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Novel antipsychotics in bipolar and schizoaffective mania
1Department of Psychotic Disorders, Mental Health Centre Drenthe, Assen, The Netherlands.
Objective:
Novel antipsychotics are increasingly used in the treatment of bipolar and schizoaffective mania. This paper presents an overview of the controlled studies in this field.
Method:
Using cross-references, a computerized search was performed on MEDLINE and EMBASE psychiatry covering the period 1990-2002.
Results:
Olanzapine and risperidone, added to mood stabilizers, and olanzapine as monotherapy enjoy the most evidential support in terms of efficacy and side-effect profile for their use in acute bipolar mania. The use of modern antipsychotics in bipolar prophylaxis and in both the short- and long-term treatment of schizomania has not been widely studied yet.
Conclusion:
More controlled trials are still needed comparing modern antipsychotics as monotherapy and adjunctive to mood stabilizers with conventional antipsychotics, lithium, anticonvulsants and with each other in short-term and, especially, maintenance treatment of (schizo)mania. Partly based on controlled studies, olanzapine, risperidone and other modern antipsychotics could become preferable for these indications.
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