The effect of reserpine on the duration of manic attacks.

Many authors, in advocating special treatments for mania, do not consider the duration of the illness but give instead the number or percentage of those recovered, improved, or unchanged. Smith, Hastings, and Hughes (1943), Ziskind, SomerfeldZiskind, and Ziskind (1945), and Schiele and Schneider (1949) advocate E.C.T. General experience with this treatment is that it must often be given intensively and relapses are frequent (Noyes, 1953; Mayer-Gross, Slater, and Roth, 1954; Sargent and Slater, 1948). Hennelly (1936), Kearney and Courtney (1938), and Wilson and Gillman (1938) recommend prolonged narcosis. Lithium is recommended by Cade (1949), Schou, Juel-Nielsen, Stromgren, and Voldby (1954), Glesinger (1954), and Rice (1956), chlorpromazine by Vaughan, Lieberman, and Cook (1955), and Kinross-Wright (1955). With each of these treatments about half the cases remitted during the period of treatment. As most attacks of mania are self-limiting, however, such results do not demonstrate the treatment's efficacy. The beneficial effect of reserpine on excited patients has been noted by several authors (Barsa and Kline, 1955; Sommerness, Lucero, Hamlon, Erickson, and Matthews, 1955; Altschule, 1956; Hes and Bracha, 1956). Its calming effect in mania, the illness most frequently characterized by excitement, is mentioned specifically by Colombati and Benassi (1954), Flach (1955), Glynn (1955), Kirkpatrick and Saunders (1955), Kinross-Wright (1955), Luttrell and Morrison (1955), Brooks (1956), Sarwer-Foner and Ogle (1956), and Zeller, Graffagnino, Cullen, and Rietman (1956). No author has yet measured its effect on the duration of manic attacks. The efficacy of particular treatments in mania cannot be estimated by the proportion of attacks issuing in " recovery " or " improvement," however. The majority terminate without special treatment and it is imperative, therefore, to take into account the duration of the attack which is, at present, the only measurable index of the treatment's effect. This is undertaken in the present study to make a more precise assessment of reserpine in the treatment of mania and to compare it with other treatments.