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    Am J Psychiatry. 2004 Jan;161(1):169-71.

    Double-blind comparison of the continued use of antipsychotic treatment versus its discontinuation in remitted manic patients.

    Zarate CA Jr, Tohen M.

    Consolidated Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, Mass, USA. zaratec@intra.nimh.nih.gov

    OBJECTIVE: The goal of this study was to determine the benefits of the continued use of a typical antipsychotic agent following remission from an acute manic episode. METHOD: Immediately following remission of a manic episode treated with the combination of a typical antipsychotic (perphenazine) and a mood stabilizer (lithium, carbamazepine, or valproate), 37 patients were randomly assigned to 6 months of double-blind treatment in which in addition to the mood stabilizer they received either continued perphenazine treatment or placebo. RESULTS: Patients randomly assigned to continue perphenazine treatment, relative to those who discontinued it, were more likely to have a shorter time to depressive relapse, discontinue the study, and have increased rates of dysphoria, depressive symptoms, and extrapyramidal symptoms. CONCLUSIONS: There were no short-term benefits with the continued use of a typical antipsychotic after achieving remission from an episode of acute mania. In fact, its continued use was associated with detrimental effects.

    PMID: 14702269 [PubMed - indexed for MEDLINE]

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    Patient drug information

    • Lithium (Eskalith CR®, Eskalith®, Lithobid®)

      Lithium is used to treat and prevent episodes of mania (frenzied, abnormally excited mood) in people with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and ...

    • Carbamazepine (Carbatrol®, Epitol®, Equetro®, ...)

      Carbamazepine is used alone or in combination with other medications to control certain types of seizures. It is also used to treat trigeminal neuralgia (a condition that causes facial nerve pain). Carbamazepine extended...

    • Perphenazine

      Perphenazine is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions). Perphenazine is also used to contr...