{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:26:32Z","timestamp":1777857992924,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2008,6,26]],"date-time":"2008-06-26T00:00:00Z","timestamp":1214438400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Psychopharmacol"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:p>The psychopathologies underlying affective disorders are thought to involve persistent changes in the expression and function of both mineralocorticoid receptors and glucocorticoid receptors in the hippocampus. In addition, exposure to stressful stimuli can precipitate episodes in vulnerable individuals. The aim of this study is to determine if spironolactone as an adjunctive therapy is effective in improving residual symptoms in bipolar disorder. Four cases of euthymic bipolar disorder (BD) patients were treated with spironolactone as an adjunctive therapy in a private treatment sector. All patients met the DSM-IV diagnosis criteria for bipolar disorder. Clinical response was assessed retrospectively using the Clinical Global Impression Scale for Improvement. Spironolactone was effective in all patients. The four cases illustrate a clinical response to residual symptoms and improvement in stress response after use of spironolactone as an adjunctive therapy in BD. This pilot case series suggests reducing in residual symptoms, with spironolactone as an adjunctive therapy in these DSM-IV BD patients. Mineralocorticoid receptors antagonists\u2019 role in reducing stress-induced symptoms deserves further investigation through placebo-controlled trials.<\/jats:p>","DOI":"10.1177\/0269881108092121","type":"journal-article","created":{"date-parts":[[2008,6,26]],"date-time":"2008-06-26T20:54:22Z","timestamp":1214513662000},"page":"985-987","source":"Crossref","is-referenced-by-count":31,"title":["Improved stress response in bipolar affective disorder with adjunctive spironolactone (mineralocorticoid receptor antagonist): case series"],"prefix":"10.1177","volume":"23","author":[{"given":"MF","family":"Juruena","sequence":"first","affiliation":[{"name":"Section of Neurobiology of Mood Disorders and Stress, Psychiatry and Immunology Lab, Institute of Psychiatry, King's College\/University of London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CS","family":"Gama","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina: Psiquiatria, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre, RS, Brazil, , Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Berk","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biomedical Sciences, Barwon Health, University of Melbourne, Geelong, Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PS","family":"Belmonte-de-Abreu","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina: Psiquiatria, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre, RS, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2008,6,26]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2249.2003.02249.x"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4001981"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.1177\/026988119100500414"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1038\/nrn1683"},{"key":"atypb5","first-page":"269","volume":"19","author":"de Kloet, ER","year":"1998","journal-title":"Endocr Rev"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4530(00)00006-8"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1601-5215.2003.00051.x"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-006-0555-4"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(97)00484-8"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1016\/S0893-133X(99)00129-3"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2003.02025.x"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2007.11.067"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1210\/endo-117-6-2505"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1159\/000054410"},{"key":"atypb15","first-page":"143","volume":"137","author":"Storey, JD","year":"2002","journal-title":"Br J Pharmacol"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4001139"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.1.24"}],"container-title":["Journal of Psychopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269881108092121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0269881108092121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:05:23Z","timestamp":1777507523000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0269881108092121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,6,26]]},"references-count":17,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2009,11]]}},"alternative-id":["10.1177\/0269881108092121"],"URL":"https:\/\/doi.org\/10.1177\/0269881108092121","relation":{},"ISSN":["0269-8811","1461-7285"],"issn-type":[{"value":"0269-8811","type":"print"},{"value":"1461-7285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,6,26]]}}}