In maintenance trials atypical antipsychotics had significantly fewer relapses to depression or mania than placebo or active comparator .
Conclusion Atypical antipsychotics are effective in treating both phases of bipolar disorder compared with placebo , and as effective as established drug therapies .
Atypical antipsychotics produce fewer extrapyramidal symptoms , but weight gain is more common ( with olanzapine ) .
There is insufficient data confidently to distinguish between different atypical antipsychotics
Background Atypical antipsychotics are increasingly used for treatment of mental illnesses like schizophrenia and bipolar disorder , and considered to have fewer extrapyramidal effects than older antipsychotics .
Ziprasidone in the treatment of acute bipolar mania: a three-week, placebo-controlled, double-blind, randomized trial.
OBJECTIVE The study evaluated the efficacy and tolerability of ziprasidone , compared with placebo , in the treatment of adult patients with acute bipolar mania . METHOD Patients with a primary DSM-IV diagnosis of bipolar I disorder and a current manic or mixed episode ( confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders , Patient Edition ) ( N=210 ) were r and omly assigned in a 2:1 ratio to 3 weeks of double-blind treatment with ziprasidone ( 40 - 80 mg twice daily ) or placebo . Efficacy was assessed with the Schedule for Affective Disorders and Schizophrenia , Change Version ( which contains the Mania Rating Scale ) , Positive and Negative Syndrome Scale , Clinical Global Impression ( CGI ) severity scale , CGI improvement scale , and Global Assessment of Functioning Scale . Primary efficacy variables were differences from baseline to endpoint ( last observation carried forward ) in mean Mania Rating Scale and CGI severity scale scores between the ziprasidone and placebo groups . Safety evaluations included monitoring of adverse events , vital signs , electrocardiogram results , and clinical laboratory values and assessment of movement disorders and akathisia . RESULTS Ziprasidone produced rapid , sustained improvements relative to baseline and placebo on all primary and most secondary efficacy measures at endpoint . Significant improvements were typically observed within 2 days after treatment commenced and were maintained throughout the 3 weeks . Ziprasidone was well tolerated and associated with a low rate of extrapyramidal symptoms ; neither weight gain nor clinical ly significant changes in vital signs or other safety parameters were observed with ziprasidone . CONCLUSIONS Ziprasidone monotherapy was significantly superior to placebo in reducing symptoms of acute mania in patients with bipolar I disorder . Onset of action was rapid , and tolerability of ziprasidone was generally comparable to that of placebo
In maintenance trials atypical antipsychotics had significantly fewer relapses to depression or mania than placebo or active comparator .
Conclusion Atypical antipsychotics are effective in treating both phases of bipolar disorder compared with placebo , and as effective as established drug therapies .
Atypical antipsychotics produce fewer extrapyramidal symptoms , but weight gain is more common ( with olanzapine ) .
There is insufficient data confidently to distinguish between different atypical antipsychotics
Background Atypical antipsychotics are increasingly used for treatment of mental illnesses like schizophrenia and bipolar disorder , and considered to have fewer extrapyramidal effects than older antipsychotics .