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In this clinical trial, we evaluated the effectiveness of spironolactone in controlling mood and cognitive symptoms, sleep quality, appetite, and body mass index in patients with bipolar disorder in manic episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty inpatients with bipolar disorder in manic episodes were treated with spironolactone\/placebo in an 8\u2010week randomized, double\u2010blind, placebo\u2010controlled clinical trial. They were evaluated using the Young Mania Rating Scale (YMRS), mini\u2010mental state examination (MMSE), Pittsburgh sleep quality index, Simplified Nutritional Appetite Questionnaire, and body mass index in weeks 1, 4, and 8.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For cognitive impairment (MMSE), there were significant interaction effects of group and time at week 8 (B\u00a0=\u00a0\u22121.60, SE\u00a0=\u00a00.69,\n                      <jats:italic>t<\/jats:italic>\n                      \u00a0=\u00a0\u22122.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.021) such that individuals in the spironolactone group experienced more improvement in their cognitive performance. For manic symptoms (YMRS), there were no significant interaction effects of group and time at week 8 (B\u00a0=\u00a0\u22122.53, SE\u00a0=\u00a01.46,\n                      <jats:italic>t<\/jats:italic>\n                      \u00a0=\u00a0\u22121.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.085).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Considering the promising findings in this clinical trial, further study of spironolactone as adjunctive therapy in bipolar disorder in manic episodes with larger sample sizes, multicenter settings, and longer follow\u2010ups are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.3313","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T01:34:20Z","timestamp":1699320860000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar\u2010I disorder: A double\u2010blind, randomized, placebo\u2010controlled clinical trial"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4725-1734","authenticated-orcid":false,"given":"Atefeh","family":"Zandifar","sequence":"first","affiliation":[{"name":"Social Determinants of Health Research Center Alborz University of Medical Sciences  Karaj Iran"},{"name":"Department of Psychiatry, Imam Hossein Hospital, School of Medicine Alborz University of Medical Sciences  Karaj Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9808-1678","authenticated-orcid":false,"given":"Rahim","family":"Badrfam","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Imam Hossein Hospital, School of Medicine Alborz University of Medical Sciences  Karaj Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatemeh","family":"Gholamian","sequence":"additional","affiliation":[{"name":"School of Medicine Alborz University of Medical Sciences  Karaj Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1941-4399","authenticated-orcid":false,"given":"Arman","family":"Shafiee","sequence":"additional","affiliation":[{"name":"Clinical Research Development Unit Alborz University of Medical Sciences  Karaj Iran"},{"name":"Student Research Committee, School of Medicine Alborz University of Medical Sciences  Karaj Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.15321"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0306\u20104530(76)90009\u20103"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0101\u201081082005000200008"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.5866"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902\u2010022\u201001143\u2010y"},{"issue":"3","key":"e_1_2_11_7_1","article-title":"Mini\u2010Mental State Examination (MMSE) for the detection of Alzheimer's disease and other dementias in people with mild cognitive impairment (MCI)","volume":"2015","author":"Arevalo\u2010Rodriguez I.","year":"2015","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974\u2010020\u20101724\u20109"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2020.104705"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2023.04.013"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","unstructured":"Bates D. 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