Double-blind comparison of the continued use of antipsychotic treatment versus its discontinuation in remitted manic patients.
OBJECTIVE
The goal of this study was to determine the benefits of the continued use of a typical antipsychotic agent following remission from an acute manic episode.


METHODS
Immediately following remission of a manic episode treated with the combination of a typical antipsychotic (perphenazine) and a mood stabilizer (lithium, carbamazepine, or valproate), 37 patients were randomly assigned to 6 months of double-blind treatment in which in addition to the mood stabilizer they received either continued perphenazine treatment or placebo.


RESULTS
Patients randomly assigned to continue perphenazine treatment, relative to those who discontinued it, were more likely to have a shorter time to depressive relapse, discontinue the study, and have increased rates of dysphoria, depressive symptoms, and extrapyramidal symptoms.


CONCLUSIONS
There were no short-term benefits with the continued use of a typical antipsychotic after achieving remission from an episode of acute mania. In fact, its continued use was associated with detrimental effects.
Zarate
Carlos A
CA
Consolidated Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass, USA. zaratec@intra.nimh.nih.gov
Tohen
Mauricio
M
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D010546:Perphenazine / Q000008:administration & dosage / Q000627:therapeutic use*; D012074:Remission Induction; D012720:Severity of Illness Index
D014150:Antipsychotic Agents; D010546:Perphenazine