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Depressive mania associated with nonresponse to antimanic agents
S C Dilsaver1, A C Swann, A M Shoaib
1Harris County Psychiatric Center, Department of Psychiatry and Behavioral Sciences, University of Texas School of Medicine, Houston 77021.
The American Journal of Psychiatry
|October 1, 1993
Summary
Patients with "depressive" mania, a subtype of bipolar disorder, show a lower response rate to antimanic drugs compared to those with pure mania. This highlights the distinct and more severe nature of mixed states in bipolar disorder.
Area of Science:
- Psychiatry
- Neuroscience
- Clinical Psychology
Background:
- Primary mania is a severe mental health condition characterized by elevated mood and energy.
- The presence of depressive symptoms alongside mania, termed "mixed" or "depressive" mania, complicates diagnosis and treatment.
- Understanding treatment response in different mania subtypes is crucial for effective patient care.
Purpose of the Study:
- To investigate the treatment response rates of antimanic agents in patients with primary mania.
- To compare the efficacy of antimanic drugs in patients with pure mania versus those with depressive mania.
Main Methods:
- A cohort of 39 patients admitted for primary mania treatment was analyzed.
- Patients were assessed for the simultaneous presence of major depressive disorder criteria (depressive mania).
- Response to antimanic agents was recorded and compared between the depressive mania and pure mania groups.
Main Results:
- Over half of the patients (53.8%) presented with depressive mania.
- Only 42.9% of patients with depressive mania responded to antimanic agents.
- In contrast, 88.9% of patients with pure mania responded to the same treatments.
Conclusions:
- Depressive mania demonstrates a significantly lower response rate to antimanic agents compared to pure mania.
- The findings support the notion that mixed states of mania represent a more severe and treatment-resistant form of the disorder.
- Further research into targeted therapies for depressive mania is warranted.