Summary
Six manic patients were studied in an open sequential drug trial of placebo and the serotonin antagonist methysergide; lithium was then substituted double-blind. No dramatic change occurred in individual manic item scores or in mean daily mania ratings after 48 hours or seven days of methysergide, although several of the patients showed slight trends toward improvement. However, after a mean duration of 10.3 days of lithium treatment, all manic item scores improved dramatically and significantly, so that complete clinical remission was evident in all patients. In view of the discrepancy between these essentially negative findings and several recent positive reports on the efficacy of methysergide in the treatment of mania, the authors feel that the indolealkylamine hypothesis of affective disorders should be further investigated.
This is a preview of subscription content, log in via an institution to check access.
References
Dewhurst, W. G.: Methysergide in mania. Nature (Lond.) 219, 506–507 (1968).
—, and E. Marley: The effects of α-methyl derivatives of noradrenaline, phenylethylamine and tryptamine on the central nervous system of the chicken. Brit. J. Pharmacol. 25, 682–704 (1965a).
— —: Action of sympathomimetic and allied amines on the central nervous system of the chicken. Brit. J. Pharmacol. 25, 705–727 (1965b).
Fieve, R. R., S. R. Platman, and R. R. Plutchik: The use of lithium in affective disorders. Amer. J. Psychiat. 125, 487–498 (1968).
Haškovec, L., and K. Souček: Trial of methysergide in mania. Nature (Lond.) 219, 507–508 (1968).
Spitzer, R. L., J. Endicott, and J. L. Fleiss: Instruments and recording forms for evaluating psychiatric status and history: rationale, method of development and description. Comprehens. Psychiat. 8, 321–343 (1967).
Verster, J. P.: Preliminary report on the treatment of mentally disordered patients by intrathecally administered phenothiazine drugs and an antiserotonin substance. S. Afr. med. J. 37, 1086–1089 (1963).
Author information
Authors and Affiliations
Additional information
This study was performed at the New York State Psychiatric Institute Metabolic Research Unit. Dr. Fieve is Chief of Psychiatric Research, Department of Internal Medicine, and Dr. Fleiss is Biostatistician in the Department of Biometrics. Dr. Platman is currently with the Department of Psychiatry, Downstate Medical Center, Brooklyn, N. Y.
This work was supported in part by U. S. Public Health Service Grant No. MH-13450 from the National Institute of Mental Health.
Rights and permissions
About this article
Cite this article
Fieve, R.R., Platman, S.R. & Fleiss, J.L. A clinical trial of methysergide and lithium in mania. Psychopharmacologia 15, 425–429 (1969). https://doi.org/10.1007/BF00403718
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00403718