Treatment of severe mania with intravenous magnesium sulphate as a supplementary therapy

Ten patients with severe, therapy-resistant manic agitation received magnes ium sulphate infusions with a continuous magnesium (Mg) flow of approximate ly 200 mg/h (4353 +/- 836 mg/day; daily monitored Mg plasma level: 2.44 +/- 0.34 mmol/l) for periods ranging from 7 to 23 days. Concomitant psychotrop ic treatment consisted of lithium (n = 10), haloperidol (n = 5) and clonaze pam (n = 10). During i.v. Mg treatment the mean values of the maximum dosag es of neuroleptics (in chlorpromazine equivalents) and benzodiazepines (in diazepam equivalents) were significantly lower than during the last day of pretreatment (=baseline). Seven patients showed a marked improvement in the Clinical Global Impression scale. In case of bradycardia detected by the E CG monitor (n = 5), Mg flow was reduced and bradycardia disappeared promptl y. Mg i.v. may be a useful supplementary therapy for the clinical managemen t of severe manic agitation. This open study needs double-blind confirmatio n. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.