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J Clin Psychiatry. 1996 Nov;57(11):543-6.

Superiority of lithium over verapamil in mania: a randomized, controlled, single-blind trial.

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  • 1Department of Psychiatry, University of the Witwatersrand Medical School, Johannesburg, South Africa.



Both case reports and small controlled studies suggest the efficacy of verapamil in the treatment of mania.


Forty patients with DSM-IV mania were studied in a 28-day randomized, controlled, single-blind trial of either lithium or verapamil.


The patients receiving lithium showed a significant improvement on all rating scales (Brief Psychiatric Rating Scale [BPRS], Mania Rating Scale [MRS], Global Assessment of Functioning [GAF], and Clinical Global Impression [CGI]) compared with those receiving verapamil. The mean MRS score at 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).


This study suggests that lithium is superior to verapamil in the management of acute mania.

[PubMed - indexed for MEDLINE]
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