Treatment of mixed mania

The Lithium Ion: A Foundation for Psychopharmacological Specificity

“…In typical "pure" manic states, lithium is usually very effective, with response rates varying from 60 to 90% (Himmelhoch et al 1976;Secunda et al 1985;Swann et al 1986;Prien et al 1988a;Dilsaver et al 1993). However, about 40% of manic patients present with a mixed picture, with a combination of manic and depressive symptoms (Himmelhoch et al 1976;McElroy et al 1992a).…”

“…However, about 40% of manic patients present with a mixed picture, with a combination of manic and depressive symptoms (Himmelhoch et al 1976;McElroy et al 1992a). These patients tend to have poorer response rates to lithium, varying from 29 to 42% (Himmelhoch et al 1976;Secunda et al 1985;Swann et al 1986;Prien et al 1988a;Dilsaver et al 1993). Mania secondary to known medical conditions is also associated with poor response (Krauthammer and Klerman 1978).…”

Diagnóstico e tratamento dos estados mistos

“…The response to traditionally efficient treatments for acute mania have presented worse results for MS both in the short-and in the long-term (Prien et al 43 , Goldberg et al 44 and Montgomery et al 45 ). The first step in the treatment of MS is the withdrawal of all mood-increasing substances 46 .…”

“…27 Poor response does not seem to be related to the severity of the condition, but to the presence of mixed characteristics. 43 46,[53][54] ). ECT: It is a good treatment for acute episode (Small et al, 55 Dilsaver et al 47,51 ).…”

“…Lithium 1. Lithium MS is a predictor of bad response to lithium, 43,[46][47] and it fails to treat manic symptoms and improves depressive and cognitive symptoms. 27 Poor response does not seem to be related to the severity of the condition, but to the presence of mixed characteristics.…”