Participant
neurological or cardiovascular disorders, manic, comorbidity, anxiety, malignancy, acidosis, mania, bipolar disorder, psychiatric, hyperkalemia, obsessive‐compulsive disorder, chronic medical disorder
DISORDER, DISORDERS, ALLERGY TO SPIRONOLACTONE, ACIDOSIS, ELECTROLYTE DISORDER, LIVER DISEASE, DISORDERS, IMMUNE DEFICIENCY, CHRONIC DISEASE
The statistical population included patients referred to the outpatient clinic of Imam Ali Hospital, Alborz, Iran, who needed hospitalization in the psychiatric ward due to the severity of their symptoms. They were then admitted to the psychiatry department of Imam Hossein Hospital, Alborz, Iran. After conducting an independent structured interview based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition (DSM‐5) by two experienced psychiatrists who were faculty members of the Psychiatry Department of Alborz University of Medical Sciences, in case of the final diagnosis of bipolar disorder type 1 in the manic episode and providing written consent by the patient's guardian, they were included in the study.The study inclusion criteria included patients diagnosed with bipolar disorder type 1 in a mania episode, who were between the ages of 18 and 50 and had a minimum score of 20 based on the Young Mania Rating Scale (YMRS). It was also necessary to provide a written consent form from the patients and/or their guardians to enter the study. Exclusion criteria included comorbidity of obsessive‐compulsive disorder, anxiety disorders, any substance use during the 3 months before the recent episode (except for nicotine and caffeine use in the absence of any dependence), non‐continuity of participation in the study, accompanying neurological or cardiovascular disorders at the same time, accompanying any metabolic and hormonal disorder in need of medication, active kidney and liver disease, presence of any chronic disease, history of malignancy, immune deficiency, major surgery, any chronic medical disorder requiring long‐term medication, any fluid–electrolyte disorder, hyperkalemia, acidosis, pregnancy or breastfeeding, history of allergy to spironolactone and other drugs in the same category, and simultaneous use of steroids, lithium, and any drug that increases serum potassium levels (including angiotensin‐converting enzyme inhibitors, angiotensin receptor antagonists, digoxin, cholestyramine, NSAIDS, eplerenone, heparin, skeletal muscle relaxants such as cyclobenzaprine, diuretics such as amiloride, norepinephrine, potassium supplements, and other related drugs).