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 .
Aripiprazole in the treatment of acute manic or mixed episodes in patients with bipolar I disorder: a 3-week placebo-controlled study
This study compares the efficacy , safety , and tolerability of a partial dopamine agonist , aripiprazole , with placebo in the treatment of patients with bipolar I disorder experiencing an acute manic or mixed episode . In total , 272 hospitalized patients were r and omized to aripiprazole 30mg/day or placebo in this 3-week , double-blind , placebo-controlled trial . Dosing could be reduced to 15mg/day for tolerability and , subsequently , increased to 30mg/day based on clinical response . Primary efficacy measure was mean change from baseline to endpoint in Young Mania Rating Scale ( YMRS ) total score ; response was defined as 50 % decrease from baseline YMRS score . Aripiprazole-treated patients demonstrated significantly greater improvement from baseline to endpoint in mean YMRS total scores compared with placebo-treated patients as early as Day 4 and sustained through Week 3 . A significantly higher response rate was observed in aripiprazole-treated patients ( 53 % vs. 32 % at endpoint ) . Aripiprazole produced significantly greater improvements from baseline on other efficacy assessment s compared with placebo , including Clinical Global Impression – Bipolar Version Severity and Improvement scores . The 30mg/day dose was maintained by 85 % of aripiprazole-treated patients . Incidence of discontinuations due to adverse events was similar for aripiprazole ( 8.8 % ) and placebo ( 7.5 % ) . Aripiprazole treatment result ed in no significant difference from placebo in change in mean body weight and was not associated with elevated serum prolactin or QTc prolongation . In conclusion , aripiprazole demonstrated superior efficacy to placebo in the treatment of patients with bipolar I disorder presenting with acute manic or mixed episodes , and exhibited a favourable safety and tolerability profile
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 .