Monitoring Sleep Architecture Changes in Antidepressant-Triggered Hypomania Associated with Bipolar Disorder: A Case Study Using Wearable Actigraphy During Transition from Venlafaxine ER to Lamotrigine

We report the case of a 24-year-old male with a suspected bipolar spectrum disorder who developed dysphoric hypomania following a transition from an atypical antidepressant to Venlafaxine ER. Longitudinal actigraphy was used to monitor sleep architecture across three medication phases: atypical antidepressant, SNRI, and mood stabilizer. The patient’s transition to Lamotrigine, guided by pharmacogenomic testing, was associated with increased REM sleep percentage and reduced nocturnal wake time, changes that paralleled clinical stabilization.