Novel antipsychotics for patients with bipolar disorder: a systematic review

Shukla V K, McAuley L
Record ID 32001000964
English, French
Authors' objectives:

The purpose of this assessment is to assess the efficacy of the novel antipsychotic drugs (olanzapine, risperidone, quetiapine and clozapine) both as monotherapy and as add-on therapy for acute and maintenance treatment of bipolar disorder.

Authors' results and conclusions: Of the 58 potentially relevant studies identified, eight met the inclusion criteria. In four studies, novel antipsychotic drugs were used as monotherapy for the acute treatment of mania. The other four studies considered novel antipsychotics as add-on therapy to regular treatment. Improvement in primary clinical outcome was measured through use of the Young Mania Rating Scale (YMRS). Available evidence suggests the novel antipsychotic olanzapine improves the treatment of acute mania in patients with bipolar disorder, as compared to placebo. No clear advantage is seen in a small trial (n=30) where olanzapine was compared with lithium. Information related to the efficacy of other novel antipsychotics as monotherapy or add-on therapy for the treatment of acute mania is limited and is not transparent. Studies show no significant difference between novel antipsychotics and traditional agents in the incidence of extrapyramidal side effects. Results of long-term therapy were not available.
Authors' recomendations: Too little information is currently available to draw any meaningful conclusions concerning the use of novel antipsychotics in the treatment of bipolar disorder. Given the high cost of these agents, and the lack of conclusive evidence concerning their benefit over traditional therapies, a cautious approach is warranted when considering their use. This is a rapidly changing field and other trials with new information will soon be completed.
Authors' methods: Systematic review
Project Status: Completed
URL for project:
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Antipsychotic Agents
  • Clozapine
  • Risperidone
  • Bipolar Disorder
Organisation Name: Canadian Coordinating Office for Health Technology Assessment
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553, Fax: +1 613 226 5392;
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Copyright: Canadian Coordinating Office for Health Technology Assessment
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