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Report of the Veterans Administration and National Institute of Mental Health Collaborative Study Group

Robert F. Prien, PhD; Eugene M. Caffey, Jr., MD; C. James Klett, PhD

Arch Gen Psychiatry. 1972;26(2):146-153.

Abstract
In an 18-hospital collaborative study, 255 newly admitted manic patients were randomly assigned to lithium carbonate or chlorpromazine for a three-week period. Patients were classified as highly active or mildly active on the basis of degree of motor activity shown at admission. Treatments were compared in terms of early terminations, symptom change, and toxicity. The following results were obtained: (1) Chlorpromazine was clearly superior to lithium carbonate in treating the highly active patient. Chlorpromazine acted more quickly, produced significantly fewer dropouts, and had a lower incidence of severe side effects. (2) The difference between lithium carbonate and chlorpromazine was less pronounced among mildly active patients. Lithium carbonate, however, appeared to be the better treatment. Both drugs effectively reduced manic symptomatology but lithium carbonate left the patient feeling less sluggish and fatigued. Lithium carbonate also produced fewer severe side effects than chlorpromazine.

Author Affiliations
Perry Point, Md; Washington, DC; Perry Point, Md

From the Central Neuropsychiatric Research Laboratory, Veterans Administration Hospital, Perry Point, Md (Drs. Prien and Klett) and the Psychiatry Division, Psychiatry, Neurology, and Psychology Service, Department of Medicine and Surgery, Veterans Administration, Washington, DC (Dr. Caffey).

Footnotes
Accepted for publication Aug 19, 1971.

Reprint requests to Central Neuropsychiatric Research Laboratory, Veterans Administration Hospital, Perry Point, Md 21902 (Dr. Prien).

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