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Many patients with bipolar illness do not respond adequately to the limited treatments currently available. Two research groups now present data on novel adjunctive treatments, one for mania and one for depression.
Bartoli and colleagues performed a meta-analysis of five randomized, placebo-controlled efficacy studies of allopurinol — a xanthine oxidase inhibitor and gout treatment — as an addition to mood-stabilizer treatment. Study length ranged from 4 to 8 weeks. Of the 433 randomized patients, about three fourths completed the treatment. Allopurinol (300–600 mg daily) was superior to placebo, with a small effect size on the Young Mania Rating Scale. Dosage, follow-up length, and mood stabilizer used did not affect results, but mixed epis…