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 .
Mood stabilisers plus risperidone or placebo in the treatment of acute mania. International, double-blind, randomised controlled trial.
BACKGROUND Few double-blind trials have examined the efficacy of a combination of a mood stabiliser and an atypical antipsychotic  in acute mania . AIMS To determine the efficacy of risperidone in combination with a mood stabiliser in acute mania . METHOD Patients taking a mood stabiliser were r and omised to 3 weeks ' treatment with risperidone ( n=75 ) or placebo ( n=76 ) . RESULTS Young Mania Rating Scale ( YMRS ) scores improved rapidly with significantly greater reductions at week 1 in the risperidone group compared with the placebo group . At end-point YMRS scores decreased by 14.5 and 10.3 points in the risperidone and placebo groups , respectively . Significant improvements v. placebo ( P<0.05 ) were noted in the risperidone group on several other clinical ly meaningful measures . Additionally , a post hoc analysis excluding carbamazepine-treated patients ( plasma concentrations of risperidone active moiety were 40 % lower in this group ) revealed significantly greater reductions ( P=0.047 ) in YMRS scores in the risperidone group than in the placebo group . Incidence of adverse events was similar in both groups . CONCLUSIONS Risperidone is superior to placebo when used in combination with lithium or divalproex in acute mania
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 .