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Letters   |    
Benzodiazepine-Induced Coma in the Treatment of Severe Acute Mania
Julien Elowe, M.D.; Marie-Agathe Zimmermann, M.D.; Michel Hasselmann, M.D., Ph.D.; Jean-Marie Danion, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E09-E10. doi:10.1176/appi.neuropsych.12120387
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The authors report no financial or other relationship relevant to the subject of this article.

Service de Psychiatrie I – Pôle de Psychiatrie et de Santé Mentale
Service de Réanimation Médicale
Hôpitaux Universitaires de Strasbourg
Strasbourg cedex, France

e-mail: Dr. Elowe; julien.elowe@gmail.com

Copyright © 2014 by the American Psychiatric Association


To the Editor: The management of bipolar disorders remains a considerable challenge in psychiatry, especially when taking into consideration the lifetime prevalence of these debilitating conditions which range from 0.7% to 6% in the general population,1,2 depending on the various clinical criteria, and their impact on functional outcome, underpinned by cognitive impairment and various psychosocial disabilities.3 Mortality is also increased in bipolar patients,4 accounted for both by a higher suicide rate5 and by the occurrence of diverse medical comorbidities such as cardiovascular and respiratory conditions.6 Acute mania remains a crucial characteristic phase of bipolar disorder, and its treatment is of particular interest. Indeed, a recent review has identified 11 pharmacological agents that have proven anti-manic efficacy, but a complete remission of symptoms is rare.7 In refractory and severe cases, electroconvulsive therapy (ECT) is also recommended.8

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