A combination treatment with a mood stabilizer and an
antipsychotic drug is often used in as many as 90% of subjects with acute
mania. Recently, augmentation
therapy with atypical
antipsychotics has been investigated in both the acute and long-term treatment of
bipolar disorder with or without
psychosis. In the present study, the authors investigated the efficacy of
risperidone treatment for both acute manic and depressive episodes in
bipolar disorder. Eighteen patients (M/F: 8/10, age: 34 +/- 15 yr) who met the DSM-IV criteria for bipolar I disorder (12 cases of
manic episodes, 6 cases of depressive episodes) with
risperidone treatment were evaluated regarding their clinical improvement using the Young
Mania rating Scale (YMRS) and the Hamilton rating Scale for Depression (Ham-D). Plasma concentrations of HVA and
MHPG were analyzed by HPLC-ECD and plasma
brain-derived neurotrophic factor (
BDNF) levels were detected by sandwich ELISA. The mean scores of the YMRS were 22, 18, 12, 8, and 5 at time points before and 1, 2, 3, and 4 weeks after the
risperidone administration, respectively. The mean scores of the Ham-D were 24, 25, 21, 21, and 19 at time points before and 1, 2, 3, and 4 weeks after the
risperidone administration, respectively. The plasma levels of HVA and 3-methoxy-4-hydroxyphenylglycol (
MHPG) were observed to have decreased 4 weeks after
risperidone administration in manic patients. The levels did not change in depressive patients. The plasma levels of
BDNF were decreased in depressive patients compared with manic patients or healthy controls. However, the administration of
risperidone did not alter plasma
BDNF levels.