A review of randomized, controlled clinical trials in acute mania.
This review considers the evidence supporting the use of somatic therapies (medications and electroconvulsive therapy) in the treatment of acute mania associated with bipolar disorder. Data from randomized, controlled clinical trials have established the efficacy of lithium, divalproex sodium, and carbamazepine in the treatment of acute mania. The use of combinations of mood stabilizers in the treatment of acute mania has not been well examined in controlled trials. Conventional antipsychotics and some atypical antipsychotics are frequently used as initial or adjunctive treatment. Similarly, benzodiazepines are frequently used as adjunctive agents. Preliminary data suggest that some calcium channel blockers and several anticonvulsants, e.g., lamotrigine, gabapentin, and topiramate, may have therapeutic value in the treatment of acute mania. In contrast, electroconvulsive therapy is generally accepted as being highly effective despite the lack of controlled evidence.
Keck
P E
PE
Biological Psychiatry Program, Department of Psychiatry, University of Cincinnati College of Medicine, PO Box 670559, 231 Bethesda Avenue, 45267-0559, Cincinnati, OH, USA.
Mendlwicz
J
J
Calabrese
J R
JR
Fawcett
J
J
Suppes
T
T
Vestergaard
P A
PA
Carbonell
C
C
D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D002121:Calcium Channel Blockers