Introduction:
The emergence of neuropsychiatric symptoms secondary to the use of
antineoplastic agents is known but often underreported. Capecitabine and
Oxaliplatin regimen is one of the standard chemotherapy regimens used in
clinical practice for the treatment of carcinoma rectum. Capecitabine is
a prodrug of 5-fluorouracil (5-FU) and is associated with several
behavioral syndromes including encephalopathy, psychosis, and depression
across heterogeneous subgroups. 1–7. However, the
emergence of syndromal mania is rarely reported with Capecitabine use in
carcinoma rectum. The exact mechanism of development of syndromal manic
symptoms due to capecitabine is not fully known but few hypotheses are
linked with inflammatory cascade implicated in cancer and mood
disorders8,9. Further regular adherence to
pharmacovigilance guidelines may be overlooked especially in such cases
where behavioral adverse effects are the only manifestations. We report
the development of Euphoric mania after the initiation of the third
cycle of chemotherapy with capecitabine in one of the patients.