Verapamil for Mania in Bipolar Disorder

Verapamil for Mania in Bipolar Disorder Bipolar Disorder Treatment Medications Print Verapamil for Mania in Bipolar Disorder The Scarce Science Behind the Calcium Channel Blocker By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Updated on May 14, 2019 Bipolar Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Your Rights Peter Dazeley/Getty Images Verapamil, a type of calcium channel blocker, was studied years ago as a therapy for manic episodes in people with bipolar disorder. That being said, the scientific data behind it is scarce and controversial, meaning some studies have found a benefit and others have not. Regardless, its not a typical or standard medication used by psychiatrists in treating bipolar disorder. Lets examine the scientific history behind using verapamil and other calcium channel blockers in bipolar disorder. What Are Calcium Channel Blockers? Calcium channel blockers affect the movement of calcium into cells of the heart and blood vessels, relaxing the blood vessels and increasing the supply of blood and oxygen to the heart. They are generally used to treat high blood pressure, arrhythmia (irregular heartbeats) and angina pectoris (heart-related chest pain). The main calcium channel blocking agents that have been examined as potential therapies for bipolar disorder, especially with manic episodes include: Verapamil - Brand names Calan, Isoptin SRNimodipine - Brand name NimotopDiltiazem - Brand names Cardizem, Cartia XT, Dilacor XR, Tiazac Verapamil Benefits and Side Effects Regarding its potential benefit, one 2002 study in Biological Psychiatry examined 11 women with either mania or mixed symptoms of depression and mania. Of these 11 women, 9 of them showed a positive response or improvement in their mania after being treated with verapamil. In a 2008 study in Bipolar Disorders, verapamil alone did not improve manic episodes, but when combined with lithium, it did. That being said, the study was still small, with only 10 patients taking the combination of verapamil and lithium. The author did note too that any person taking a combination of verapamil and lithium needs to be monitored closely, as there is a possibility of serious side effects like: Worsening of lithium side effectsChoreoathetosis â€" involuntary movementsSlow heart rate with a possible heart attackProblems with coordination Nimodipine One 2002 case study in the American Journal of Obstetrics and Gynecology reported on the successful use of nimodipine in a woman who was pregnant. She was unable to tolerate a more traditional mood stabilizer, lithium. Also, according to an older study in Bipolar Disorders, nimodipine may be useful for people with bipolar disorder who do not respond to traditional medications, especially those with ultra-rapid-cycling and brief recurrent depressive episodes. Diltiazem In a small 2000 study in the Journal of Psychiatry and Neuroscience, of eight patients with treatment-resistant bipolar disorder, there was a decrease in both their manic and depressive episodes after taking diltiazem. That being said, there were some problems with the design of the study. For instance, the patients were taking other medications other than diltiazem, and it was small. What Does This All Mean? Its important to understand that calcium channel blockers are not typical medications for mania â€" as evidenced by the fact that there are few studies on them. With that, its unclear at this time what the future role of calcium channel blockers will be in treating the mania of bipolar disorder. It may be that its used in combination with other mood stabilizers when a person is not responding to the mood stabilizer alone or other combinations of medications.