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Sertraline slightly more effective than CBT in patients on hemodialysis

in scores at treatment endpoint on the Young Mania Rating Scale. Among the secondary outcomes were response to treatment, or at least a 50% reduction in rating-scale score from baseline to treatment endpoint, and overall acceptability of treatment as measured by dropout rate. Five placebo-controlled trials were identified for the treatment of acute mania, ranging from 3 to 6 weeks in duration and involving a total of 164 participants. Two of the trials evaluated tamoxifen as monotherapy, and three examined the drug as an augmentation strategy with lithium or valproate. Tamoxifen resulted in greater improvement on mania symptoms overall, with effect estimates greater for monotherapy studies than augmentation studies. Response rates also were higher in patients receiving tamoxifen. Acceptability was similar between tamoxifen and placebo. Although the researchers stated that tamoxifen appears to be a promising treatment for manic episodes, they added that the total number of participants in the studies on which this conclusion is based remains relatively low. [Palacios J, et al. J Psychopharmacol 2019; 33:177–184]