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 .
A placebo-controlled, double-blind study of the efficacy and safety of aripiprazole in patients with acute bipolar mania.
OBJECTIVE The authors compared the efficacy and safety of aripiprazole , a novel antipsychotic , to placebo for treatment of patients in an acute manic or mixed episode of bipolar disorder . METHOD This 3-week , multicenter , double-blind study r and omly assigned 262 bipolar disorder patients in an acute manic or mixed episode to  aripiprazole , 30 mg/day ( reduced to 15 mg/day if needed for tolerability ) , or placebo .  Patients remained hospitalized for at least 2 of the weeks . The primary efficacy measure was mean change from baseline in total score on the Young Mania Rating Scale ; response was defined as a decrease in score of > or = 50 % . RESULTS Aripiprazole produced statistically significant mean improvements in total score on the Young Mania Rating Scale compared with placebo ( -8.2 versus -3.4 , respectively ) and produced a significantly higher response rate ( 40 % versus 19 % ) . For key efficacy variables ( response per Young Mania Rating Scale ; Clinical Global Impression-Bipolar Version scores for severity of illness [ mania ] and change from preceding phase [ mania ] ) , aripiprazole separated from placebo by day 4 . The completion rate was significantly higher with aripiprazole than with placebo ( 42 % versus 21 % ) . Discontinuations due to adverse events did not differ significantly between the aripiprazole and placebo groups . There were no significant changes in body weight versus placebo , and aripiprazole was not associated with elevated serum prolactin or QTc prolongation . CONCLUSIONS Aripiprazole had significantly greater efficacy than placebo for the treatment of bipolar disorder patients in acute manic or mixed episodes and was safe and well tolerated in this r and omized controlled trial
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 .