Lithium plus reserpine in refractory manic patients

The authors report on six refractory manic or schizo-affective manic male outpatients who failed to respond to lithium combined with a neuroleptic. A beneficial response was noted in most patients when reserpine was substituted for their currently prescribed standard neuroleptic; in some cases lithium dosage could then be reduced. No major side effects were encountered. The use of reserpine may offer an alternative mode of therapy for manic patients who cannot tolerate large doses of lithium or do not completely respond to lithium either alone or in combination with a standard neuroleptic.