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Dysphoric mania.

J Clothier¹, A C Swann, T Freeman

¹Department of Psychiatry and Behavioral Sciences, University of Arkansas Medical School, Little Rock 72205-7199.

Journal of Clinical Psychopharmacology

|February 1, 1992

Summary

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Lithium is a common bipolar disorder treatment, but valproate may be better for patients with higher depression scores. Mixed states showed equal response to both lithium and valproate.

Area of Science:

Psychiatry
Pharmacology
Neuroscience

Background:

Lithium is a primary treatment for bipolar disorder.
Patients with mixed states or dysphoria often respond poorly to lithium.
Predicting treatment response based on illness characteristics is crucial.

Purpose of the Study:

To compare lithium and valproate efficacy in bipolar mania.
To identify predictors of positive response to lithium or valproate.

Main Methods:

Double-blind, parallel-group study.
27 patients with bipolar disorder.
Comparison of lithium versus valproate for mania control.

Main Results:

Valproate responders had higher pretreatment depression scores than nonresponders.

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Patients with depressed mood/anxiety in mixed states responded similarly to lithium and valproate.

Significant differences observed between valproate responders and nonresponders.

Conclusions:

Higher depression scores may predict valproate response in bipolar disorder.
Lithium and valproate show comparable efficacy for mixed states with depressed mood or anxiety.
Further research is needed to clarify mixed/dysphoric states and validate treatment predictors.