dodd-atypical-2007.pdf (317.41 kB)
Atypical antipsychotics for bipolar disorder : overblown or blown over?
journal contribution
posted on 2007-07-01, 00:00 authored by F Ng, Seetal DoddSeetal Dodd, Michael BerkMichael BerkObjective:Developments in the pharmacological treatment of bipolar disorder are of much interest, as the chronicity and disability of the disorder become better understood, and as treatment goals have shifted to emphasise early control of illness course and maintenance of euthymia in addition to acute episodic remission. Atypical antipsychotics have emerged as treatment options, and this paper aims to review the evidence for their role in bipolar disorder.
Methods:A MEDLINE search was conducted for publications up till October 2006.
Results:The search yielded a number of randomised, controlled clinical trials of various atypical antipsychotics as monotherapy or adjunctive therapy in bipolar disorder. The majority of such trials have investigated their efficacy in acute mania, with fewer studies devoted to acute bipolar depression or maintenance treatment. There are no specific trials on mixed states, which have mainly been studied together with bipolar mania. The most robust evidence supports a class effect of atypical agents in the treatment of mania.
Conclusions:There are placebo-controlled trials that support the efficacy of olanzapine and quetiapine in bipolar depression, and of olanzapine and aripiprazole as maintenance treatment. There is strong support for the role of atypical antipsychotics in bipolar disorder management despite a relatively narrow literature base, chiefly for the treatment of mania. However, these findings need to be replicated, and further investigation is warranted to clarify their spectrum of efficacy in bipolar disorder.
Methods:A MEDLINE search was conducted for publications up till October 2006.
Results:The search yielded a number of randomised, controlled clinical trials of various atypical antipsychotics as monotherapy or adjunctive therapy in bipolar disorder. The majority of such trials have investigated their efficacy in acute mania, with fewer studies devoted to acute bipolar depression or maintenance treatment. There are no specific trials on mixed states, which have mainly been studied together with bipolar mania. The most robust evidence supports a class effect of atypical agents in the treatment of mania.
Conclusions:There are placebo-controlled trials that support the efficacy of olanzapine and quetiapine in bipolar depression, and of olanzapine and aripiprazole as maintenance treatment. There is strong support for the role of atypical antipsychotics in bipolar disorder management despite a relatively narrow literature base, chiefly for the treatment of mania. However, these findings need to be replicated, and further investigation is warranted to clarify their spectrum of efficacy in bipolar disorder.
History
Journal
Clinical psychopharmacology and neuroscienceVolume
5Issue
2Pagination
53 - 64Publisher
Korean College of NeuropsychopharmacologyLocation
Seoul, KoreaISSN
1738-1088eISSN
2093-4327Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2007, Korean College of NeuropsychopharmacologyUsage metrics
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