoxical reaction), lithium, and stimulants, e.g. dexamfetamine (used in attention deficit hyperactivity disorder, ADHD).

Medications used in other health conditions can also induce mania, such as Parkinson’s treatment, steroids, propranolol, salbutamol and TB treatment.