Comparison of clinical efficacy of carbamazepine and haloperidol as adjuncts to lithium in patients with acute manic phase: A double-blind clinical trial
Bibliographic record
Abstract
There is abundant evidence that the efficacy of the carbamazepine-lithium combination in acute manic episodes is comparable to that of other custom medications (e.g., a haloperidol-lithium combination). The aim of the current investigation was to compare the clinical efficacy and side effects of lithium combined with carbamazepine versus lithium combined with haloperidol and biperiden in patients with bipolar disorder. In the present study, 24 patients in an acute manic phase were randomly assigned to receive either lithium-carbamazepine (Li-CBZ) or lithium-haloperidol (Li-Hal) combinations for 8 weeks. Clinical (including ESRS, MRS, CBZ side effect profile, and HAM-D) and laboratory measurements were regularly performed on all patients. Both therapeutic regimens were effective in alleviating manic symptoms, whether psychotic features were present or not (p<.001). However, there was a faster response to treatment for the Li-CBZ group compared to the Li-Hal group, as revealed by a lower mean MRS score on day 14 in the former group (p=.018). HAM-D scores revealed significantly better outcomes for the Li-CBZ group. A higher mean HAM-D score on day 56, as well as a higher mean alteration in HAM-D scores throughout the study period, were noted in the Li-Hal group (p=.008 and p=.011, respectively). Dropouts in the Li-Hal group were considerable due to noncompliance resulting from neuroleptic-induced side effects (depressive and extrapyramidal). Similarly, several subjects in the Li-CBZ group had to end the study prematurely as a result of developing side effects for which drug discontinuation is indicated. It may be prudent to reevaluate neuroleptic medications in manic patients, specifically for long-term management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".