SUPERIORITY OF LITHIUM OVER VERAPAMIL IN MANIA - A RANDOMIZED, CONTROLLED, SINGLE-BLIND TRIAL

Background: Both case reports and small controlled studies suggest the efficacy of verapamil in the treatment of mania. Method: Forty patien ts with DSM-IV mania were studied in a 28-day randomized, controlled, single-blind trial of either lithium or verapamil. Results: The patien ts receiving lithium showed a significant improvement on all rating sc ales (Brief Psychiatric Rating Scale [BPRS], Mania Rating Scale [MRS], Global Assessment of Functioning [GAF], and Clinical Global Impressio n [CGI]) compared with those receiving verapamil. The mean MRS score a t 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.