A four week randomised control trial of adjunctive medroxyprogesterone and tamoxifen in women with mania

Psychoneuroendocrinology. 2014 May;43:52-61. doi: 10.1016/j.psyneuen.2014.02.004. Epub 2014 Feb 14.

Abstract

Emerging research has suggested that hormone treatments such as selective oestrogen receptor modulators (SERMs) or progestins may be useful in the treatment of mania. The current pilot study compared the use of the SERM tamoxifen and the progestin medroxyprogesterone acetate (MPA), as an adjunct to mood stabiliser medications, for the treatment of mania symptoms in 51 women in a 28-day double blind, placebo controlled study. The primary outcome was the change between baseline and day 28 mania scores as measured by the Clinician Administered Rating Scale for Mania (CARS-M). Adjunctive MPA treatment provided greater and more rapid improvement in mania symptoms compared with adjunctive placebo and tamoxifen treatment. Adjunctive therapy with MPA may be a potentially useful new treatment for persistent mania, leading to a greater and more rapid resolution of symptoms compared with mood stabiliser treatment alone.

Keywords: Bipolar disorder; Mania; Medroxyprogesterone acetate; Schizoaffective disorder; Tamoxifen; Treatment.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / psychology
  • Double-Blind Method
  • Estrogen Antagonists / adverse effects
  • Estrogen Antagonists / therapeutic use*
  • Female
  • Gonadal Steroid Hormones / blood
  • Humans
  • Medroxyprogesterone / adverse effects
  • Medroxyprogesterone / therapeutic use*
  • Middle Aged
  • Protein Kinase C / antagonists & inhibitors
  • Selective Estrogen Receptor Modulators / adverse effects
  • Selective Estrogen Receptor Modulators / therapeutic use*
  • Tamoxifen / adverse effects
  • Tamoxifen / therapeutic use*
  • Treatment Outcome

Substances

  • Estrogen Antagonists
  • Gonadal Steroid Hormones
  • Selective Estrogen Receptor Modulators
  • Tamoxifen
  • Protein Kinase C
  • Medroxyprogesterone