Hepatic Encephalopathy Resulting in Mania, a Possible Role of Bilirubin and Glutamate?

Abstract

Two case reports up to date suggest that hyperbilirubinemia may induce mania in patients with pre-existing vulnerability for psychiatric disorders. Pathophysiology may consist of increased glutamatergic neuronal transmission related to unconjugated bilirubin, interacting with other clinical conditions or treatment interventions that increase brain glutamate levels, such as electroconvulsive therapy. This article is protected by copyright. All rights reserved.