Because bipolar disorder covers a vast range of emotional states, we need to consider medications and other substances of use and abuse that can cause both abnormal elevations and dips in a person’s mood. Many substances can become toxic in the body and lead to a delirious state. If not discovered, the result could be permanent damage, coma, and even death. This is why it’s so important to not jump to conclusions when someone is in a manic or psychotic state, even if she has a well-documented history of bipolar disorder.
Medications implicated in causing significant mood changes (this is not meant to be an all-inclusive list.):
• Steroids (e.g., cortisone, prednisone), can cause psychotic symptoms and precipitate both depressed and manic states
• Interferon, (used to treat hepatitis C and multiple sclerosis and to prevent rejection of organ transplants) carries a high rate of depression
• Thyroid hormone, if too much can mimic mania, too little can present as depression
• Some heart and blood pressure medications, beta-blockers (propranolol, Inderal, Lopressor, Cogentin, Artane, Benadryl), often used to counteract side effects of older antipsychotic medications
• Antihistamines, this includes many over-the-counter cold and allergy products, such diphenhydramine (Benadryl), pseudophedrine (Sudafed) etc..
There are many substances with abuse potential that can mimic or precipitate symptoms of bipolar disorder:
• Hallucinogens, including LSD, Ecstasy, ketamine, peyote, mescaline