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Verapamil in treatment-resistant mania: an open trial

Insights

Verapamil did not improve acute mania or hypomania in a small study. However, it showed potential for prophylactic use and managing persistent hypomania, warranting further investigation.

Area of Science:

  • Psychiatry
  • Pharmacology

Background:

  • Lithium is a primary treatment for mania.
  • Some patients exhibit mania unresponsive to lithium.

Observation:

  • An open study investigated verapamil for lithium-unresponsive mania.
  • Fourteen patients with mania or hypomania participated.

Findings:

  • Verapamil showed no efficacy in acute manic or hypomanic episodes.
  • Four patients experienced dysphoria, with two transitioning to depression.
  • Prophylactic verapamil use yielded mild to clear positive responses in two patients.
  • Verapamil helped two patients with persistent pharmacological hypomania achieve euthymia while on antidepressants.

Implications:

  • Verapamil may not be suitable for acute mania treatment.
  • Verapamil shows promise as a prophylactic agent for mania/hypomania.
  • Further controlled trials are needed to confirm verapamil's efficacy in preventing pharmacological mania/hypomania.

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