Psychiatria pre prax 3/2006

ANTIMANIC EFFICACY OF SECOND-GENERATION ANTIPSYCHOTICS

The evidence shows that second-generation antipsychotics are effective in the treatment of bipolar mania, either alone or in combination with traditional mood stabilisers. Use of second-generation antipsychotics is associated with more rapid symptom improvement than in mood stabilisers treatment, and earlier and stronger antimanic effect in combination with lithium or anticonvulsants than in monotherapy. Olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole demonstrate good therapeutic effect, with no significant differences in antimanic efficacy among these agents. Second-generation antipsychotics, lithium and valproate are recommended first-line treatments for acute bipolar mania.

Keywords: second-generation antipsychotics, bipolar mania, randomized double-blind trial.