Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis
Open accessAbstract
Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder. Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy of modern atypical antipsychotics in bipolar depression. We systematically reviewed published or registered randomized, double-blind, placebo-controlled trials (RCTs) of modern antipsychotics in adult bipolar I and/or II depressive patients (DSM-IV criteria). Efficacy outcomes were assessed based on changes in the Montgomery-Asberg Depression Rating Scale (MADRS) during an 8-wk period. Data were combined through meta-analysis using risk ratio as an effect size with a 95% confidence interval (95% CI) and with a level of statistical significance of 5% (p<0.05). We identified five RCTs; four involved antipsychotic monotherapy and one addressed both monotherapy and combination with an antidepressant. The two quetiapine trials analysed the safety and efficacy of two doses: 300 and 600 mg/d. The only olanzapine trial assessed olanzapine monotherapy within a range of 5-20 mg/d and olanzapine-fluoxetine combination within a range of 5-20 mg/d and 6-12 mg/d, respectively. The two aripiprazole placebo-controlled trials assessed doses of 5-30 mg/d. Quetiapine and olanzapine trials (3/5, 60%) demonstrated superiority over placebo (p<0.001). Only 2/5 (40%) (both aripiprazole trials) failed in the primary efficacy measure after the first 6 wk. Some modern antipsychotics (quetiapine and olanzapine) have demonstrated efficacy in bipolar depressive patients from week 1 onwards. Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
2 of 26 cited sources checked · 0 supported · 1 flagged · accuracy not yet measured
- Premisecitation
Currently, atypical antipsychotics are only considered by treatment guidelines as second- or third-line therapy in the management of bipolar depression.
“Currently, atypical antipsychotics are only considered by treatment guidelines as second-or third-line therapy in the management of bipolar depression”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Fountoulakis et al. 2007 source
Table 1 in the Background section lists olanzapine, an atypical antipsychotic, as a first-step treatment for acute bipolar depression under the 2002 TMAP guideline. That contradicts the claim that guidelines consider atypical antipsychotics only as second- or third-line therapy. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measured
- Findingown data
Treatment effects regarding remission showed a high degree of heterogeneity on global assessment (p=0.0010).
“Treatment effects regarding remission also showed a high degree of heterogeneity on global assessment (p=0.0010).”
Quote in the paperSubstantial claim - Findingown data
Quetiapine and olanzapine trials (3/5, 60%) demonstrated superiority over placebo (p<0.001) at week 8.
“Quetiapine and olanzapine trials (3/5, 60 %) demonstrated superiority over placebo (p<0.001).”
- Also stated in: § Assessment of the MADRS scale · boosted
“All quetiapine and olanzapine trials demonstrated significant superiority over placebo at week 8 (i.e.all CIs in the pooled analysis excluded zero).”
Quote in the paperSubstantial claim - Also stated in: § Assessment of the MADRS scale · boosted
- Findingown data
Within each drug, heterogeneity was substantially reduced (quetiapine p=0.803; olanzapine non-estimable; aripiprazole p=0.813).
“However, when assessing the estimates within each drug, the heterogeneity was substantially reduced [quetiapine : p=0.803 ; olanzapine : p non-estimable (one study) ; aripiprazole : p=0.813].”
Quote in the paperNot a substantial claim - Findingown data
Within each drug, response heterogeneity was substantially reduced (quetiapine p=0.266; olanzapine non-estimable; aripiprazole p=0.5930).
“However, when assessing the estimates within each drug, the heterogeneity was substantially reduced [quetiapine : p=0.266 ; olanzapine : p non-estimable (one study) ; aripiprazole : p=0.5930].”
Quote in the paperNot a substantial claim
- Findingown data
Treatment effects exhibited a high degree of heterogeneity on the global assessment (p=0.013).
“Treatment effects exhibited a high degree of heterogeneity on the global assessment (p=0.013).”
Quote in the paperSubstantial claim - Findingown data
Random-effects pooled overall effect size for remission was 0.67 (95% CI 0.45-0.98).
“Random-effects analysis were pooled, estimated with an overall effect size of 0.67 (95 % CI 0.45-0.98)”
Quote in the paperSubstantial claim - Findingown data
Within each drug, remission heterogeneity was substantially reduced (quetiapine p=0.119; olanzapine nonestimable; aripiprazole p=0.415).
“However, when assessing the estimates within each drug, the heterogeneity was substantially reduced [quetiapine : p=0.119 ; olanzapine : p nonestimable (one study) ; aripiprazole : p=0.415].”
Quote in the paperNot a substantial claim - Findingown data
Random-effects pooled overall effect size for response was OR 0.66 (95% CI 0.49-0.89).
“Random-effects analysis were pooled, estimated with an overall effect size (OR 0.66, 95 % CI 0.49-0.89)”
Quote in the paperSubstantial claim - Findingown data
Treatment effects regarding response exhibited a high degree of heterogeneity on the global assessment (p=0.018).
“Treatment effects regarding response exhibited a high degree of heterogeneity on the global assessment (p=0.018).”
Quote in the paperNot a substantial claim - Findingown data
Placebo response may not be considered as a source of heterogeneity.
“Severity of depression at baseline did not show substantial differences and placebo response between studies was surprisingly highly homogeneous and may be not considered as a source of heterogeneity.”
Quote in the paperNot a substantial claim - Findingown data
Severity of depression at baseline did not show substantial differences.
“Severity of depression at baseline did not show substantial differences and placebo response between studies was surprisingly highly homogeneous and may be not considered as a source of heterogeneity.”
Quote in the paperNot a substantial claim - Findingown data
Weight gain associated to quetiapine administration was dose-related.
“In fact, weight gain associated to quetiapine administration was mild and dose-related, with <9 % of patients gaining o7% from baseline as a clinical meaningfully measurement.”
Quote in the paperNot a substantial claim - Findingown data
Completion rates were homogeneous.
“Overall, completion rates were homogeneous with an average of y60 % for patients under quetiapine and OFC and slightly less for olanzapine monotherapy and aripiprazole treatment groups.”
Quote in the paperNot a substantial claim - Findingreasoning
Aripiprazole may be considered an important single source of heterogeneity.
“Therefore, in our results, aripiprazole may be considered an important single source of heterogeneity, therefore there were no relevant differences in design among the bipolar depression studies or in dosage used for the same drugs.”
Quote in the paperSubstantial claim - Findingown data
Except for aripiprazole, quetiapine and olanzapine had lower drop-out rates due to adverse events.
“The superiority of quetiapine and olanzapine monotherapy by week is emphasized by higher response and remission rates and, except for aripiprazole, lower drop-out rates due to adverse events.”
Quote in the paperSubstantial claim - Findingnone given
No meaningfully clinical changes on weight were reported.
“No meaningfully clinical changes on weight were reported”
Quote in the paperNot a substantial claim - Findingown data
Changes in weight observed in all three groups were relatively small.
“Importantly, changes in weight observed in all three groups were relatively small and did not result in withdrawal from the study.”
Quote in the paperNot a substantial claim - Findingown data
Completion rate was slightly less for olanzapine monotherapy and aripiprazole treatment groups.
“Overall, completion rates were homogeneous with an average of y60 % for patients under quetiapine and OFC and slightly less for olanzapine monotherapy and aripiprazole treatment groups.”
Quote in the paperNot a substantial claim - Findingown data
Weight gain associated to quetiapine administration was mild.
“In fact, weight gain associated to quetiapine administration was mild and dose-related, with <9 % of patients gaining o7% from baseline as a clinical meaningfully measurement.”
Quote in the paperNot a substantial claim - Findingown data
Bipolar II and rapid-cycling patients show significant superiority to placebo group in the treatment of bipolar depression.
“Overall, bipolar II and rapid-cycling patients highlight lower effect sizes in primary outcome, although with significantly superiority to placebo group in the treatment of bipolar depression.”
Quote in the paperSubstantial claim - Findingown data
Quetiapine and olanzapine monotherapy showed superiority by week.
“The superiority of quetiapine and olanzapine monotherapy by week is emphasized by higher response and remission rates and, except for aripiprazole, lower drop-out rates due to adverse events.”
Quote in the paperSubstantial claim - Findingown data
Drop-outs were more associated to intolerable adverse events, especially akathisia.
“The high rates of drop-outs had been related to aripiprazole trials (study 1, 46.8 % vs. 35.1 % in placebo arm and study 2, 41.2 % vs. 29.8%, respectively), and they were more associated to intolerable adverse events, especially akathisia.”
Quote in the paperNot a substantial claim - Findingreasoning
There were no relevant differences in design among the bipolar depression studies.
“Therefore, in our results, aripiprazole may be considered an important single source of heterogeneity, therefore there were no relevant differences in design among the bipolar depression studies or in dosage used for the same drugs.”
Quote in the paperSubstantial claim - Findingnone given
Only 9% of patients dropped out in olanzapine trials due to overall adverse events.
“Nevertheless, only 9 % of patients dropped out in olanzapine trials due to overall adverse events.”
Quote in the paperNot a substantial claim - Findingown data
Average completion rate was approximately 60% for patients under quetiapine and OFC.
“Overall, completion rates were homogeneous with an average of y60 % for patients under quetiapine and OFC and slightly less for olanzapine monotherapy and aripiprazole treatment groups.”
Quote in the paperNot a substantial claim - Findingown data
Small but statistically significant mean increases in glucose and cholesterol levels were seen.
“Small but statistically significant mean increases in glucose and cholesterol levels were also seen.”
Quote in the paperNot a substantial claim - Findingown data
Placebo response between studies was surprisingly highly homogeneous.
“Severity of depression at baseline did not show substantial differences and placebo response between studies was surprisingly highly homogeneous and may be not considered as a source of heterogeneity.”
Quote in the paperSubstantial claim - Findingnone given
Exploratory analyses reported to date suggest little or no difference in overall efficacy across these subgroups.
“However, the exploratory analyses reported to date suggest little or no difference in overall efficacy across these subgroups.”
Quote in the paperNot a substantial claim - Findingown data
The most common adverse effects were mostly somnolence and sedation leading to withdrawal from the study.
“The most common adverse effects reported in y30 % of patients were not severe, mostly somnolence and sedation leading to withdrawal from the study, with most discontinuations occurring within the first week.”
Quote in the paperNot a substantial claim - Findingown data
The incidence of treatment-emergent mania was not significantly different from placebo for any drug.
“Moreover, the incidence of treatment-emergent mania was low (from 3.6 % for higher quetiapine doses to a maximum of 5.7 % for olanzapine trials) and not significantly different from placebo for any drug.”
Quote in the paperSubstantial claim - Findingown data
Quetiapine was generally safe and well tolerated in both tested doses.
“Regarding tolerability, quetiapine was generally safe and well tolerated in both tested doses.”
Quote in the paperNot a substantial claim - Findingown data
Significant progressive superiority was obtained throughout the first 6 weeks for all drugs.
“We obtained significant progressive superiority throughout the first 6 wk for all drugs, which was maintained to an endpoint only by quetiapine and olanzapine.”
Quote in the paperSubstantial claim - Findingnone given
We studied higher aripiprazole doses as monotherapy compared to its use in combination with mood stabilizers.
“It should be taken into account that we studied higher aripiprazole doses as a monotherapy compared to its use in combination with mood stabilizers.”
Quote in the paperSubstantial claim - Findingown data
Changes in weight did not result in withdrawal from the study.
“Importantly, changes in weight observed in all three groups were relatively small and did not result in withdrawal from the study.”
Quote in the paperNot a substantial claim - Findingown data
Heterogeneity was not due to intra-treatment heterogeneity.
“The heterogeneity in this meta-analysis was due to a differential effect in the aripiprazole group compared to the olanzapine and quetiapine groups, but not due to intra-treatment heterogeneity.”
Quote in the paperSubstantial claim - Findingown data
The incidence of treatment-emergent mania was low (from 3.6% for higher quetiapine doses to a maximum of 5.7% for olanzapine trials).
“Moreover, the incidence of treatment-emergent mania was low (from 3.6 % for higher quetiapine doses to a maximum of 5.7 % for olanzapine trials) and not significantly different from placebo for any drug.”
Quote in the paperSubstantial claim - Findingreasoning
There were no relevant differences in dosage used for the same drugs.
“Therefore, in our results, aripiprazole may be considered an important single source of heterogeneity, therefore there were no relevant differences in design among the bipolar depression studies or in dosage used for the same drugs.”
Quote in the paperSubstantial claim - Findingown data
High rates of drop-outs had been related to aripiprazole trials (study 1, 46.8% vs. 35.1% in placebo arm and study 2, 41.2% vs. 29.8%, respectively).
“The high rates of drop-outs had been related to aripiprazole trials (study 1, 46.8 % vs. 35.1 % in placebo arm and study 2, 41.2 % vs. 29.8%, respectively), and they were more associated to intolerable adverse events, especially akathisia.”
Quote in the paperNot a substantial claim - Findingcitation
Exploratory analysis performed in quetiapine trials exerts quite qualitative homogeneous results for this subpopulation.
“Nevertheless, exploratory analysis performed in quetiapine trials exerts quite qualitative homogeneous results for this subpopulation (Suppes et al. 2008).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Suppes et al. 2008 source
- Findingown data
The most common adverse effects reported in >30% of patients were not severe.
“The most common adverse effects reported in y30 % of patients were not severe, mostly somnolence and sedation leading to withdrawal from the study, with most discontinuations occurring within the first week.”
Quote in the paperNot a substantial claim - Findingown data
Heterogeneity in this meta-analysis was due to a differential effect in the aripiprazole group compared to the olanzapine and quetiapine groups.
“The heterogeneity in this meta-analysis was due to a differential effect in the aripiprazole group compared to the olanzapine and quetiapine groups, but not due to intra-treatment heterogeneity.”
Quote in the paperSubstantial claim - Findingown data
Patients under olanzapine treatment reported about an 18% significant weight gain compared to the placebo arm.
“Patients under olanzapine treatment reported, as expected, about an 18 % significant weight gain compared to the placebo arm.”
Quote in the paperNot a substantial claim - Findingown data
Bipolar II and rapid-cycling patients highlight lower effect sizes in primary outcome.
“Overall, bipolar II and rapid-cycling patients highlight lower effect sizes in primary outcome, although with significantly superiority to placebo group in the treatment of bipolar depression.”
Quote in the paperNot a substantial claim - Findingown data
Superiority was maintained to an endpoint only by quetiapine and olanzapine.
“We obtained significant progressive superiority throughout the first 6 wk for all drugs, which was maintained to an endpoint only by quetiapine and olanzapine.”
Quote in the paperSubstantial claim - Premisereasoning
This is the first structured review and meta-analysis of randomized, placebo-controlled trials of atypical antipsychotics as monotherapy for the acute treatment of depression in bipolar I and/or II disorder.
“Therefore, we conducted the first structured review and meta-analysis of randomized, placebo-controlled trials of atypical antipsychotics as monotherapy for the acute treatment of depression in bipolar I and/or II disorder.”
Quote in the paperSubstantial claim- Rests on an assumption: No published systematic reviews or meta-analyses evaluating the efficacy of modern atypical antipsychotics in bipolar depression existed at the time of the study.
- Premisecitation
Based on data from latest studies and RCTs in bipolar depression, atypical antipsychotics do not seem to induce depressive episodes as anti-manic agents.
“Based on data from the latest studies and RCTs conducted in bipolar depression, atypical antipsychotics do not seem to induce depressive episodes as anti-manic agents”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Brugue & Vieta, 2007 source
- Interpretationcitation
Some second-generation antipsychotics (quetiapine and olanzapine) may represent a monotherapy management option of bipolar I and/or II depression.
“Its results suggest that some second-generation antipsychotics (quetiapine and olanzapine) may additionally represent a monotherapy management option of bipolar I and/or II depression.”
Quote in the paperSubstantial claim - Study design and conductnone given
There were very few studies available that currently met the inclusion criteria.
“Regarding limitations, there were very few studies available that currently met the inclusion criteria.”
Quote in the paperSubstantial claim - Interpretationreasoning
Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression.
“Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression.”
Quote in the paperSubstantial claim - Interpretationnone given
The relevant question of whether initial combination therapy with a mood stabilizer is superior to monotherapy with an atypical antipsychotic cannot be answered with the present available data.
“The relevant question of whether initial combination therapy with a mood stabilizer is superior to monotherapy with an atypical antipsychotic thus cannot be answered with the present available data.”
Quote in the paperSubstantial claim - Premisecitation
There is a dearth of positive placebo-controlled trials with alternative compounds, such as lithium, lamotrigine or various combinations of antidepressant and mood-stabilizing agents, which are still mentioned as first-line treatments for bipolar depression.
“despite the dearth of positive placebocontrolled trials with alternative compounds, such as lithium, lamotrigine or various combinations of antidepressant and mood-stabilizing agents, which are still mentioned as first-line treatments for bipolar depression”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Yatham et al. 2005a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Yatham et al. 2006 source
- Study design and conductnone given
The studies included in that meta-analysis were not adequately powered to detect differences in subpopulations of bipolar depression to allow subanalysis for bipolar II subtype.
“Moreover, the studies included in that meta-analysis were not adequately powered to detect differences in subpopulations of bipolar depression to allow us to perform subanalysis for bipolar II subtype.”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 21
- May combine two claims. 20
- The quote only partly states this claim. 3
Classified as probably not a substantial claim.
PremisecitationAtypical antipsychotics have not traditionally been considered a major option in depression guidelines unless psychotic features were present during the acute depressive episode.
“Atypical antipsychotics have not traditionally been considered as a major option in depression guidelines, unless psychotic features were present during the acute depressive episode”
Quote in the paperSubstantial claim1 of 3 sources checked- cites APA, 2002
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Grunze et al. 2002 source
The Recommendations (page unavailable) discuss atypical-antipsychotic augmentation in the context of severe and psychotic depression, while the Conclusions identify a mood stabiliser plus antidepressant as the emerging first-line approach. But the paper does not establish a historical rule across depression guidelines that atypical antipsychotics were a major option only when psychotic features were present; it also notes possible antidepressant effects from atypicals themselves. (LLM, conf=0.80)
Experimental — accuracy not yet measured - cites Yatham et al. 2005b
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
FindingcitationAripiprazole trials excluded patients with psychotic features; bipolar II patients were only enrolled in quetiapine studies (32-34%); no trials excluded rapid cycling, which represented 18-40% of patients in studies reporting such data.
“The aripiprazole trials (Thase et al. 2008) excluded patients with psychotic features and bipolar II patients were only enrolled in the quetiapine studies (32-34 %) ; no trials excluded patients with rapid cycling, which represented 18-40 % of patients in the studies reporting such data”
Quote in the paperNot a substantial claim0 of 3 sources checkedClassified as probably not a substantial claim. May combine two claims.
Findingown dataThe Medline search identified 15 studies; only three met inclusion criteria; two additional studies were identified from review of meeting proceedings or consultation with study investigators.
“The Medline search identified 15 studies.Only three of these met the inclusion criteria.Two additional studies were identified from a review of meeting proceedings or consultation with study investigators.”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataSensitivity analysis excluding aripiprazole for remission showed smaller heterogeneity (p=0.052) and pooled OR 0.51 (95% CI 0.35-0.74, p<0.001).
“Moreover, when performing the sensitivity analysis excluding the aripiprazole group, the heterogeneity was smaller (p=0.052), and the pooled OR was 0.51 (95 % CI 0.35-0.74,p<0.001)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataSensitivity analysis excluding aripiprazole for response showed smaller heterogeneity (p=0.1280) and pooled OR 0.55 (95% CI 0.41-0.74, p<0.001).
“Further, when performing the sensitivity analysis excluding the aripiprazole group, the heterogeneity was smaller (p=0.1280), and the pooled OR was 0.55 (95 % CI 0.41-0.74,p<0.001)”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Findingnone givenA total of five studies were included.
“A total of five studies were included.”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataThe overall mean estimate for MADRS change was -3.91 (95% CI -5.55 to -2.26, p<0.001).
“The overall mean estimate was x3.91 (95 % CI x5.55 to x2.26, p<0.001).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataSensitivity analysis excluding aripiprazole showed negligible heterogeneity (p=0.302) and pooled mean -4.90 (95% CI -6.21 to -3.59, p<0.001).
“Moreover, when performing the sensitivity analysis excluding the aripiprazole group, the heterogeneity was then negligible (p=0.302), and the pooled mean was x4.90 (95 % CI x6.21 to x3.59, p<0.001)”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataBaseline depression scores were similar in all studies, with moderate to severely depressed patients at inclusion (score range 28.49 to 32.6).
“The baseline depression scores were similar in all the studies with moderate to severely depressed patients at inclusion (score range from 28.49 to 32.6).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataAll atypical antipsychotics demonstrated significant efficacy from week 1 and throughout the first 6 wk, the time with maximal effect size reported by all studies.
“All of the atypical antipsychotics demonstrated significant efficacy from week 1 and throughout the first 6 wk, which was the time with the maximal effect size reported by all of the studies.”
Quote in the paperSubstantial claimMay combine two claims. The quote only partly states this claim.
Findingown dataOnly 2/5 (40%) (both aripiprazole trials) failed in the primary efficacy measure after the first 6 wk; from week 6 to endpoint quetiapine and olanzapine maintained superiority over placebo, but aripiprazole did not.
“Only 2/5 (40 %) (both aripiprazole trials) failed in”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataLess than 9% of patients gained more than 7% from baseline as a clinically meaningful measurement.
“In fact, weight gain associated to quetiapine administration was mild and dose-related, with <9 % of patients gaining o7% from baseline as a clinical meaningfully measurement.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe studies differed in whether they included rapid-cycling patients or those in mixed states.
“The studies also differed in whether they included rapid-cycling patients or those in mixed states and also in the proportion of bipolar I or II patients with psychotic features.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone givenThe olanzapine adverse-event profile was consistent with previously reported findings.
“The olanzapine adverse-event profile was consistent with previously reported findings whereas the OFC profile was similar to that of olanzapine, except for higher rates of nausea and diarrhoea.”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationAripiprazole trials showed a 6-week limited superiority compared to placebo, with decreasing effect size at endpoint.
“except for aripiprazole trials which have shown a 6-wk limited superiority compared to placebo, decreasing its effect size at endpoint (Thase et al. 2008).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Thase et al. 2008 source
May combine two claims.
Findingown dataQuetiapine and olanzapine monotherapy had higher response and remission rates.
“The superiority of quetiapine and olanzapine monotherapy by week is emphasized by higher response and remission rates and, except for aripiprazole, lower drop-out rates due to adverse events.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingnone givenThe studies differed in the proportion of bipolar I or II patients with psychotic features.
“The studies also differed in whether they included rapid-cycling patients or those in mixed states and also in the proportion of bipolar I or II patients with psychotic features.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataMost discontinuations occurred within the first week.
“The most common adverse effects reported in y30 % of patients were not severe, mostly somnolence and sedation leading to withdrawal from the study, with most discontinuations occurring within the first week.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataThe OFC profile was similar to that of olanzapine, except for higher rates of nausea and diarrhoea.
“The olanzapine adverse-event profile was consistent with previously reported findings whereas the OFC profile was similar to that of olanzapine, except for higher rates of nausea and diarrhoea.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataHomogeneity across the trials' design and study sample characteristics were the rule.
“The homogeneity across the trials' design and also in their study sample characteristics were the rule.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAtypical antipsychotics are generally classified as a class despite marked differences in pharmacodynamic properties.
“Moreover, atypical antipsychotics, are generally classified as a class, despite their marked differences in pharmacodynamic properties”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Brugue & Vieta, 2007 source
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationCombining atypical antipsychotics and mood stabilizers is the most efficacious treatment in acute mania.
“Currently available data suggest that combining atypical antipsychotics and mood stabilizers is the most efficacious treatment in acute mania, reinforced after a systematic review and meta-analysis of pooled data conducted by Perlis and Scherk”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims. The quote only partly states this claim.
Interpretationown dataQuetiapine and olanzapine as monotherapy were significantly more efficacious than placebo, as indicated by greater reductions in MADRS scores, in the treatment of acute bipolar depression from week 1 onwards.
“Some modern antipsychotics (quetiapine and olanzapine) have demonstrated efficacy in bipolar depressive patients from week 1 onwards.”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S4 (based).
Premisenone givenMeta-analytical procedures allow answering questions about overall magnitude of effect and relative effect by week with greater statistical power than individual trials.
“Meta-analytical procedures allow us to answer questions about overall magnitude of effect and relative effect by week with greater statistical power than individual trials.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationRandomized controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder.
“Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder.”
- Also stated in: § Introduction · boosted
“Randomized, placebo-controlled trials (RCTs) have demonstrated efficacy for atypical antipsychotics in the treatment of acute mania in bipolar disorder, either as monotherapy or adjunctive treatment”
Quote in the paperNot a substantial claim0 of 3 sources checked- Also stated in: § Introduction · boosted
May combine two claims.
PremisecitationEvidence suggests some atypical antipsychotics may have antidepressant and stabilizing effects.
“while evidence suggests some atypical antipsychotics may have antidepressant (Yatham et al. 2005a) and stabilizing effects (Vieta et al. 2008a).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Yatham et al. 2005a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Vieta et al. 2008a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim. May combine two claims.
Study design and conductnone givenTo avoid publication bias, the authors checked the web (clinicaltrials.gov) and contacted all industry sponsors for finalized studies.
“To avoid publication bias, we checked the web (www. clinicaltrials.gov)and contacted all industry sponsors for finalized studies.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S2 (checkable). May combine two claims.
InterpretationreasoningThese results raise questions on the current approach by most treatment guidelines and on the potential mechanism of the action involved in the improvement of depressive symptoms in bipolar depression by means of drugs traditionally considered as antipsychotics.
“These results raise questions on the current approach by most treatment guidelines and on the potential mechanism of the action involved in the improvement of depressive symptoms in bipolar depression by means of drugs traditionally considered as antipsychotics.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductreasoningIn the olanzapine trial that included an olanzapine-fluoxetine combination, only the olanzapine monotherapy arm was considered for the analysis to obtain homogeneous comparative results.
“In the only olanzapine trial which included an olanzapinefluoxetine combination (OFC) treatment, we only considered the olanzapine monotherapy arm for the analysis in order to obtain homogeneous comparative results.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationBipolar disorders present initially with a depressive episode in >50% of patients, which is considered the major burden of bipolar disorder in terms of disability and suicide risk.
“Bipolar disorders present initially with a depressive episode in >50 % of patients, which is considered the major burden of bipolar disorder in terms of disability and suicide risk”
Quote in the paperNot a substantial claim0 of 3 sources checkedClassified as probably not a substantial claim.
Study design and conductreasoningA random-effects model was considered preferable to a fixed-effects model because it was considered likely a priori that not all trials would produce exactly equal underlying effect sizes.
“Since it was considered likely a priori that not all trials would produce exactly equal underlying effect sizes, a random-effects model was considered preferable to a fixed-effects models.”
Quote in the paperSubstantial claimMay combine two claims.
InterpretationreasoningThe question of their class effect seems to be answered positively regarding its early onset of action but with differences in the magnitude and maintenance of effect.
“The question of their class effect seems to be answered positively regarding its early onset of action but with differences in the magnitude and maintenance of effect.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
InterpretationreasoningHigher aripiprazole doses as monotherapy compared to combination use suggests one potential reason for failed results in the aripiprazole trials, involving tolerability issues (especially akathisia perhaps related to dosing), leading to drop-outs, and differences in mechanism of action such as too high D2 affinity and low H1 affinity compared to quetiapine and olanzapine.
“This fact suggests one potential reason for failed results in the aripiprazole trials (tolerability issues, especially akathisia perhaps related to dosing), leading to drop-outs and also related to differences in its mechanism of action such as too high D 2 affinity and low H 1 affinity compared to quetiapine and olanzapine.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataA sensitivity analysis was performed to assess the source of heterogeneity by excluding the aripiprazole studies, as they were negative on the primary outcome.
“We also performed a sensitivity analysis to assess the source of heterogeneity by excluding the aripiprazole studies, as they were negative on the primary outcome.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
InterpretationreasoningThe very early onset of action of all tested atypical antipsychotics in the treatment of bipolar depression, even as monotherapy, may highlight an overlapping mechanism of action of these drugs as a potential class effect with independence of the monoaminergic pathways.
“The very early onset of action of all tested atypical antipsychotics in the treatment of bipolar depression, even as monotherapy, may highlight an overlapping mechanism of action of these drugs as a potential class effect with independence of the monoaminergic pathways.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataOur results suggest some atypical antipsychotics (quetiapine and olanzapine) may be considered as a first-line management option in acute bipolar I and/or II depression, even for poor responder subgroups such as rapid cyclers and patients with psychotic features.
“In summary our results suggest some atypical antipsychotics (quetiapine and olanzapine) may be considered as a first-line management option in acute bipolar I and/or II depression, even for poor responder subgroups such as rapid cyclers and patients with psychotic features.”
Quote in the paperSubstantial claim
The paper relies on this without support.
No published systematic reviews or meta-analyses evaluating the efficacy of modern atypical antipsychotics in bipolar depression existed at the time of the study.
“Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy of modern atypical antipsychotics in bipolar depression.”
“meta-analyses addressing the efficacy and effectiveness of atypical antipsychotics in bipolar depression are lacking.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Abstract names a different effect measure
MinorThe abstract says the meta-analysis used risk ratios, but the methods and reported response and remission results use odds ratios. These are different effect measures.
“Data were combined through meta-analysis using risk ratio as an effect size with a 95 % confidence interval (95 % CI)”
“The between-treatment comparisons were estimated by means of the odds ratio (OR) and 95 % confidence intervals (95 % CI) for the binary variables (remission and response)”
Cites
Journal of Clinical Psychiatry
(2018) · Journal of Clinical Psychiatry · doi:10.5505/kpd · Cited by 13,703 · see citing works
Extending Indications for Long-Term Pharmacotherapy: Opportunities and Challenges
Kane, J. M. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.1.1 · Cited by 989 · see citing works
Tohen, M., Vieta, E., Calabrese, J., Ketter, T. A., Sachs, G., Bowden, C., Mitchell, P. B., Centorrino, F., Risser, R., Baker, R. W., et al. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.11.1079 · Cited by 908 · see citing works
Self-citationCalabrese, J. R., Keck, P. E., Macfadden, W., Minkwitz, M., Ketter, T. A., Weisler, R. H., Cutler, A. J., McCoy, R., Wilson, E., Mullen, J., et al. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.7.1351 · Cited by 883 · see citing works
Olanzapine versus placebo in the treatment of acute mania
Tohen, M., Sanger, T. M., McElroy, S. L., Tollefson, G. D., Chengappa, K. N. R., Daniel, D. G., Petty, F., Centorrino, F., Wang, R., Grundy, S. L., et al. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.5.702 · Cited by 585 · see citing works
Thase, M. E., Macfadden, W., Weisler, R. H., Chang, W., Paulsson, B., Khan, A., & Calabrese, J. R. (2006) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000248603.76231.b7 · Cited by 559 · see citing works
Efficacy of Olanzapine in Acute Bipolar Mania A Double-blind, Placebo-Controlled Study
Tohen, M. F. (2000) · Archives of General Psychiatry · doi:10.1001/archpsyc.57.9.841 · Cited by 539 · see citing works
Keck, P. E., Marcus, R. N., Tourkodimitris, S., Ali, M. W., Liebeskind, A., Saha, A. R., Ingenito, G. G., & Aripiprazole Study Group (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.9.1651 · Cited by 501 · see citing works
Bauer, M., Bschor, T., Pfennig, A., Whybrow, P. C., Angst, J., Versiani, M., Möller, H., & WFSBP Task Force on Unipolar Depres (2007) · The World Journal of Biological Psychiatry · doi:10.1080/15622970701227829 · Cited by 474 · see citing works
Tohen, M. F., Chengappa, K. N. R., Suppes, T. M., Zarate, C. A., Calabrese, J. R., Bowden, C. L., Sachs, G. S., Kupfer, D. J., Baker, R. W., Risser, R. C., et al. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.1.62 · Cited by 464 · see citing works
Sachs, G. S., Grossman, F., Ghaemi, S. N., Okamoto, A., & Bowden, C. L. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.7.1146 · Cited by 424 · see citing works
Yatham, L. N., Kennedy, S. H., O'Donovan, C., Parikh, S., MacQueen, G., McIntyre, R., Sharma, V., Silverstone, P., Alda, M., Baruch, P., et al. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00219.x · Cited by 388 · see citing works
Bowden, C. L., Grunze, H., Mullen, J., Brecher, M., Paulsson, B., Jones, M., Vågerö, M., & Svensson, K. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0116 · Cited by 376 · see citing works
Keck, P. E., Versiani, M., Potkin, S. G., West, S. A., Giller, E. L., Ice, K. S., & the Ziprasidone in Mania Study Group (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.4.741 · Cited by 369 · see citing works
Diagnostic guidelines for bipolar depression: a probabilistic approach
Mitchell, P. B., Goodwin, G. M., Johnson, G. F., & Hirschfeld, R. M. (2008) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00559.x · Cited by 350 · see citing works
Clinical and therapeutic implications of predominant polarity in bipolar disorder
Colom, F., Vieta, E., Daban, C., Pacchiarotti, I., & Sánchez-Moreno, J. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.01.032 · Cited by 301 · see citing works
Self-citationHirschfeld, R. M. A., Keck, P. E., Kramer, M., Karcher, K., Canuso, C., Eerdekens, M., & Grossman, F. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.6.1057 · Cited by 273 · see citing works
Yatham, L. N., Kennedy, S. H., O'Donovan, C., Parikh, S. V., MacQueen, G., McIntyre, R. S., Sharma, V., Beaulieu, S., & for CANMAT guidelines group (2006) · Bipolar Disorders · doi:10.1111/j.1399-5618.2006.00432.x · Cited by 264 · see citing works
Sachs, G. S., Chengappa, K. R., Suppes, T. M., Mullen, J., Brecher, M., Devine, N. A., & Sweitzer, D. E. (2004) · Bipolar Disorders · doi:10.1111/j.1399-5618.2004.00115.x · Cited by 260 · see citing works
Thase, M. E., Jonas, A., Khan, A., Bowden, C. L., Wu, X., McQuade, R. D., Carson, W. H., Marcus, R. N., & Owen, R. (2008) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181618eb4 · Cited by 251 · see citing works
Yatham, L. N., Grossman, F., Augustyns, I., Vieta, E., & Ravindran, A. (2003) · British Journal of Psychiatry · doi:10.1192/bjp.182.2.141 · Cited by 248 · see citing works
Self-citationSachs, G. S., Sanchez, R., Marcus, R. N., Stock, E. G., McQuade, R. D., Carson, W. H., Abou-Gharbia, N., Impellizzeri, C., Kaplita, S., Rollin, L., et al. (2006) · Journal of Psychopharmacology · doi:10.1177/0269881106059693 · Cited by 245 · see citing works
Scherk, H., Pajonk, F. G., & Leucht, S. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.4.442 · Cited by 243 · see citing works
Vieta, E., Suppes, T., Eggens, I., Persson, I., Paulsson, B., & Brecher, M. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.001 · Cited by 227 · see citing works
Self-citationMcIntyre, R. S., Brecher, M., Paulsson, B., Huizar, K., & Mullen, J. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.02.006 · Cited by 226 · see citing works
Bipolar depression: phenomenological overview and clinical characteristics
Mitchell, P. B., & Malhi, G. S. (2004) · Bipolar Disorders · doi:10.1111/j.1399-5618.2004.00137.x · Cited by 210 · see citing works
Perlis, R. H., Welge, J. A., Vornik, L. A., Hirschfeld, R. M. A., & Keck, P. E. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0401 · Cited by 196 · see citing works
Smulevich, A. B., Khanna, S., Eerdekens, M., Karcher, K., Kramer, M., & Grossman, F. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2004.06.003 · Cited by 192 · see citing works
Risperidone in the treatment of acute mania
Khanna, S., Vieta, E., Lyons, B., Grossman, F., Eerdekens, M., & Kramer, M. L. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.3.229 · Cited by 187 · see citing works
Self-citationGrunze, H., Kasper, S., Goodwin, G., Bowden, C., Baldwin, D., Licht, R., Vieta, E., Möller, H.-J., & WFSBP Task Force on Treatment Guide (2002) · The World Journal of Biological Psychiatry · doi:10.3109/15622970209150612 · Cited by 185 · see citing works
Self-citationGrunze, H., Kasper, S. F., Goodwin, G. M., Bowden, C. L., Baldwin, D. S., Licht, R. W., Vieta, E., & Möller, H. (2003) · The World Journal of Biological Psychiatry · doi:10.3109/15622970309167904 · Cited by 166 · see citing works
Self-citationVieta, E., T'joen, C., McQuade, R. D., Carson, W. H., Marcus, R. N., Sanchez, R., Owen, R., & Nameche, L. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07101560 · Cited by 160 · see citing works
Self-citationAtypical antipsychotics in bipolar depression: potential mechanisms of action.
Yatham, L. N., Goldstein, J. M., Vieta, E., Bowden, C. L., Grunze, H., Post, R. M., Suppes, T. M., & Calabrese, J. R. (2005) · PubMed · Cited by 159 · see citing works
Self-citationZiprasidone in Acute Bipolar Mania
Potkin, S. G., Keck, P. E., Segal, S., Ice, K. S., & English, P. (2005) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000169068.34322.70 · Cited by 159 · see citing works
Grunze, H., Kasper, S. F., Goodwin, G. M., Bowden, C. L., ller, H.-J. R. M., & WFSBP Task Force on Treatment Guide (2004) · The World Journal of Biological Psychiatry · doi:10.1080/15622970410029924 · Cited by 144 · see citing works
Clinical correlates of first-episode polarity in bipolar disorder
Daban, C., Colom, F., Sanchez-Moreno, J., García-Amador, M., & Vieta, E. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2006.03.009 · Cited by 138 · see citing works
Self-citationBipolar rapid cycling: focus on depression as its hallmark.
Calabrese, J. R., Shelton, M. D., Bowden, C. L., RAPPORT, D. J., Suppes, T. M., Shirley, E. R., Kimmel, S. E., & Caban, S. (2001) · PubMed · Cited by 133 · see citing works
Clark, W. S., Street, J. S., Feldman, P. D., & Breier, A. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n0108 · Cited by 101 · see citing works
Vieta, E., Ramey, T. S., Keller, D., English, P., Loebel, A. D., & Miceli, J. J. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108099418 · Cited by 77 · see citing works
Self-citationTreatment of bipolar disorder: a complex treatment for a multi-faceted disorder
Fountoulakis, K. N., Vieta, E., Siamouli, M., Valenti, M., Magiria, S., Oral, T., Fresno, D., Giannakopoulos, P., & Kaprinis, G. S. (2007) · Annals of General Psychiatry · doi:10.1186/1744-859x-6-27 · Cited by 76 · see citing works
Self-citationOlanzapine plus carbamazepinev.carbamazepine alone in treating manic episodes
Tohen, M. F., Bowden, C. L., Ab, S., Bergstrom, R. F., Quinlan, T., Osuntokun, O. O., Wang, W. V., Oliff, H. S., Martényi, F., Kryzhanovskaya, L. A., et al. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.107.041301 · Cited by 75 · see citing works
Yatham, L. N., Vieta, E., Young, A. H., Möller, H., Paulsson, B., & Vågerö, M. (2007) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e328080ca57 · Cited by 73 · see citing works
Self-citationSuppes, T., Hirschfeld, R. M., Vieta, E., Raines, S., & Paulsson, B. (2008) · The World Journal of Biological Psychiatry · doi:10.1080/15622970701317265 · Cited by 73 · see citing works
Self-citationAtypical antipsychotics in bipolar depression: Neurobiological basis and clinical implications
Brugue, E., & Vieta, E. (2007) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2006.06.014 · Cited by 54 · see citing works
Self-citationCharacterizing barriers, challenges and unmet needs in the management of bipolar disorder
Chengappa, K. R., & Goodwin, G. M. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00188.x · Cited by 29 · see citing works
Role of aripiprazole in treating mood disorders
García-Amador, M., Pacchiarotti, I., Valentí, M., Sanchez, R. F., Goikolea, J. M., & Vieta, E. (2006) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.6.12.1777 · Cited by 25 · see citing works
Self-citationOlanzapine versus placebo in the treatment of acute mania
Tohen, M. F., Sanger, T. M., & Tollefson, G. D. (1998) · European Psychiatry · doi:10.1016/s0924-9338(99)80316-2 · Cited by 22 · see citing works
Vieta, E., Eggens, I., Persson, I., et al. (2008) · European Psychiatry · doi:10.1016/j.eurpsy.2008.01.446
Self-citationTreatment of bipolar disorder: a complex treatment for a multi-facet disorder
Fountoulakis, K., Vieta, E., Siamouli, M., et al. (2008) · Annals of General Psychiatry · doi:10.1186/1744-859x-7-s1-s316
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- Vieta, Journal of Psychopharmacology
Cited by
Sorted by citations
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Beaulieu, S., Alda, M., O’Donovan, C., MacQUEEN, G. M., McIntyre, R. S., Sharma, V., et al. (2012) · Bipolar Disorders · doi:10.1111/bdi.12025 · Cited by 1,209 · see citing works
“Several meta-analyses have assessed the efficacy of atypical antipsychotic agents and other medications for the treatment of bipolar depression (81, 82).”
BackgroundAngst, J. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.87 · Cited by 414 · see citing works
“We chose 15 characteristics known to be associated with a diagnosis of bipolar disorder.(13,17,23-28) Each item was required to assess avariable relatively independentof all others.”
BackgroundMethodDurgam, S., Earley, W., Lipschitz, A., Guo, H., Laszlovszky, I., Németh, G., Vieta, E., Calabrese, J. R., & Yatham, L. N. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15020164 · Cited by 209 · see citing works
Self-citationOstacher, M. J., Ng‐Mak, D., Patel, P., Ntais, D., Schlueter, M., & Loebel, A. D. (2017) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2017.1285050 · Cited by 201 · see citing works
“…examined acute treatments for bipolar depression, and also reported that quetiapine and olanzapine were significantly more efficacious than placebo (Cruz et al. 2010; Vieta et al. 2010), while aripiprazole (Cruz et al. 2010; Vieta et al. 2010; NICE 2014; Taylor et al. 2014; Franklin et al. 2015)…”
BackgroundResultInfluentialBipolar Depression: Overview and Commentary
Baldessarini, R. J., Vieta, E., Calabrese, J. R., Tohen, M. F., & Bowden, C. L. (2010) · Harvard Review of Psychiatry · doi:10.3109/10673221003747955 · Cited by 156 · see citing works
Self-citationHasan, A., Falkai, P., Wobrock, T., Lieberman, J. A., Glenthoj, B. Y., Gattaz, W. F., Thibaut, F., Möller, H., & on behalf of the WFSBP Task Force on Treatment Guidelines for Schizophrenia (2015) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2015.1009163 · Cited by 146 · see citing works
“For some of the aforementioned antipsychotics (mainly quetiapine), the effi cacy in major depression and in bipolar depression has been shown (e.g., Cruz et al. 2010; Komossa et al. 2010; De Fruyt et al. 2012).”
BackgroundPharmacologic Treatments for Pediatric Bipolar Disorder: A Review and Meta-Analysis
Liu, H. Y., Potter, M. P., Woodworth, K. Y., Yorks, D. M., Petty, C. R., Wozniak, J. R., Faraone, S. V., & Biederman, J. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.05.011 · Cited by 133 · see citing works
Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry
Fountoulakis, K. Ν., Kasper, S. F., Andreassen, O. A., Blier, P., Okasha, A., Severus, E., Versiani, M., Tandon, R., Möller, H., & Vieta, E. (2012) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-012-0323-x · Cited by 130 · see citing works
“A review on the effect of SGAs that included 4 monotherapy and one with both monotherapy and combination with an antidepressant reported that the quetiapine and olanzapine trials demonstrated superiority over placebo but both aripiprazole trials failed [132].”
ResultSelf-citationSelle, V., Schalkwijk, S., Vázquez, G., & Baldessarini, R. (2014) · Pharmacopsychiatry · doi:10.1055/s-0033-1363258 · Cited by 128 · see citing works
Treatment Options for Bipolar Depression
Vieta, E., Locklear, J. C., Günther, O., Ekman, M., Miltenburger, C., Chatterton, M. L., Åström, M., & Paulsson, B. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181f15849 · Cited by 117 · see citing works
Self-citationFountoulakis, K. Ν., Yatham, L. N., Grunze, H., Vieta, E., Young, A. H., Blier, P., Kasper, S. F., & Moeller, H. J. (2016) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyw100 · Cited by 115 · see citing works
“They also reported negative results for lamotrigine and aripiprazole, lithium as well as for adjunctive inositol (Cruz et al., 2010; Kemp et al., 2010; Tamayo et al., 2010; Vieta et al., 2010c; De Fruyt et al., 2011, 2012; Gao et al., 2011; Silva et al., 2013; Citrome et al., 2014; Mukai et al., 2014; Suttajit et al.,…”
Self-citationHoertel, N., Strat, Y. L., Angst, J., & Dubertret, C. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.09.016 · Cited by 106 · see citing works
“, 1994) should be carefully evaluated and might better benefit from mood stabilizers or certain atypical antipsychotics alone or in addition after response to antidepressant treatment rather than antidepressant therapy alone, as previously suggested (Angst, 2007; Cruz et al., 2010; Keck et al., 2008; Licht et al., 200…”
BackgroundTherapeutic options in treatment-resistant depression
Vieta, E., & Colom, F. (2011) · Annals of Medicine · doi:10.3109/07853890.2011.583675 · Cited by 100 · see citing works
Self-citationPatton, M. H., Bizup, B. T., & Grace, A. A. (2013) · The Journal of Neuroscience · doi:10.1523/jneurosci.2449-13.2013 · Cited by 94 · see citing works
Vieta, E., Langosch, J., Figueira, M., Souery, D., Blasco-Colmenares, E., Medina, E., Moreno-Manzanaro, M., Gonzalez, M., & Bellivier, F. (2013) · International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713000278 · Cited by 85 · see citing works
“, 2011) and, in some cases, in depression (Cruz et al., 2010).”
BackgroundSelf-citationFruyt, J. D., Deschepper, E., Audenaert, K., Constant, E., Floris, M., Pitchot, W., Sienaert, P. A., Souery, D., & Claes, S. J. (2011) · Journal of Psychopharmacology · doi:10.1177/0269881111408461 · Cited by 94 · see citing works
“In another meta-analysis (Cruz et al., 2009), aripiprazole data were included but only efficacy data were analyzed.”
MethodPharmacological Management of Bipolar Depression: Acute Treatment, Maintenance, and Prophylaxis
Vieta, E., & Valentí, M. (2013) · CNS Drugs · doi:10.1007/s40263-013-0073-y · Cited by 95 · see citing works
“Interestingly, a rapid onset of action seems to be a common feature [67], as both quetiapine and olanzapine showed efficacy from week 1 of treatment onwards.”
BackgroundMethodSelf-citationOverview of antidepressant treatment of bipolar depression
Vázquez, G. H., Tondo, L., Undurraga, J. P., & Baldessarini, R. J. (2013) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713000023 · Cited by 93 · see citing works
Excess Mortality in Bipolar Disorders
Miller, C. J., & Bauer, M. S. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-014-0499-z · Cited by 91 · see citing works
“These negative outcomes continue to occur despite a large and expanding selection of treatment options dating back to lithium [8] and now including anticonvulsants [9, 10], antipsychotics [11–14], and evidence-based psychotherapies [15–19].”
BackgroundLopez-Munoz, F. J., & Álamo, C. (2013) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2013.00102 · Cited by 84 · see citing works
Kadakia, A., Dembek, C., Heller, V., Singh, R., Uyei, J., Hagi, K., Nosaka, T., & Loebel, A. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03220-3 · Cited by 79 · see citing works
Sanford, M., & Keating, G. M. (2012) · CNS Drugs · doi:10.2165/11203840-000000000-00000 · Cited by 78 · see citing works
“valproate semisodium [divalproex sodium], carbamazepine and lamotrigine).([7-10]) However, the use of antidepressant drugs in bipolar depression is controversial, as clinical benefits are uncertain and some studies indicate that there is an increased risk of”
BackgroundLombardo, I., Sachs, G. S., Kolluri, S., Kremer, C. M. E., & Yang, R. (2012) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31825ccde5 · Cited by 73 · see citing works
“The following subjects were excluded from both studies: (1) subjects diagnosed with schizophrenia or schizoaffective disorder, schizophreniform disorder, delusional disorder, or psychotic disorders not otherwise specified; (2) subjects who failed 3 or more adequate studies (more than 4 weeks at an adequate dose) of an…”
The effects of neuropsychiatric drugs on glycogen synthase kinase-3 signaling
Sutton, L. P., & Rushlow, W. J. (2011) · Neuroscience · doi:10.1016/j.neuroscience.2011.09.056 · Cited by 71 · see citing works
Prediction of response to drug therapy in psychiatric disorders
Stern, S., Linker, S. B., Vadodaria, K. C., Marchetto, M. C., & Gage, F. H. (2018) · Open Biology · doi:10.1098/rsob.180031 · Cited by 65 · see citing works
Zhornitsky, S., Rizkallah, É., Pampoulova, T., Chiasson, J., Stip, É., Rompré, P.-P., & Potvin, S. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181e7810a · Cited by 63 · see citing works
Sajatovic, M., & Chen, P. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2011.02.007 · Cited by 63 · see citing works
Szegedi, A., Zhao, J., van Willigenburg, A. P. P., Nations, K. R., Mackle, M., & Panagides, J. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-101 · Cited by 63 · see citing works
“59) when negative aripiprazole trials were excluded [30].”
BackgroundZhou, J., Li, M., Wang, X., He, Y., Xia, Y., Sweeney, J. A., Kopp, R. F., Liu, C., & Chen, C. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.674273 · Cited by 56 · see citing works
An update of evidence-based treatment of bipolar depression: where do we stand?
Fountoulakis, K. Ν. (2009) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e328333e132 · Cited by 53 · see citing works
Baghai, T. C., Blier, P., Baldwin, D. S., Bauer, M., Goodwin, G. M., Fountoulakis, K. Ν., Kasper, S. F., Leonard, B. E., Malt, U. F., Stein, D. J., et al. (2011) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-011-0259-6 · Cited by 51 · see citing works
“A significant and clinically relevant efficacy of the atypical antipsychotics olanzapine and quetiapine has been shown [108], as mentioned below in case of olanzapine especially in combination with fluoxetine (OFC) [398].”
BackgroundThe Role of Antipsychotics in the Management of Fibromyalgia
Calandre, E. P., & Rico‐Villademoros, F. (2012) · CNS Drugs · doi:10.2165/11597130-000000000-00000 · Cited by 49 · see citing works
A clinical review of aripiprazole in bipolar depression and maintenance therapy of bipolar disorder
Yatham, L. N. (2011) · Journal of Affective Disorders · doi:10.1016/s0165-0327(11)70005-2 · Cited by 48 · see citing works
“, 2008b); however, the number of studies investigating their potential in acute bipolar depression or long-term relapse prevention is limited (Cruz et al., 2010).”
BackgroundQuetiapine XR: Current status for the treatment of major depressive disorder
Pae, C., Sohi, M. S., Seo, H., Serretti, A., Patkar, A. A., Steffens, D. C., & Masand, P. S. (2010) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2010.03.023 · Cited by 46 · see citing works
Suppes, T. M., Vieta, E., Gustafsson, U., & Ekholm, B. (2013) · Depression and Anxiety · doi:10.1002/da.22136 · Cited by 42 · see citing works
Self-citationGoikolea, J. M., Colom, F., Torres, I., Capapey, J., Valentí, M., Undurraga, J. P., Grande, I., Sánchez‐Moreno, J., & Vieta, E. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.07.038 · Cited by 40 · see citing works
“In fact, atypicals have already shown different efficacy profiles in the treatment of bipolar depression (Cruz et al., 2010).”
BackgroundSelf-citationQuetiapine monotherapy in bipolar II depression: combined data from four large, randomized studies
Young, A. H., Calabrese, J. R., Gustafsson, U., Berk, M., McElroy, S. L., Thase, M. E., Suppes, T., & Earley, W. (2013) · International Journal of Bipolar Disorders · doi:10.1186/2194-7511-1-10 · Cited by 35 · see citing works
“Emerging reports support the effectiveness of several therapies in the treatment of acute bipolar II depression (Cruz et al. 2010; Swartz and Thase 2011).”
ResultEarley, W. R., Durgam, S., Lu, K., Debelle, M., Laszlovszky, I., Vieta, E., & Yatham, L. N. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.03.032 · Cited by 36 · see citing works
Self-citationKorean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision
Woo, Y. S., Bahk, W., Lee, J. G., Jeong, J., Kim, M.-D., Sohn, I., Shim, S.-H., Jon, D., Seo, J. S., Min, K. J., et al. (2018) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2018.16.4.434 · Cited by 34 · see citing works
Broadening the diagnosis of bipolar disorder: benefits vs. risks
Strakowski, S. M., Fleck, D. E., & Maj, M. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00046.x · Cited by 32 · see citing works
Fountoulakis, K. Ν., Gazouli, M., Kelsoe, J. R., & Akiskal, H. S. (2014) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2014.11.010 · Cited by 32 · see citing works
“…with the data concerning also aripiprazole and ziprasidone, suggest that the early antidepressant effect in bipolar depression (until week 6) (Cruz et al., 2010; Vieta, 2010a, b; Vieta et al., 2010) can be achieved through an agonistic activity at 5HT-1A and antagonism at alpha1…”
Trends in quetiapine use and non-fatal quetiapine-related ambulance attendances
Heilbronn, C., Lloyd, B., McElwee, P., Eade, A., & Lubman, D. I. (2013) · Drug and Alcohol Review · doi:10.1111/dar.12028 · Cited by 31 · see citing works
Antipsychotic switching in bipolar disorders: a systematic review
Grande, I., Bernardo, M., Bobes, J., Sáiz-Ruiz, J., Álamo, C., & Vieta, E. (2013) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145713001168 · Cited by 30 · see citing works
“, 2013; Vieta and Valentí, 2013a), but antipsychotics are also a well-grounded treatment for acute depression and the prevention of relapses (Cruz et al., 2010; Frye et al., 2011; Nivoli et al., 2011a; Vieta et al., 2011; Grunze et al., 2013; Vieta and Valentí, 2013b).”
Self-citationAltamura, A. C., Moliterno, D., Paletta, S., Buoli, M., Dell’Osso, B. M., Mauri, M. C., & Bareggi, S. R. (2012) · Clinical Drug Investigation · doi:10.2165/11597330-000000000-00000 · Cited by 29 · see citing works
Baghai, T. C., Blier, P., Baldwin, D. S., Bauer, M., Goodwin, G. M., Fountoulakis, K. N., Kasper, S. F., Leonard, B. E., Malt, U. F., Stein, D. J., et al. (2011) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-011-0274-7 · Cited by 26 · see citing works
“For atypical antipsychotics such as quetiapine and olanzapine, efficacy in both bipolar [24, 34, 42, 110, 126] and unipolar depression [18, 37] has been confirmed.”
Köhler, S., Gaus, S., & Bschor, T. (2014) · Pharmacopsychiatry · doi:10.1055/s-0033-1364004 · Cited by 26 · see citing works
Korean Medication Algorithm for Bipolar Disorder 2018: Comparisons with Other Treatment Guidelines
Jeong, J., Bahk, W., Woo, Y. S., Lee, J. G., Kim, M.-D., Sohn, I., Shim, S.-H., Jon, D., Seo, J. S., Kim, W. K., et al. (2019) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2019.17.2.155 · Cited by 25 · see citing works
Slow dissociation of partial agonists from the D2 receptor is linked to reduced prolactin release
Carboni, L., Negri, M., Michielin, F., Bertani, S., Fratte, S. D., Oliosi, B., & Cavanni, P. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145711000824 · Cited by 24 · see citing works
“…and widely used therapeutic agents in the treatment of many psychiatric disorders, such as schizophrenia (Falkai et al. 2005), bipolar disorder (Cruz et al. 2010), psychotic depression (Hamoda & Osser, 2008), generalized anxiety disorder (Gao et al. 2009), and eating disorders (McKnight &…”
BackgroundAntipsychotics in the Treatment of Bipolar Disorder
Singh, J. B., Chen, G., & Canuso, C. M. (2012) · Handbook of experimental pharmacology · doi:10.1007/978-3-642-25761-2_8 · Cited by 24 · see citing works
Hoertel, N., Strat, Y. L., Limosin, F., Dubertret, C., & Gorwood, P. A. P. M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0055448 · Cited by 23 · see citing works
Katagiri, H., Tohen, M. F., McDonnell, D., Fujikoshi, S., Case, M. G., Kanba, S., Takahashi, M., & Gomez, J.-C. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-138 · Cited by 23 · see citing works
“Multiple agents have shown efficacy in the treatment of bipolar mania including lithium, valproate, and all currently available atypical antipsychotics [2-4].”
BackgroundBobo, W. V., EPSTEIN, R. A., Lynch, A., Patton, T. D., Bossaller, N. A., & Shelton, R. C. (2011) · Clinical Neuropharmacology · doi:10.1097/wnf.0b013e318237709a · Cited by 22 · see citing works
Bartoli, F., Dell’Osso, B. M., Crocamo, C., Fiorillo, A., Ketter, T. A., Suppes, T. M., Clerici, M., & Carrà, G. (2017) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.12.021 · Cited by 22 · see citing works
Jeong, J., Bahk, W., Woo, Y. S., Yoon, B.-H., Lee, J. G., Kim, W., Sohn, I., Park, S., Shim, S.-H., Seo, J. S., et al. (2023) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2023.21.1.32 · Cited by 20 · see citing works
“This reflects some results showing that ARP monotherapy is not superior to placebo [60,61].”
Role of paliperidone extended-release in treatment of schizoaffective disorder
Canuso, C. M. (2010) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s12612 · Cited by 19 · see citing works
Björkholm, C., Frånberg, O., Malmerfelt, A., Marcus, M. M., Konradsson‐Geuken, Å., Schilström, B., Jardemark, K. E., & Svensson, T. H. (2014) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyu068 · Cited by 18 · see citing works
Diagnosis and treatment depression in schizophrenia
Mosolov, S. N. (2020) · Consortium Psychiatricum · doi:10.17650/2712-7672-2020-1-2-29-42 · Cited by 20 · see citing works
Gao, K., Pappadopulos, E. A., Karayal, O. N., Kolluri, S., & Calabrese, J. R. (2013) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3182917f3f · Cited by 17 · see citing works
“For the treatment of BPD, however, only quetiapine and the combination of fluoxetine and olanzapine showed superior efficacy over placebo.(2) As with typical antipsychotics, the atypical antipsychotics also carry the risk of adverse effects such as extrapyramidal side effects (EPS), akathisia, somnolence, sedation, an…”
BackgroundFountoulakis, K. Ν., Ioannou, M., Tohen, M. F., Haarman, B. C. M., & Zarate, C. A. (2023) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2023.03.009 · Cited by 16 · see citing works
Korean Medication Algorithm Project for Bipolar Disorder: third revision
Bahk, W., Woo, Y. S., Lee, J. G., Jeong, J., Kim, M.-D., Sohn, I., Shim, S.-H., Jon, D., Seo, J. S., Min, K. J., et al. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s77838 · Cited by 16 · see citing works
Antipsychotic and anticholinergic drugs
Meltzer, H. Y., & Bobo, W. V. (2020) · doi:10.1093/med/9780198713005.003.0064 · Cited by 16 · see citing works
Pharmacological Therapies in Bipolar Disorder: a Review of Current Treatment Options.
Joshi, A., Bow, A., & Agius, M. A. (2019) · PubMed · Cited by 16 · see citing works
Overview of Antidepressant Treatment of Bipolar Depression
Vázquez, G. H., Tondo, L., Undurraga, J. P., & Baldessarini, R. J. (2015) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.130119 · Cited by 15 · see citing works
Management of bipolar I depression: clinical utility of lurasidone
El‐Mallakh, R. S., Findlay, L., & El-Mallakh, P. L. (2015) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s57695 · Cited by 14 · see citing works
“However, clinical research increasingly supports the use of antipsychotic medications as an effective treatment option for depression in bipolar disorder.(27,28) For example, lurasidone, a second-generation antipsychotic that is already approved for the treatment of schizophrenia,(29,30) has been approved by the Unite…”
Bauer, M. S., Miller, C. J., Li, M., Bajor, L., & Lee, A. F. (2016) · Bipolar Disorders · doi:10.1111/bdi.12425 · Cited by 13 · see citing works
Korean Medication Algorithm for Bipolar Disorder 2014: comparisons with other treatment guidelines
Jeong, J., Lee, J. G., Kim, M.-D., Sohn, I., Shim, S.-H., Wang, H. R., Woo, Y. S., Jon, D., Seo, J. S., Shin, Y.-C., et al. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s86552 · Cited by 11 · see citing works
“28,29 However, another meta-analysis suggested that aripiprazole mono-therapy could be effective for the treatment of acute depression because the combined data from two negative studies revealed a significant effect.”
The Ascendancy of Second-Generation Antipsychotics as Frontline Antimanic Agents
Miller, C. J., Li, M., Penfold, R. B., Lee, A. F., Smith, E. G., Nordberg, S. S., Osser, D. N., Bajor, L., Zhang, F., & Bauer, M. S. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000405 · Cited by 11 · see citing works
Altınbaş, K., Smith, D., & Oral, E. T. (2011) · PubMed · Cited by 11 · see citing works
Pharmaceutical treatment of acute bipolar depression
Fountoulakis, K. Ν. (2010) · F1000 Medicine Reports · doi:10.3410/m2-47 · Cited by 10 · see citing works
“Some suggest that only quetiapine – and to a lesser extent, olanzapine – show efficacy as a monotherapy for bipolar depression [42-44].”
BackgroundÁlamo, C., Lopez-Munoz, F. J., & García‐García, P. (2014) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2014.915741 · Cited by 10 · see citing works
“The role of quetiapine in the treatment of acute bipolar depression I–II is supported by some studies (BOLDER I and II; EMBOLDEN II and II) [56] and a meta-analysis [54] that indicate that it is effective and well tolerated in the treatment of bipolar depression.”
BackgroundResultPharmakologische Behandlung der bipolaren Depression
Köhler, S., Bauer, M., & Bschor, T. (2013) · Der Nervenarzt · doi:10.1007/s00115-013-3919-0 · Cited by 7 · see citing works
Antidepressants in Acute Bipolar Depression
Cruz, N., & Vieta, E. (2011) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.10lr06638 · Cited by 8 · see citing works
Self-citationFernández‐Pastor, B., Ortega, J. E., Grandoso, L., et al. (2016) · Neuropharmacology · doi:10.1016/j.neuropharm.2016.11.025 · Cited by 8 · see citing works
“Likewise, this facilitatory effect of a2-adrenoceptor antagonism could be a contributing pharmacological mechanism to the enhancement of antidepressant response induced by atypical antipsychotic drugs (Cruz et al., 2010; Zhou et al., 2015 and references therein).”
Miller, C. J., Li, M., Penfold, R. B., et al. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0339-z · Cited by 8 · see citing works
“mania, depression, and mixed states [7-10], with further support from meta-analyses [11-14].”
ResultPharmacokinetic evaluation of armodafinil for the treatment of bipolar depression
Niemegeers, P., Maudens, K. E. K., Morrens, M., Patteet, L., Joos, L., Neels, H. M., & Sabbe, B. G. (2012) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1517/17425255.2012.708338 · Cited by 8 · see citing works
“Monotherapy with quetiapine and olanzapine, as well as the olanzapine--fluoxetine combination, are effective in bipolar depression with all showing a rapid onset of action starting in the first week of treatment [12-15].”
BackgroundPrediction of Response to Drug Therapy in Psychiatric Disorders
Stern, S., Linker, S. B., Vadodaria, K. C., Marchetto, M. C., & Gage, F. H. (2019) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.17304 · Cited by 8 · see citing works
Ogasawara, M., Takeshima, M., Esaki, Y., Kaneko, Y., Utsumi, T., Aoki, Y., Watanabe, N., Suzuki, M., & Takaesu, Y. (2022) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12283 · Cited by 7 · see citing works
Cremaschi, L., Ketter, T. A., Arici, C., Miller, S., Hooshmand, F., & Dell’Osso, B. M. (2019) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000283 · Cited by 7 · see citing works
Porcelli, S., Balzarro, B., Ronchi, D. D., & Serretti, A. (2014) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000103 · Cited by 6 · see citing works
Bohlken, J., Konrad, M., & Kostev, K. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112758 · Cited by 6 · see citing works
Fountoulakis, K. Ν., Tohen, M. F., & Zarate, C. A. (2024) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2024.01.002 · Cited by 6 · see citing works
Ferrari, M., Godio, M., Callegari, C., Cosentino, M., & Marino, F. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4432 · Cited by 5 · see citing works
Baldessarini, R. J. (2012) · Springer eBooks · doi:10.1007/978-1-4614-3710-9_3 · Cited by 5 · see citing works
Park, D. Y., Goffin, K. C., Shah, S., Yuen, L. D., Holtzman, J. N., Hooshmand, F., Miller, S., Wang, P. W., & Ketter, T. A. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.01.016 · Cited by 5 · see citing works
On the treatment of bipolar affective disorder
Петрова, Н. Н. (2022) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202212201280 · Cited by 5 · see citing works
Tao, H., Wang, J., Shen, D., Sun, F., & Jin, W. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.850021 · Cited by 5 · see citing works
“guidelines for bipolar depression (8, 12, 14, 15).”
BackgroundTamayo, J. M. (2011) · Actas Españolas de Psiquiatría · Cited by 3 · see citing works
Schweitzer, I., Sarris, J. J., Tuckwell, V., Maguire, K. P., Smith, D. J., & Ng, C. H. (2013) · International Journal of Bipolar Disorders · doi:10.1186/2194-7511-1-4 · Cited by 3 · see citing works
“This reflects the conclusions of Cruz et al. (2012) who found that both aripiprazole trials reviewed failed on the primary efficacy measure after the first 6 weeks.”
InfluentialFountoulakis, K. N. (2014) · Springer eBooks · doi:10.1007/978-3-642-37216-2_16 · Cited by 3 · see citing works
The use of (newer) antipsychotics in bipolar inpatients over a 17-year observation period
Dehning, J., Grunze, H., Walpoth, M., Kemmler, G., & Hausmann, A. (2018) · International Clinical Psychopharmacology · doi:10.1097/yic.0000000000000233 · Cited by 3 · see citing works
Effects of olanzapine and paroxetine on phospholipase D activity in the rat brain
Krzystanek, M., Krzystanek, E., Trzeciak, H. I., Małecki, A., Krupka-Matuszczyk, I., Janas-Kozik, M. H., & RYBAKOWSKI, J. K. (2013) · Pharmacological Reports · doi:10.1016/s1734-1140(13)71051-x · Cited by 3 · see citing works
Abhari, S. A. A., Sadeghi, M., Ardestani, S. M. S., Semnani, Y., Mirsepassi, G., Sadr, S. S., Kamaloo, A., Ahadi, M., Pourmirza, B., & Mir, E. (2013) · Europe PMC (PubMed Central) · Cited by 3 · see citing works
Antipsychotics in bipolar depression: in reply
Vieta, E., Franco, C., & Cruz, N. (2010) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145710000477 · Cited by 2 · see citing works
“…2010; First published online 6 May 2010 Krishnadas & Livingston (2010) make the case for caution when interpreting the results of our metaanalysis showing the efficacy of some secondgeneration antipsychotics in bipolar depression, as well as their apparent rapid onset of action (Cruz et al. 2010).”
BackgroundSelf-citationMedikamente zur Behandlung bipolarer affektiver Störungen
Grunze, H., & Bauer, M. (2011) · Springer eBooks · doi:10.1007/978-3-642-19844-1_54 · Cited by 1 · see citing works
The Role of Atypical Antipsychotic Therapy for Patients with Treatment- Resistant Bipolar Depression
Shah, A. S. (2014) · African Journal of Psychiatry · doi:10.4172/1994-8220.1000150 · Cited by 1 · see citing works
Actualización en el uso y el manejo del litio en neuropsiquiatría
Corrales, A., Cetkovich, M., Abadi, A. F., Camino, S., Bonetto, G. G., Mato, A. M. L., Marengo, E., Abraham, E., Maresca, T., Bagnati, P. R. A. D. N., et al. (2024) · Vertex Revista Argentina de Psiquiatría · doi:10.53680/vertex.v34i162.504 · Cited by 1 · see citing works
Stevenson, H. P. (2020) · Clinical Research in Practice The Journal of Team Hippocrates · doi:10.22237/crp/1593562020 · Cited by 1 · see citing works
Traitement d’un premier épisode dépressif dans le cadre du trouble bipolaire
Pringuey, D., Chérikh, F., Tible, O., & Giordana, B. (2010) · L Encéphale · doi:10.1016/s0013-7006(10)70007-5 · Cited by 1 · see citing works
“Stade 1 Évaluation du statut psychopharmacologique psychoéducation, stratégies comportementales et rythmiques Stade 2 Initier la médication, optimiser le traitement, vérifier la compliance Stade 3 Ajouter ou changer entre les composés de la première ligne Stade 4 Ajouter ou changer entre les composés de 1re et 2e lign…”
BackgroundKrishnadas, R., & Livingston, M. (2010) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145710000350 · Cited by 1 · see citing works
“…caution Received 14 February 2010; Reviewed 14 February 2010; Revised 14 February 2010; Accepted 5 March 2010; First published online 30 March 2010 Cruz et al. (2010) in their recent meta-analysis of efficacy of modern antipsychotics in bipolar depression suggest that olanzapine and quetiapine…”
BackgroundKeßler, U. (2014) · NORA - Norwegian Open Research Archives · Cited by 1 · see citing works
- Authors
- Cruz, N., Sanchez-Moreno, J., Torres, F., Goikolea, J. M., Valentí, M., & Vieta, E.
- Affiliations
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Harvard University (US)
- Corresponding author
- Vieta, Eduard
- Venue
- The International Journal of Neuropsychopharmacology
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-07-29
- Volume
- 13
- Issue
- 01
- Pages
- 5
- ISSN
- 1461-1457 (ISSN-L)
- 1469-5111
- OpenAlex
- W2142698669
- Cited by
- 121
- References
- 45
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 4 · 2016: 4 · 2015: 7 · 2014: 12 · 2013: 17 · 2012: 15
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The International Journal of Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, public-domain)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- Sanofi
- Ministerio de Ciencia e Innovación
- Centro de Investigación Biomédica en Red de Salud Mental
- Servier
- Cilag
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar depression, atypical antipsychotics, quetiapine, olanzapine, aripiprazole, antipsychotic monotherapy, antidepressant combination therapy, rapid onset of action, Montgomery-Asberg Depression Rating Scale
- MeSH terms
- Aripiprazole, Quetiapine Fumarate, Olanzapine, Antidepressive Agents, Benzodiazepines, Bipolar Disorder, Dibenzothiazepines, Drug Combinations, Drug Therapy, Combination, Fluoxetine, Humans, Piperazines, Placebos, Antipsychotic Agents, Quinolones, Randomized Controlled Trials as Topic, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
