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- Title
The efficacy of Adding Folic Acid to Sodium Valproate in treating patients with Acute Mania.
- Authors
Rad, Peyman; Derakhshanpoor, Firoozeh
- Abstract
Background and purpose: Acute mania attack in type 1 bipolar disorder (BMD I) is a serious psychiatric emergency with adverse and personal and social adverse effects. Several clinical studies have also been conducted on the role of folic acid in mood disorders. These studies have shown that not only depression symptoms are the most common neuropsychiatric manifestations of folate deficiency, but also many patients with major depression and both bipolar disorder have low serum folate concentrations. Studies on the efficacy of this folic acid regimen are very limited in the treatment of mania in patients with bipolar disorder. Therefore, the aim of this study was to determine the effect of simultaneous use of folic acid and sodium valproate in the treatment of acute mania in patients referred to the Gorgan-Azad hospital in 2017-2018. Materials and methods: In this clinical trial study, 60 patients with inclusion criteria and no exclusion criteria will be included in the study. In both case and control groups, sodium valproate starts at 400 mg / day and at most up to 20 mg / kg / day or the highest dose that the patient can withstand will increase. In addition to sodium valproate, the case group will receive one tablet of folic acid 5 mg daily and the control group will receive one placebo tablet (lacking medicinal properties). Since the study is designed in a blind way, therapists and prescribing nurses do not know the type of medication prescribed to patientsall of the patients at the beginning of the study, at the end of the third week and at the end of the sixth week, tested with Young Mania Rating Scale (YMRS) and Mini-mental state examination -1. Results: Of the 49 patients under study, in folic acid group 11 (45.8%) cases were male and 13 (54.2%) were female. In the placebo group, 12 (48%) were male and 13 (52%) were male. The mean age of folic acid group was 35.12 ± 10.97 and in the placebo group was 34.00 ± 7.98 years. The mean score of Mini-mental state examination- 1 test at the beginning and the third week was not statistically significant between the two groups, but at the end of the sixth week, there was a significant difference in the folic acid treated group compared to the placebo group (p = 0.0001) Mean Young Mania Rating Scale scores did not differ significantly between the two groups at the beginning, but at the end of the third and sixth weeks, there was a significant decrease in the folic acid treated group compared to the placebo group (0.0001 = p) In the group treated with folic acid, the reduction in the Young Manic Test score was significantly higher than the placebo group. (P = 0.0001), which was significantly lower among men and age more than 33 years of age. (P = 0.0001) Conclusion: Highly folic acid (5 mg / day) supplementation in patients with type 1 bipolar disorder in a manic phase that is treated with sodium valproate is recommended at least six weeks after the onset of treatmentand due to the lack of a negative effect on the cognitive problems of patients and the absence of significant side effects, it can be used as an adjuvant for the treatment of acute mania.
- Subjects
FOLIC acid; VALPROIC acid; MINI-Mental State Examination; MANIA; HYPOMANIA; BIPOLAR disorder; AFFECTIVE disorders
- Publication
Iranian Journal of Psychiatry & Behavioral Sciences / Progress in Psychiatry & Behavioral Sciences, 2018, p176
- ISSN
1735-8639
- Publication type
Article