A four week randomised control trial of adjunctive medroxyprogesterone and tamoxifen in women with mania.
Emerging research has suggested that hormone treatments such as selective oestrogen receptor modulators (SERMs) or progestins may be useful in the treatment of mania. The current pilot study compared the use of the SERM tamoxifen and the progestin medroxyprogesterone acetate (MPA), as an adjunct to mood stabiliser medications, for the treatment of mania symptoms in 51 women in a 28-day double blind, placebo controlled study. The primary outcome was the change between baseline and day 28 mania scores as measured by the Clinician Administered Rating Scale for Mania (CARS-M). Adjunctive MPA treatment provided greater and more rapid improvement in mania symptoms compared with adjunctive placebo and tamoxifen treatment. Adjunctive therapy with MPA may be a potentially useful new treatment for persistent mania, leading to a greater and more rapid resolution of symptoms compared with mood stabiliser treatment alone.
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia. Electronic address: jayashri.kulkarni@monash.edu.
Jayashri
J
Kulkarni
IMPACT Strategic Research Centre, School of Medicine, Deakin University, Barwon Health, Ryrie Street, Geelong, Victoria 3220, Australia.
Michael
M
Berk
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia.
Wei
W
Wang
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia.
Ling
L
Mu
The Florey Institute of Neuroscience and Mental Health Victoria, Parkville, Victoria 3052, Australia.
Elizabeth
E
Scarr
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia.
Tamsyn E
TE
Van Rheenen
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia; Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University and Alfred Hospital, Victoria 3004, Australia.
Roisin
R
Worsley
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia.
Caroline
C
Gurvich
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia.
Emorfia
E
Gavrilidis
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia.
Anthony
A
de Castella
Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria 3004, Australia.
Paul
P
Fitzgerald
Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University and Alfred Hospital, Victoria 3004, Australia.
Susan R
SR
Davis
D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004965:Estrogen Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008525:Medroxyprogesterone / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011493:Protein Kinase C / Q000037:antagonists & inhibitors; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects / Q000627:therapeutic use*; D013629:Tamoxifen / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D004965:Estrogen Antagonists; D012739:Gonadal Steroid Hormones; D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen; D011493:Protein Kinase C; D008525:Medroxyprogesterone
Bipolar disorder; Mania; Medroxyprogesterone acetate; Schizoaffective disorder; Tamoxifen; Treatment