Pharmacologic loading in the treatment of acute mania.
The rapid and safe reduction of manic symptoms is an important initial goal of the pharmacologic treatment of acute mania. The pharmacokinetics and studies of pharmacologic loading of lithium, valproate, and carbamazepine were reviewed. In addition, the feasibility of administering other agents with potential efficacy in mania, e.g., atypical antipsychotics and new anticonvulsants, was discussed. Further double-blind, controlled studies with adequate sample sizes comparing loading strategies with more gradual titration schedules of candidate antimanic agents are needed.
Biological Psychiatry Program, Department of Psychiatry, University of Cincinnati College of Medicine, OH 45267-0559, USA. keckpe@eamil.uc.edu
P E
PE
Keck
S L
SL
McElroy
J A
JA
Bennett
D000208:Acute Disease; D000927:Anticonvulsants / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D002220:Carbamazepine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008094:Lithium / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D014635:Valproic Acid / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*
D000927:Anticonvulsants; D018692:Antimanic Agents; D002220:Carbamazepine; D014635:Valproic Acid; D008094:Lithium