title: Comparative study of electrocardiographic changes in patients of acute mania receiving verapamil or lithium carbonate.
abstract: OBJECTIVE
  TO compare the ECG changes in patients of acute mania receiving verapamil and lithium carbonate.
  
  
  OBJECTIVE
  Verapamil used in resistant manic patients not responding to any drug therapy, should be considered for its side effects on cardiovascular system. It causes bradycardia and myocardial infarction in risk patients. So it is important to take clinical and other relevant history and do ECG before the patient to put on verapamil drug therapy.
  
  
  METHODS
  Patients with acute mania were randomized to receive lithium (n =25) or verapamil (n=25) in a 4-wk double-blind comparative study. Both groups were homogeneous with regard to demographic and disease variables. After giving first dose of verapamil, patients were observed for any cardiovascular side effects and ECG changes during the study. The study parameters were recorded at the baseline, after 7 d and 28 d of trial medication.
  
  
  METHODS
  The Unpaired t-test was used for comparing baseline data in two groups and paired t-test was used for the interval data. A level of less than 5% value of p was considered statistically significant.
  
  
  RESULTS
  Both treatment groups showed no major differences in ECG changes during the trial except for the heart rate and T wave changes. The study showed that verapamil produces more bradycardia and T wave depression than with lithium in the treatment of mania.
  
  
  CONCLUSIONS
  The baseline electrocardiogram should be done and heart rate should be monitored during the treatment.
authors: Associate Professor, Department of Pharmacology, Maharishi Markandeshwar Medical College and Hospital , Kumarhatti, Solan, India .
authors: Mukhtiar
authors: M
authors: Singh
authors: Assistant Professor, Department of Pharmacology, Maharishi Markandeshwar, Medical College and Hospital , Kumarhatti Solan, India .
authors: Sharanjit
authors: S
authors: Kaur
authors: Associate Professor, Department of Pharmacology, GMC , Patiala, India .
authors: Vijay Kumar
authors: VK
authors: Sehgal
keywords: Bradycardia; Cardiovascular effects; Heart rate; Hypotension
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