Treatment of mixed bipolar states
Open accessAbstract
Mixed bipolar states are associated with more severe symptoms and outcome. Our aim is to review the literature examining their treatment. We conducted a literature search of randomized clinical studies and post-hoc analyses on mixed bipolar states' treatment. Remarkably, there is only one double-blind, placebo-controlled trial, recruiting a mixed episode cohort, and one post-hoc analysis of this trial, while most data come from post-hoc analyses of trials including both manic and mixed patients. Improvement of manic symptoms in mixed episodes is similar to that seen in pure manic episodes and independent of baseline depressive features. The magnitude of response to manic symptoms' treatment probably exceeds that of depressive symptoms, which appear to resolve later. Valproate and carbamazepine are effective in acute mixed episodes, but the efficacy of lithium appears questionable. Atypical antipsychotic monotherapy improves both manic and depressive symptoms. Mood-stabilizer-atypical antipsychotic combination increases this effect. Atypical antipsychotic-antidepressant combination against acute mixed depression does not increase the risk for mania, although its superior efficacy vs. atypical antipsychotic monotherapy cannot be supported by current data. As regards prophylaxis, atypical antipsychotic monotherapy is associated with a lower incidence of and a longer time to relapse of any kind. The augmentation of lithium or divalproex with atypical antipsychotics increases prophylactic efficacy. Lithium or divalproex monotherapy have not been associated with significant prophylactic benefits following mixed mania. New, randomized prospective trials involving homogeneous cohorts of mixed bipolar patients are needed in order to delineate the appropriate pharmacological treatment of mixed states.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Evidence supports the preferential use of atypical antipsychotics and divalproex in cases of mixed features, with combination therapy frequently required.
“Evidence supports the preferential use of atypical antipsychotics and divalproex in these cases, with combination therapy frequently required.195, 203”
From Canadian Network for Mood and Anxiety Treatments ( <scp>CANMAT</scp> ) and International Society for Bipolar Disorders ( <scp>ISBD</scp> ) 2018 guidelines for the management of patients with bipolar disorder (2018) · cites this paper as [203]
The Abstract and Discussion support atypical antipsychotics and valproate for acute mixed bipolar states, and report benefits from some combinations. They also describe effective monotherapies; they do not say that combination therapy is frequently required. Page numbers are unavailable in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Journal of Clinical Psychiatry
(2018) · Journal of Clinical Psychiatry · doi:10.5505/kpd · Cited by 13,703 · see citing works
Manic-Depressive Insanity and Paranoia.
(1921) · JAMA · doi:10.1001/jama.1921.02630330070026 · Cited by 1,612 · see citing works
Manic Depressive Insanity and Paranoia
Kraepelin, E. (1921) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-192104000-00057 · Cited by 1,327 · 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
Bowden, C. L. (1994) · JAMA · doi:10.1001/jama.271.12.918 · Cited by 955 · 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
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
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
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
Course of the Manic-Depressive Cycle and Changes Caused by Treatments
Kukopulos, A., Reginaldi, D., Laddomada, P., Floris, G., Serra, G., & Tondo, L. (2008) · Pharmacopsychiatry · doi:10.1055/s-2007-1019628 · Cited by 436 · cited 1× · see citing works
“As opposed to typical antipsychotics, aripiprazole, olanzapine and paliperidone do not appear to precipitate depression in mixed patients (Kukopulos et al. 1980; Tohen et al. 2001; White et al. 1993).”
ResultClinical and research implications of the diagnosis of dysphoric or mixed mania or hypomania
McElroy, S. L., Keck, P. E., Pope, H. G., Hudson, J. I., Faedda, G. L., & Swann, A. C. (1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.12.1633 · Cited by 428 · 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
The Expert Consensus Guideline Series: Medication Treatment of Bipolar Disorder 2000.
Sachs, G. S., PRINTZ, D. J., Kahn, D. A., Carpenter, D. P., & Docherty, J. P. (2000) · PubMed · Cited by 394 · 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
Weisler, R. H., Kalali, A. H., Ketter, T. A., & SPD417 Study Group (2004) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v65n0405 · Cited by 349 · see citing works
The Texas Implementation of Medication Algorithms
Suppes, T. M., Dennehy, E. B., Hirschfeld, R. M. A., Altshuler, L. L., Bowden, C. L., Calabrese, J. R., Crismon, M. L., Ketter, T. A., Sachs, G. S., Swann, A. C., et al. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0710 · Cited by 327 · see citing works
Keller, M. B. (1986) · JAMA · doi:10.1001/jama.255.22.3138 · Cited by 318 · see citing works
Tohen, M., Calabrese, J. R., Sachs, G. S., Banov, M. D., Detke, H. C., Risser, R., Baker, R. W., Chou, J. C.-Y., & Bowden, C. L. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.2.247 · Cited by 317 · see citing works
A double-blind comparison of valproate and lithium in the treatment of acute mania
Freeman, T. W., Clothier, J. L., Pazzaglia, P. J., Lesem, M. D., & Swann, A. C. (1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.1.108 · Cited by 301 · see citing works
Akiskal, H. S., Hantouche, E. G., Bourgeois, M. L., Azorin, J., Sechter, D., Allilaire, J., Lancrenon, S., Fraud, J.-P., & Châtenet-Duchêne, L. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00113-x · Cited by 288 · see citing works
Clinical Practice Guidelines for Bipolar Disorder From the Department of Veterans Affairs
Bauer, M. S., Callahan, A. M., JAMPALA, C. V., Petty, F., Sajatovic, M., Schaefer, V., Wittlin, B., & Powell, B. J. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n0104 · Cited by 268 · 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
Incidence and Significance of Mixed Affective States in a Bipolar Population
Himmelhoch, J. M. (1976) · Archives of General Psychiatry · doi:10.1001/archpsyc.1976.01770090052004 · Cited by 230 · see citing works
Suppes, T., Vieta, E., Liu, S., Brecher, M., Paulsson, B., & Trial 127 Investigators (2009) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.08020189 · Cited by 230 · 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
McIntyre, R. S., Cohen, M., Zhao, J., Alphs, L. D., Macek, T. A., & Panagides, J. (2009) · Bipolar Disorders · doi:10.1111/j.1399-5618.2009.00748.x · Cited by 189 · see citing works
Signs and symptoms of mania in pure and mixed episodes
Cassidy, F., Murry, E., Forest, K., & Carroll, B. J. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00016-0 · Cited by 188 · 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
Sources of lithium resistance in mixed mania.
Himmelhoch, J. M., & Garfinkel, M. E. (1986) · PubMed · Cited by 164 · see citing works
Extended-Release Carbamazepine Capsules as Monotherapy for Acute Mania in Bipolar Disorder
Weisler, R. H., Keck, P. E., Swann, A. C., Cutler, A. J., Ketter, T. A., Kalali, A. H., & SPD417 Study Group (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0308 · Cited by 162 · see citing works
Ziprasidone 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
Prien, R. F., Himmelhoch, J. M., & Kupfer, D. J. (1988) · Journal of Affective Disorders · doi:10.1016/0165-0327(88)90003-1 · Cited by 148 · see citing works
Bowden, C. L., Swann, A. C., Calabrese, J. R., Rubenfaer, L. M., Wozniak, P. J., Collins, M. A., Abi‐Saab, W., Saltarelli, M., & Depakote ER Mania Study Group (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n1003 · Cited by 142 · see citing works
Vieta, E., Nuamah, I. F., Lim, P., Yuen, E., Palumbo, J., Hough, D. W., & Berwaerts, J. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00815.x · Cited by 122 · see citing works
Association of Recurrent Suicidal Ideation With Nonremission From Acute Mixed Mania
Goldberg, J. F., Garno, J. L., Leon, A. C., Kocsis, J. H., & S, L. P. M. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.12.1753 · Cited by 114 · see citing works
Divalproex in the Treatment of Acute Bipolar Depression
Ghaemi, S. N., & Gilmer, W. S. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n1203 · Cited by 111 · see citing works
Asenapine for long-term treatment of bipolar disorder: A double-blind 40-week extension study
McIntyre, R. S., Cohen, M., Zhao, J., Alphs, L. D., Macek, T. A., & Panagides, J. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.04.005 · Cited by 102 · see citing works
Swann, A. C., Secunda, S. K., Katz, M. M., Croughan, J. L., Bowden, C. L., Koslow, S. H., Berman, N., & Stokes, P. E. (1993) · Journal of Affective Disorders · doi:10.1016/0165-0327(93)90036-j · Cited by 98 · see citing works
Suppes, T. M., Eudicone, J. M., McQuade, R. D., Pikalov, A., & Carlson, B. X. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.08.015 · Cited by 84 · see citing works
A meta-analysis of the use of typical antipsychotic agents in bipolar disorder
Tohen, M. F., Zhang, F., Taylor, C. C., Burns, P., Zarate, C. A., Sanger, T. M., & Tollefson, G. D. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00162-2 · Cited by 82 · see citing works
Depot antipsychotics in bipolar affective disorder
White, E., Cheung, P., & Silverstone, T. (1993) · International Clinical Psychopharmacology · doi:10.1097/00004850-199300820-00007 · Cited by 76 · see citing works
Extended-Release Carbamazepine Capsules as Monotherapy in Bipolar Disorder
Weisler, R. H., Hirschfeld, R. M. A., Cutler, A. J., Gazda, T. D., Ketter, T. A., Keck, P. E., Swann, A., & Kalali, A. H. (2006) · CNS Drugs · doi:10.2165/00023210-200620030-00004 · Cited by 76 · see citing works
Diagnosis and treatment of mixed mania
Secunda, S. K., Swann, A. C., Katz, M. M., Koslow, S. H., Croughan, J. L., & Chang, S. S. (1987) · American Journal of Psychiatry · doi:10.1176/ajp.144.1.96 · Cited by 75 · see citing works
Pharmacotherapy of bipolar mixed states
Krüger, S., Young, L. T., & Bräunig, P. (2005) · Bipolar Disorders · doi:10.1111/j.1399-5618.2005.00197.x · Cited by 68 · see citing works
Houston, J., Tohen, M. F., Degenhardt, E. K., Jamal, H. H., Liu, L. L. L., & Ketter, T. A. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04895yel · Cited by 67 · see citing works
Berwaerts, J., Xu, H., Nuamah, I. F., Lim, P., & Hough, D. W. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.06.030 · Cited by 66 · see citing works
Olanzapine/Fluoxetine Combination for the Treatment of Mixed Depression in Bipolar I Disorder
Benazzi, F., Berk, M., Frye, M. A., Wang, W., Barraco, A., & Tohen, M. F. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.08m04772gre · Cited by 65 · see citing works
Acute Dysphoric Mania: Treatment Response to Olanzapine Versus Placebo
Baker, R. W., Tohen, M. F., FAWCETT, J. A., Risser, R. C., Schuh, L. M., Brown, E., Stauffer, V. L., Shao, L., & Tollefson, G. D. (2003) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-200304000-00005 · Cited by 62 · see citing works
Mania: differential effects of previous depressive and manic episodes onresponse to treatment
Swann, A. C., Bowden, C. L., Calabrese, J. R., Dilsaver, S. C., & Morris, D. D. (2000) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2000.101006444.x · Cited by 61 · see citing works
Olanzapine Versus Placebo in Acute Mania
Baldessarini, R. J., Hennen, J. A., Wilson, M., Calabrese, J. R., Chengappa, R., Keck, P. E., McElroy, S. L., Sachs, G. S., Vieta, E., Welge, J. A., et al. (2003) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000085410.08426.9a · Cited by 61 · see citing works
Self-citationTreatment of mania, mixed state, and rapid cycling.
Kusumakar, V., Yatham, L. N., Haslam, D. R. S., Parikh, S. V., Matte, R., Silverstone, P. H., & Sharma, V. (1997) · PubMed · Cited by 60 · see citing works
Self-citationEfficacy of olanzapine combined with valproate or lithium in the treatment of dysphoric mania
Baker, R. W., Brown, E., Akiskal, H. S., Calabrese, J. R., Ketter, T. A., Schuh, L. M., Trzepacz, P. T., Watkin, J. G., & Tohen, M. F. (2004) · The British Journal of Psychiatry · doi:10.1192/bjp.185.6.472 · Cited by 58 · see citing works
The prevalence of mixed episodes during the course of illness in bipolar disorder
Kessing, L. V. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2007.01131.x · Cited by 55 · see citing works
Bowden, C. L., Collins, M. A., McElroy, S. L., Calabrese, J. R., Swann, A. C., Weisler, R. H., & Wozniak, P. J. (2005) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300788 · Cited by 55 · see citing works
Dissimilar morbidity following initial mania versus mixed-states in type-I bipolar disorder
Baldessarini, R. J., Salvatore, P., Khalsa, H.-M. K., & Tohen, M. F. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.03.014 · Cited by 53 · see citing works
Houston, J., AHL, J. S. B., Meyers, A. L., Kaiser, C. J., Tohen, M. F., & Baldessarini, R. J. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0811 · Cited by 51 · see citing works
Tohen, M. F., Sutton, V. K., Calabrese, J. R., Sachs, G. S., & Bowden, C. L. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.11.003 · Cited by 48 · see citing works
Relevance of the catatonic syndrome to the mixed manic episode
Krüger, S., Cooke, R. G., Spegg, C., & Bräunig, P. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00088-5 · Cited by 46 · see citing works
Efficacy of ziprasidone in dysphoric mania: Pooled analysis of two double-blind studies
Stahl, S. M., Lombardo, I., Loebel, A. D., & Mandel, F. S. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.023 · Cited by 39 · see citing works
Olanzapine vs placebo in the treatment of acute mania
Sanger, T. M., Tohen, M. F., Tollefson, G. D., et al. (1998) · Schizophrenia Research · doi:10.1016/s0920-9964(97)88687-2 · Cited by 30 · see citing works
Muzina, D. J. (2009) · Bipolar Disorders · doi:10.1111/j.1399-5618.2009.00713.x · Cited by 28 · see citing works
Significance of mixed features in acute mania
Cohen, S., Khan, A., & Robison, J. (1988) · Comprehensive Psychiatry · doi:10.1016/0010-440x(88)90023-5 · Cited by 27 · see citing works
Atypical antipsychotics: efficacy across bipolar disorder subpopulations.
Dünner, D. L. (2005) · PubMed · Cited by 23 · see citing works
Shi, L., Schuh, L. M., Trzepacz, P. T., Huang, L. X., Namjoshi, M. A., & Tohen, M. F. (2004) · Current Medical Research and Opinion · doi:10.1185/030079904125004493 · Cited by 21 · see citing works
Houston, J. P., Ketter, T. A., Case, M. G., et al. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2010.05.016 · Cited by 18 · see citing works
Book Review: DSM-IV: Handbook of Diagnosis and Treatment of DSM IV Personality Disorders
Links, P. S. (1997) · The Canadian Journal of Psychiatry · doi:10.1177/070674379704200114 · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- APA (2002). Practice guideline for the treatment of patients with bipolar disorder (revision). American Journal of Psychiatry 159 (Suppl.), 1-50.
Cited by
Sorted by citations
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852 · see citing works
Self-citationMalhi, G. S., Bassett, D., Boyce, P., Bryant, R., Fitzgerald, P. B., Fritz, K., Hopwood, M., Lyndon, B., Mulder, R., Murray, G., et al. (2015) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415617657 · Cited by 842 · see citing works
“Clarification of the source of such further difficulties in Australian & New Zealand Journal of Psychiatry, 49(12) management requires careful clinical assessment (Fountoulakis et al., 2012a; Grunze et al., 2013; Sienaert et al., 2013) (Level III).”
BackgroundMcIntyre, R. S., Alda, M., Baldessarini, R. J., Bauer, M., Berk, M., Correll, C. U., Fagiolini, A., Fountoulakis, K., Frye, M. A., Grunze, H., et al. (2022) · World Psychiatry · doi:10.1002/wps.20997 · Cited by 171 · see citing works
Self-citationMuralidharan, K., Ali, M., Silveira, L. E., Bond, D. J., Fountoulakis, K. N., Lam, R. W., & Yatham, L. N. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.04.032 · Cited by 47 · see citing works
Self-citationBipolar mixed states: still mixed up?
Castle, D. J. (2014) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000029 · Cited by 14 · see citing works
- Authors
- Fountoulakis, K. N., Kontis, D., Gonda, X., Siamouli, M., & Yatham, L. N.
- Affiliations
- Asklepios Klinik Langen (DE)
- University of British Columbia (CA)
- Corresponding author
- Kontis, Dimitrios
- Venue
- The International Journal of Neuropsychopharmacology
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-01-05
- Volume
- 15
- Issue
- 07
- Pages
- 1015-1026
- ISSN
- 1461-1457 (ISSN-L)
- 1469-5111
- OpenAlex
- W2093726998
- Cited by
- 68
- References
- 69
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 6 · 2019: 2 · 2018: 4 · 2017: 6 · 2016: 10 · 2015: 6 · 2014: 13 · 2013: 8 · 2012: 1
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The International Journal of Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- Sanofi
- Pfizer Foundation
- 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 disorder, mixed mania, mixed depression, manic symptoms, depressive symptoms, valproic acid, carbamazepine, lithium, atypical antipsychotics, mood stabilizers, antidepressants, prophylaxis, relapse prevention, treatment response
- MeSH terms
- Antidepressive Agents, Bipolar Disorder, Humans, Antipsychotic Agents, Randomized Controlled Trials as Topic
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.
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
