Atypical Antipsychotics in the Treatment of Mania: A Meta-Analysis of Randomized, Placebo-Controlled Trials
Abstract
Background Randomized, controlled trials have demonstrated efficacy for atypical antipsychotics in the treatment of mania in bipolar disorder, either as monotherapy or adjunctive treatment. However, there are no published comparisons of individual atypical antipsychotics for mania. Data sources and study selection We conducted a systematic review and meta-analysis of randomized, placebo-controlled monotherapy and adjunctive therapy trials of atypical antipsychotics for acute bipolar mania. Studies published through 2004 were identified using searches of PubMed/MEDLINE with the search terms mania, placebo, and each of the atypical antipsychotics, limited to randomized, controlled clinical trials; review of abstracts from the 2003 meetings of the American College of Neuropsychiatry, American Psychiatric Association, and International Conference on Bipolar Disorder; and consultations with study investigators and representatives of pharmaceutical companies that market atypical antipsychotics. Data extraction Analyses were performed on the changes in Young Mania Rating Scale or Mania Rating Scale total scores from baseline to endpoint, using last observation carried forward and computing the difference in change scores between each drug and its corresponding placebo arm. A random-effects model with fixed drug effects was used to combine the studies and make comparisons of the antipsychotics to each other and to placebo. Data synthesis Data from 12 placebo-controlled monotherapy an…
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Combining 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”
From Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis (2010) · cites this paper as Perlis et al. 2006
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- Authors
- Perlis, R. H., Welge, J. A., Vornik, L. A., Hirschfeld, R. M. A., & Keck, P. E.
- Affiliations
- Harvard University (US)
- University of Cincinnati (US)
- The University of Texas Medical Branch at Galveston (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2006-04-15
- Volume
- 67
- Issue
- 04
- Pages
- 509-516
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2004264470
- Cited by
- 196
- References
- 5
- Citations by year
- 2026: 1 · 2024: 4 · 2022: 4 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 8 · 2016: 5 · 2015: 7 · 2014: 12 · 2013: 12 · 2012: 10
- FWCI
- 18.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K23MH067060)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- atypical antipsychotics, bipolar mania, bipolar disorder, aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone, monotherapy, adjunctive therapy, antipsychotic efficacy, Young Mania Rating Scale, placebo comparison
- MeSH terms
- Bipolar Disorder, Drug Therapy, Combination, Humans, Placebos, Psychiatric Status Rating Scales, Antipsychotic Agents, Randomized Controlled Trials as Topic, Treatment Outcome
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