Treatment of manic episodes in Scandinavia: the use of neuroleptic drugs in a clinical routine setting

To provide longitudinal data on the treatment of acute mania with neuroleptics in a routine setting, 125 consecutively admitted manic patients were examined. Out of the 125 patients, 111 (89%) were primarily treated with neuroleptics during the index episode, and a substantial use of drug combinations was observed. Of the 111 patients, 27% were still hospitalized and in a manic state after 10 weeks. Our results indicate that treatment under routine conditions is an outcome variable which is determined by the severity and persistence of the manic symptoms. If typical neuroleptics are used as first choice antimanic agents, dosages can be minimized by the concomitant use of a benzodiazepine. In non-responders, a mere shift from one neuroleptic to another does not seem rational, so to improve outcome, a mood stabilizer should be added.