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 .
Effectiveness of aripiprazole v. haloperidol in acute bipolar mania: double-blind, randomised, comparative 12-week trial.
BACKGROUND Despite several treatmentoptions , adherenceto therapy is poor in patients with bipolar disorder . AIMS A double-blind , controlled comparison of aripiprazole and haloperidol in patients with bipolar I disorder experiencing acute manic or mixed episodes . METHOD Patients ( n=347 ) were r and omised to receive aripiprazole or haloperidol  in this 12-week , multicentre study . The primary outcome measure was the number of patients in response ( greater , similar 50 % improvement from baseline in Young Mania Rating Scale score ) and receiving therapy at week 12 . RESULTS At week 12 , significantly more patients taking aripiprazole ( 49.7 % ) were in response and receiving therapy compared with those taking haloperidol ( 28.4 % ; P < 0.001 ) . Continuation rates differed markedly between treatments ( week 12 : aripiprazole , 50.9 % ; haloperidol , 29.1 % ) . Extrapyramidal adverse events were more frequent with haloperidol than aripiprazole ( 62.7 % v. 24.0 % ) . CONCLUSIONS Aripiprazole showed superior levels of response and tolerability to haloperidol in the treatment of an acute manic episode for up to 12 weeks
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 .