Intravenous fosphenytoin in acute mania.

Abstract

OBJECTIVES:

Since several anticonvulsants are therapeutic in mania and since acute mania requires rapid and intensive treatment, we hypothesized that intravenous high-dose phenytoin might be acutely antimanic. A new prodrug of phenytoin, fosphenytoin, which has few cardiac or local vein side effects, was used to test this hypothesis.

METHOD:

Seven patients with a DSM-IV manic episode and minimal prior drug treatment were given intravenous fosphenytoin and were assessed at baseline and after 15, 30, 45, and 60 minutes with the Young Mania Rating Scale, the Clinical Global Impressions scale, and the Mini-Mental State Examination. Data were gathered in 2002.

RESULTS:

No antimanic effects were observed. No subject had any clear improvement in manic symptoms on the YMRS at any timepoint assessed.

CONCLUSION:

Intravenous fosphenytoin at doses that are effective in status epilepticus appears to be ineffective in acute mania.

• Authors: Julia Applebaum, Joseph Levine, R H Belmaker
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 64 Issue 4 Pg. 408-9 (Apr 2003) ISSN: 0160-6689 [Print] United States
• PMID: 12716241 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Prodrugs
• Phenytoin
• fosphenytoin

Topics

• Acute Disease
• Adult
• Bipolar Disorder (diagnosis, drug therapy)
• Drug Administration Schedule
• Female
• Humans
• Infusions, Intravenous
• Male
• Maximum Tolerated Dose
• Middle Aged
• Phenytoin (analogs & derivatives, therapeutic use)
• Prodrugs (therapeutic use)
• Psychiatric Status Rating Scales