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Related Experiment Videos

Phenytoin as an antimanic anticonvulsant: a controlled study.

A Mishory1, Y Yaroslavsky, Y Bersudsky

  • 1Stanley Center for Bipolar Research, Ministry of Health Mental Health Center, Ben Gurion University of the Negev, Beersheva, Israel.

The American Journal of Psychiatry
|March 4, 2000
PubMed
Summary

Phenytoin, an anticonvulsant, effectively treated mania in bipolar I disorder patients by blocking sodium channels. This study suggests phenytoin as a potential therapeutic option for certain manic episodes.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Phenytoin, a classical anticonvulsant, shares voltage-activated sodium channel blockade properties with known antimanic anticonvulsants.
  • This shared mechanism suggested a potential therapeutic role for phenytoin in managing manic episodes.

Purpose of the Study:

  • To investigate the efficacy of phenytoin as an adjunctive treatment for mania.
  • To compare haloperidol plus phenytoin with haloperidol plus placebo in patients with manic episodes.

Main Methods:

  • A 5-week, double-blind, controlled trial was conducted.
  • Participants included patients diagnosed with bipolar I disorder, manic type, or schizoaffective disorder, manic type.
  • Treatment arms were haloperidol plus phenytoin versus haloperidol plus placebo.

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Main Results:

  • Patients receiving phenytoin showed significantly greater improvement in manic symptoms.
  • Phenytoin demonstrated added benefit in improving scores on the Brief Psychiatric Rating Scale and Clinical Global Impression in bipolar mania patients.
  • No significant added benefit of phenytoin was observed in patients with schizoaffective mania.

Conclusions:

  • Voltage-activated sodium channel blockade may represent a common therapeutic mechanism for anticonvulsants used in treating mania.
  • Phenytoin emerges as a potential therapeutic option for managing mania in select patient populations, particularly those with bipolar I disorder.