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Abstract

ADJUNCT ALLOPURINOL TO SODIUM VALPROATE AND HALOPERIDOL IN TREATMENT OF IN-PATIENTS WITH ACUTE BIPOLAR MANIA

Gita Sadighi, Sahel Hemmati Gorgani, Reza Daneshmand, Sanaz Pajoom and Mercedeh Samiei*

ABSTRACT

Objectives: There is only limited previous evidence for the management of mania to shorten the in-patient phase of treatment, reduce costs and prevent recurrence of the episodes, as well as causing fewer side effects and enhance patient’s compliance. The main objective of the present study was to investigate effectiveness of Allopurinol adjunct treatment for the acute mania episode of bipolar disorder and determine whether this treatment is effective in relieving acute mania symptoms. Methods: This study was a double-blind randomized clinical trial, 70 bipolar patients in manic episode were treated with Allopurinol and Sodium valproate and Haloperidol versus Sodium valproate and Haloperidol plus placebo, and treatment responses were assessed on a weekly basis for 4 weeks, by Young Mania Rating Scale (YMRS). Results: YMRS score did not have statistically significant difference between intervention and control groups at the baseline. In both groups, YMRS score had significant decrease within 4 weeks (p<0.001), and a statistically significant difference was obtained between the two groups(p<0.001). The most decline in YMRS score was observed within 4 weeks of treatment. Conclusion: In the light of reported findings, it is conceivable that combination of Sodium Valproate and adjunct Allopurinol added to the routine pharmacotherapy regimen of acute mania treatment, could significantly improve most patient’s symptoms, since Allopurinol reduced the severity and duration of acute mania symptoms. On the other hand, these findings confirm the role of purinergic system malfunction in developing Mania.

Keywords: Bipolar Disorder, Allopurinol, Sodium Valproate, Mania, Haloperidol, Young Mania Rating Scale (YMRS).


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