Comparative Study of Electrocardiographic Changes in Patients of Acute Mania Receiving Verapamil or Lithium Carbonate

Abstract

Aim: TO compare the ECG changes in patients of acute mania receiving verapamil and lithium carbonate. Objectives: Verapamil used in resistant manic patients not responding to any drug therapy, should be considered for its side effects on cardiovascular system. It causes bradycardia and myocardial infarction in risk patients. So it is important to take clinical and other relevant history and do ECG before the patient to put on verapamil drug therapy. Materials and Methods: Patients with acute mania were randomized to receive lithium (n =25) or verapamil (n=25) in a 4-wk double-blind comparative study. Both groups were homogeneous with regard to demographic and disease variables. After giving first dose of verapamil, patients were observed for any cardiovascular side effects and ECG changes during the study. The study parameters were recorded at the baseline, after 7 d and 28 d of trial medication. Statistical Analysis: The Unpaired t-test was used for comparing baseline data in two groups and paired t-test was used for the interval data. A level of less than 5% value of p was considered statistically significant. Results: Both treatment groups showed no major differences in ECG changes during the trial except for the heart rate and T wave changes. The study showed that verapamil produces more bradycardia and decrease in T wave amplitude than with lithium in the treatment of mania. Conclusion: The baseline electrocardiogram should be done and heart rate should be monitored during the treatment.

Keywords

• bradycardia
• cardiovascular effects
• heart rate
• hypotension