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Superiority of lithium over verapamil in mania: a randomized, controlled, single-blind trial
1Department of Psychiatry, University of the Witwatersrand Medical School, Johannesburg, South Africa.
Background:
Both case reports and small controlled studies suggest the efficacy of verapamil in the treatment of mania.
Method:
Forty patients with DSM-IV mania were studied in a 28-day randomized, controlled, single-blind trial of either lithium or verapamil.
Results:
The patients receiving lithium showed a significant improvement on all rating scales (Brief Psychiatric Rating Scale [BPRS], Mania Rating Scale [MRS], Global Assessment of Functioning [GAF], and Clinical Global Impression [CGI]) compared with those receiving verapamil. The mean MRS score at Day 28 in the lithium group was significantly lower than that in the verapamil group (17.47 vs. 24.43, respectively; F = 6.17, df = 1, p = .018). A similar pattern was seen with the BPRS (12.68 vs. 20.57; F = 10.69, df = 1, p = .002), CGI (2.31 vs. 3.33; F = 6.05, df = 1, p = .019), and GAF (43.52 vs. 52.31; F = 4.36, df = 1, p = .044) (ANCOVA).
Conclusion:
This study suggests that lithium is superior to verapamil in the management of acute mania.