Intervention
After screening and final identification of patients participating in the study, they were randomly assigned to two groups receiving spironolactone or placebo along with receiving sodium valproate as the main mood stabilizer, based on the alternative block randomization method. In one group, the patients were prescribed spironolactone at a dose of 50 mg daily for 8 weeks, together with sodium valproate at a dose of 200 mg 3 times a day at an interval of 8 h, and in the other group, instead of spironolactone, a placebo of the same shape, size, and color was used once a day. None of the patients, psychiatrists, and pill providers knew about the content of the pills and were also unaware of the placement of the patients in each group. Before starting the study, all patients were subjected to initial clinical examinations, evaluation of vital signs, and basic electrolyte and metabolic tests. All these steps were carried out by and under the supervision of two experienced psychiatrists and faculty members of the Department of Psychiatry of Alborz University of Medical Sciences.