Superiority of lithium over verapamil in mania: a randomized, controlled, single-blind trial.
BACKGROUND
Both case reports and small controlled studies suggest the efficacy of verapamil in the treatment of mania.


METHODS
Forty patients with DSM-IV mania were studied in a 28-day randomized, controlled, single-blind trial of either lithium or verapamil.


RESULTS
The patients receiving lithium showed a significant improvement on all rating scales (Brief Psychiatric Rating Scale [BPRS], Mania Rating Scale [MRS], Global Assessment of Functioning [GAF], and Clinical Global Impression [CGI]) compared with those receiving verapamil. The mean MRS score at Day 28 in the lithium group was significantly lower than that in the verapamil group (17.47 vs. 24.43, respectively; F = 6.17, df = 1, p = .018). A similar pattern was seen with the BPRS (12.68 vs. 20.57; F = 10.69, df = 1, p = .002), CGI (2.31 vs. 3.33; F = 6.05, df = 1, p = .019), and GAF (43.52 vs. 52.31; F = 4.36, df = 1, p = .044) (ANCOVA).


CONCLUSIONS
This study suggests that lithium is superior to verapamil in the management of acute mania.
Walton
S A
SA
Department of Psychiatry, University of the Witwatersrand Medical School, Johannesburg, South Africa.
Berk
M
M
Brook
S
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007231:Infant, Newborn; D016651:Lithium Carbonate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome; D014700:Verapamil / Q000627:therapeutic use*
D010919:Placebos; D016651:Lithium Carbonate; D014700:Verapamil