Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Attention deficit hyperactivity disorder, Bipolar I disorder, Condition aggravated
Clinical narrative: Bipolar I disorder exacerbation; Bipolar I disorder exacerbation; Attention deficit hyperactivity disorder; This literature-non-study case was reported in a literature article and describes the occurrence of BIPOLAR I DISORDER (Bipolar I disorder exacerbation), CONDITION AGGRAVATED (Bipolar I disorder exacerbation) and ATTENTION DEFICIT HYPERACTIVITY DISORDER (Attention deficit hyperactivity disorder) in a 40-year-old male patient who received mRNA-1273 (Spikevax) for COVID-19 prophylaxis.      Concurrent medical conditions included Bipolar I disorder (well controlled and stable for years on the medications). Concomitant products included LAMOTRIGINE and BUPROPION for Bipolar I disorder.  On an unknown date, the patient received second dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. On an unknown date, the patient experienced BIPOLAR I DISORDER (Bipolar I disorder exacerbation) (seriousness criteria hospitalization and medically significant), CONDITION AGGRAVATED (Bipolar I disorder exacerbation) (seriousness criterion hospitalization) and ATTENTION DEFICIT HYPERACTIVITY DISORDER (Attention deficit hyperactivity disorder) (seriousness criterion hospitalization). The patient was treated with ARIPIPRAZOLE at an unspecified dose and frequency. At the time of the report, BIPOLAR I DISORDER (Bipolar I disorder exacerbation), CONDITION AGGRAVATED (Bipolar I disorder exacerbation) and ATTENTION DEFICIT HYPERACTIVITY DISORDER (Attention deficit hyperactivity disorder) outcome was unknown.   For mRNA-1273 (Spikevax) (Unknown), the reporter did not provide any causality assessments.   Patient experienced depression, mania, psychosis, and suicidal ideation that resulted in hospitalization. Symptoms subsequently worsened after patient discontinued medications five days prior to admission. Patient was treated with aripiprazole in hospital.  Author stated that the inflammatory response induced by vaccines might potentiate acute mental health exacerbations, necessitating treatment changes.  Company comment: This literature-non-study case, concerns a male patient aged 40 years, with relevant medical history of Bipolar I disorder with well-controlled symptoms and stable on medications reported, who experienced the unexpected serious (medically significant/Hospitalization) event of Bipolar I disorder (reported as Bipolar I disorder exacerbation), unexpected serious (Hospitalization) events of Condition aggravated and Attention deficit hyperactivity disorder that occurred in the context of second dose of mRNA-1273 vaccination in covid-19 vaccination series. Latency cannot be assessed since vaccination date nor event onset date was disclosed. Patient experienced depression, mania, psychosis, and suicidal ideation that resulted in hospitalization. Prior to hospitalization, he took lamotrigine and bupropion, the latter of which was changed to aripiprazole in hospital. No further information on clinical course, investigations was available in the report. Outcome of the events was unknown at the time of report. Relevant medical history remains a confounder to the events. Author concludes that Inflammation is a component of psychiatric disorders, and the inflammatory response induced by vaccines might potentiate acute mental health exacerbations, necessitating treatment changes. The benefit-risk relationship of mRNA-1273 is not affected by this report.; Sender's Comments: This literature-non-study case, concerns a male patient aged 40 years, with relevant medical history of Bipolar I disorder with well-controlled symptoms and stable on medications reported, who experienced the unexpected serious (medically significant/Hospitalization) event of Bipolar I disorder (reported as Bipolar I disorder exacerbation), unexpected serious (Hospitalization) events of Condition aggravated and Attention deficit hyperactivity disorder that occurred in the context of second dose of mRNA-1273 vaccination in covid-19 vaccination series. Latency cannot be assessed since vaccination date nor event onset date was disclosed. Patient experienced depression, mania, psychosis, and suicidal ideation that resulted in hospitalization. Prior to hospitalization, he took lamotrigine and bupropion, the latter of which was changed to aripiprazole in hospital. No further information on clinical course, investigations was available in the report. Outcome of the events was unknown at the time of report. Relevant medical history remains a confounder to the events. Author concludes that Inflammation is a component of psychiatric disorders, and the inflammatory response induced by vaccines might potentiate acute mental health exacerbations, necessitating treatment changes. The benefit-risk relationship of mRNA-1273 is not affected by this report.