[Phase prevention in bipolar affective disorder with nimodipine. A case report]

A 56-year-old female patient had a history of more than 10 years' duration of a bipolar affective disorder manifest mainly as depressive episodes. These episodes used to occur once or twice each year, frequently leading to hospital admission. On average, the episodes lasted for about 2 months, and they tended to be followed by brief periods of hypomania. Only once, in 1986, did a manic episode make hospitalization necessary. Attempted prophylaxis with lithium at therapeutic plasma levels did not prove effective. Treatment with carbamazepine was discontinued because of leukopenia. The most recent stay in hospital became necessary because of a depressive episode that lasted for 5 months and did not respond to therapy. On admission the patient's score on the Hamilton depression scale was 23. When the calcium antagonist nimodipine was given at a dosage quickly escalated to 360 mg daily, the patient could be discharged in a state of complete remission after 26 days. For the first time in many years she has been emotionally stable for almost 1 year with single agent nimodipine therapy at 180 mg daily.