Participants
Eligible participations were 45 in patient, age between 21–43 years old and met DSM-IV criteria for a current manic episode, on the basis of a clinical interview by an academician psychiatrist. In addition, a score of at least 20 points on the Young Mania rating Scale [19] was required representing at least a moderate to severe mania. Mental retardation, neurological or other medical impairment, the need for ongoing treatment with other psychoactive medications, and/or current substance dependence, seizure disorder requiring medication, participation in an investigational drug trial within 30 days before the start of the trial, known sensitivity to haloperidol, lithium or ritanserin, use of clozapine within 1 month before study entry; use of depot neuroleptics within one cycle before study entry, laboratory values outside the normal range, women of childbearing potential who were without adequate contraception were exclusionary criteria. The trial was performed in accordance with the Declaration of Helsinki and subsequent revisions and approved by ethics committee at Tehran University of Medical Sciences. Written informed consents were obtained before entering into the study.