Abstract

Investigations of drug therapy regimens in the treatment of acute mania are rare, selective, methodically problematic, and contradictory. The goal of the present study is to describe the practice of mania treatment in a large unselected collective of patients for the first time, and, following reduction of the data to global parameters such as length of stay, neuroleptic daily and total doses, to determine sources of variance and the strength of their effects by means of explorative data analysis. In contrast to widely held opinions, neuroleptics are used as primary medication in all grades of severity of manic illness. The daily dose comprises 496 +/- 379 mg of chlorpromazine (CPZ) equivalents; this result supports the first dose determination study and is at odds with other studies with much higher dosages. The amount of mean daily medication is only influenced by the severity of illness according to variance analysis, the effect is moderately strong. Neuroleptics appear to have causal effects, a property that has so far only been attributed to prophylactic medication, which is given in 80% of cases; the different application forms have no effect on the neuroleptic dosage, although they do affect the length of stay slightly. The mean length of stay is 46.6 +/- 35.7 days and is slightly affected by age, sex, severity of illness and compliance.