Combined haloperidol and electro convulsive therapy in the treatment of selected cases of mania

ABSTRACT

To compare efficacy of combined haloperidol and electro convulsive therapy [ECT] in the treatment of Mania in selected cases who are resistant to medication alone and are severely ill. Two groups of 20manic patients received eight ECT sessions either actual or simulated, in a double blind controlled study. All patients received 30mg of Haloperidol daily until the sixth treatment and subsequently dose of anti-psychotic medication was adjusted for individual patient according to level of improvement. Department of Psychiatry Jinnah Hospital, Lahore. Forty patients were included in the study between 1st July 1999 and 30th June 2000, the two groups did not differ significantly in any of the sociodemographic variables or any clinical variables as rated on Mania Rating Scale [MRS]4 and Brief Psychiatric Rating Scale [BPRS]19 before intake into the study and severity of index episode. At the end of eight sessions although 17 patients in the ECT group had made a complete recovery, in the simulated ECT group only one had recovered. Significantly more patients [16] in the simulated ECT group required an increase in anti-psychotic medication compared with the ECT group [two patients] [P < 0.05, Fisher's Exact Probability Test]. The results indicate that the group receiving the combination of Haloperidol and ECT did significantly better than the other group in severely disturbed patients. It is not recommended as routine procedure as modern antimanic drugs are affective in mania