This work may not be copied, distributed, displayed, published, reproduced, transmitted, modified, posted, sold, licensed, or used for commercial purposes. By downloading this file, you are agreeing to the publisher’s Terms & Conditions.

Original Research

Intravenous Fosphenytoin in Acute Mania

Julia Applebaum, MD; Joseph Levine, MD; and R. H. Belmaker, MD

Published: April 15, 2003

Article 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.

Volume: 64

Quick Links:

Continue Reading…

Subscribe to read the entire article


Buy this Article as a PDF