Calcium channel blockers in psychiatric disorders: a review of the literature.
OBJECTIVE
To review the published literature of the past 15 years regarding use of calcium channel blockers (CCBs) in psychiatric practice. These drugs, especially verapamil, have been recommended as possible treatments for mania and other disorders.


METHODS
The Cumulative Medical Index and other databases were searched and back-tracked to locate relevant articles. Sixty-one such articles were uncovered: 37 anecdotal reports, 7 partially controlled reports, and 17 controlled trials.


RESULTS
Most studies involved treatment of mania using verapamil. Although anecdotal reports were generally favourable, results from partially controlled reports or controlled clinical trials were mixed. Generally, verapamil was less effective than was lithium or placebo. Treatment of depression with CCBs was not very successful, regardless of the type of trial; the best trial was negative. The same was true for the treatment of schizophrenia, although the cases studied were extremely chronic and treatment-resistant. Evidence for efficacy in other illnesses, such as Alzheimer's disease or tardive dyskinesia was scanty but suggested that further trials might be in order.


CONCLUSIONS
CCBs do not at present have an established place in psychiatric treatment. Nonetheless, clinicians faced with a manic patient not responsive to other antimanic drugs, either alone or in combination, might consider adding verapamil as an adjunct. A study bearing on this specific issue is needed to determine whether or not such off-label use would really be justified.
Hollister
L E
LE
University of Texas Health Science Center at Houston, USA.
Trevino
E S
ES
D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004351:Drug Resistance; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy*; D019964:Mood Disorders / Q000188:drug therapy; D014700:Verapamil / Q000627:therapeutic use
D002121:Calcium Channel Blockers; D014700:Verapamil