{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:45:06Z","timestamp":1787021106188,"version":"build-2736575974"},"reference-count":32,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":366,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Since bipolar disorder seems to be associated with purinergic system dysfunction, allopurinol might be effective in treating symptoms of mania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To estimate the efficacy and tolerability of allopurinol as adjunctive treatment for mania symptoms in people with bipolar affective disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) comparing the effects of adjunctive allopurinol and placebo on mania symptom changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five RCTs were included in the meta-analysis. Participants with allopurinol augmentation had a significantly greater decrease in mania symptoms than those with placebo (SMD= \u22120.34,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.007), especially in people with the most severe forms of mania. Remission rates, although based on only two studies (\n                      <jats:italic>n<\/jats:italic>\n                      = 177), were significantly higher among individuals receiving allopurinol, whereas for discontinuation and side-effects no difference was found.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our finding of a small to moderate effect size and overall low evidence for add-on allopurinol in reducing mania symptoms indicate that its use in routine practice needs further elucidation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.bp.115.180281","type":"journal-article","created":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T21:30:43Z","timestamp":1479418243000},"page":"10-15","source":"Crossref","is-referenced-by-count":45,"title":["Allopurinol as add-on treatment for mania symptoms in bipolar disorder: 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