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How long would it take for Sertraline to induce a manic/mixed episode in someone with bipolar?



Well-known member
May 22, 2013
How long would it take for Sertraline to induce a manic/mixed episode in someone with bipolar?

Basically, I was on 20mg fluoxetine for 7 weeks which gave me the most horrible mixed episode, as well as having delusions. I haven't been diagnosed as of yet (was on the fluoxetine for anxiety), but bipolar runs in my family and I display a hell of a lot of symptoms. Anyway, she dismissed that it could be bipolar and switched my fluoxetine to 50mg sertraline (she was actually considering upping my first fluoxetine even though I was feeling like that...) I started taking 25mg for two weeks, then went up to 50mg. So, I've been on 50mg for about a week now but I'm so scared I'm going to go manic/mixed/psychotic again. I usually have similar things, but being on the fluoxetine seemed to induce it and make it even worse.

I know that sometimes SSRI's are used to treat bipolar on their own, but I'm just worried that in a few weeks I will go back to the place I was at, and it wasn't good at all.

So does anyone know how long it would take? Would I have already gone like it?

I'm thinking of going back to the doctor and asking to be referred to a psychiatrist for an evaluation, but I move to London in a month and I'm not sure if that will complicate appointments etc.


Well-known member
Dec 25, 2010
Hiya phezz.
Unsure how long that would take but really I do hope you can get better on your sertraline.
Fluoxetine has been associated with inducing all types of vile mood swings in those on it, hoping sertraline helps you. Good luck.


Well-known member
Aug 2, 2014
You should get a referral i think and speak to a psychiatrist. Unfortunately they don't like to be told what their diagnosis will be and feel everyone wants to have bipolar disorder so you might have to tread carefully there.

I also had a mixed episode as a result of fluoxetine. (I was later told by a different psychiatrist as i only saw a CPN during this time). I was then given another anti depressant which made me manic. I had moved out of home by this point and was working in another area. I made a lot of mistakes during this time. It was only once the high ended after a couple of months, and i was depressed and took an overdose, that i received the diagnosis.

Anti depressants are just going to destabilise your mood and make things worse for you long term. I would get an urgent referral as stopping the anti d cold turkey will send you into a depression. You probably need a mood stabiliser.


Well-known member
Jun 25, 2014
Far, far away
They're very reluctant to diagnose you with bipolar unless you've got a documented history of hypo/manic episodes, given that it's a bit of a life sentence. 'Has had depression before', you don't need to tell an employer. 'Have a diagnosis of bipolar', you probably do.

Anyway, good luck with sertraline. I had to be taken off it because I went mixed, and had weird bleeding issues (yay for being the 1/10,000), but it does work for a lot of people. If you go mixed again, push for a psych referral, because it'd be odd for two different a/d's to turn you mixed.

50mg's is a pretty low dose of sertraline, the max. dose is supposedly 200mg, and the 'usual' for most people is ~150mg. If it was going to push you mixed, it'd probably get worse the higher the dose went. Personally I started getting a bit mixed at 100mg, after 3 weeks.


Well-known member
Aug 2, 2014
I had a mixed state on three and mania on one. It happened straight away, as in within a couple of days.


Apr 18, 2014
3 days for me on sertraline at 100mg. Hell of a ride that almost got me sectioned.

Supposedly the worst way to find out your depression is actually bipolar and I'm inclined to agree.

Easy Rider

Well-known member
Nov 22, 2010
Just a mere 5mg of seroxat (Peroxatine) an ssri has a massive effect on me and the usual dose is 20mg!

I had saved five 5mg slip tabs for an emergency back up once about a year or two ago in case bad depression hit. A mate was coming from another country to stay at my apartment for a week and at the time I was undiagnosed and not being treated medically. I used those 5 tabs at 5mg to get through the week and tbh it was excellent, I looked younger, felt younger, happier etc without going manic.

Just 5mg has me optimistic, energetic, blending in better socially etc... Problem is my ex shrink and my current UK GP both say it wouldn't have any effect on a non bp / bp2 person and is really just giving me mild hypomania.

Whilst I would welcome living the rest of my life with this mild hypomania, my doctor is not so will not prescribe it for me even at 5mg. At the end of they day they are probably right and I need to get used to the occasional dullness and discomfort that is part and parcel for everyone as part of every day life without a med to do it, so hey ho...

But yeah, ssri's can be a good indicator of whether you are just depressed or bipolar 1 / bipolar 2 depednign on how you react to them.\

Obviously me taking a mere quarter dose in the morning and feeling up an hour later and it lasting all day, means I have probably different brain chemistry to someone who wouldn't even feel it.
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