Objectives: Endoxifen is a protein kinase C inhibitor. The objective of the present phase III study was to demonstrate the safety and efficacy of endoxifen in treating bipolar I disorder (BPD I) patients. Methods:A multicenter, double-blind, active-controlled study was conducted using a daily dose of 8 mg endoxifen compared to 1000 mg divalproex, the current standard treatment, in patients with BPD I acute manic episodes with/without How to cite this article: Ahmad A, Sheikh S, Khan MA, et al.Endoxifen: A new, protein kinase C inhibitor to treat acute and mixed mania associated with bipolar I disorder. Bipolar

We reviewed Ghosh et al. 1 letter based on our active-controlled, double-blind, and randomized trial 2 that demonstrated the therapeutic benefit of Endoxifen in patients with bipolar I disorder. The author's reservations about the sample size estimation, statistical analysis, and missing data handling on the published article are unfounded. The clinical study design, conduct, and analysis were done under required regulatory and Good Clinical Practice guidelines. The non-inferiority margin was chosen based on consideration of our prior study. 3

Background: The community misunderstands mental illness, resulting in stigmatizing attitudes toward persons with mental illness. High mental health literacy (MHL) among Accredited Social Health Activists (ASHA) workers can help spread mental health awareness to the community. The study aimed to assess the attitudes of ASHA workers toward the mentally ill. Method: A cross-sectional survey was conducted among ASHA workers in the city of Ahmedabad using the Community Attitude toward Mentally Ill (CAMI) scale – Gujarati version. Census sampling was used to collect data from ASHA workers at various Urban Health Centers (UHC). We analyzed 265 responses. Results: The mean (SD) of authoritarianism (AU), benevolence (BE), social restrictiveness (SR), and community mental health ideology (CMHI) subscales were 29.77(3.35), 35.33(3.78), 34.55(3.49), and 37.15(4.42), respectively (a higher mean suggests a negative attitude in the AU and SR subscales and a positive attitude in the BE and CMHI subscales). Conclusion: Although ASHA workers displayed goodwill and a welcoming attitude on the BE and CMHI subscales, they showed negative and stigmatizing attitudes on certain items of the AU and SR subscales. This necessitates a widespread mental health education campaign and training program for them.

BACKGROUND: ECT is mainstay therapy of various psychiatric disorders. It is best antidepressant available on the earth. As all antidepressant cause switch of Depression to Mania, ECT can cause the switch. AIMS & OBJECTIVES: To establish relationship between ECT & Euphoric Syndromes. To categorize Euphoria into transient Euphoria, Hypomania or Mania. MATERALS & METHODS: The study was conducted in a general hospital setting in Psychiatry Department. Study subjects were the patient hospitalized & given 6 ECTs with diagnosis of Major Depressive Disorder & Schizophrenia. Young Mania Rating Scale (YMRS) & Hypomania Check List (HCL-32) were the tools applied at various time points. RESULTS: In the study, total 40 patients were taken, amongst which 24 were schizophrenia & 16 were MDD patients. At the end of 6 ECTs total 7 patients developed euphoric syndromes, amongst which 1 patient developed Mania, 3 patients developed Hypomania & 3 patients developed Euphoria. CONCLUSION: It's found that there is positive correlation between Euphoric Syndrome & ECT. 17.5% of subject sample developed Euphoric Syndrome.

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