CNS Drugs

, Volume 15, Issue 9, pp 701–718

Comparative Efficacy and Tolerability of Drug Treatments for Bipolar Disorder

  • Stephen M. Strakowski
  • Melissa P. DelBello
  • Caleb M. Adler
Review Article

Abstract

Lithium has been the backbone of treatment for bipolar disorder for several decades, although recent advances have identified a number of other medications that have efficacy in treating various phases of the illness. These include the antiepileptic drugs valproate semisodium (divalproex sodium) and carbamazepine and some new antiepileptic drugs (e.g. lamotrigine and topiramate), and the atypical antipsychotics (e.g. olanzapine, clozapine and risperidone). Conventional antipsychotics continue to be used frequently in bipolar disorder, although they may be somewhat less effective than other treatments. Otherwise, to date, none of these treatments have been shown to be consistently more effective than any other, so that drug adverse effects and tolerability often dictate which agents are used in an individual patient.

Drugs commonly used for the treatment of bipolar disorder are generally tolerated by most patients in large samples. However, the unique adverse effect signature of a drug will often suggest that it will be less tolerable in some patients than in others. Identifying a specific treatment for a specific patient requires a careful individualised assessment of the risk of adverse effects for that patient’s unique circumstances.

References

  1. 1.
    Janicak PG, Bresnahan DB, Sharma R, et al. A comparison of thiothixene with chlorpromazine in the treatment of mania. J Clin Psychopharmacol 1988; 8: 33–7PubMedGoogle Scholar
  2. 2.
    Poolsup N, Po ALW, de Oliveira IR. Systematic overview of lithium treatment in acute mania. J Clin Pharm Ther 2000; 25(2): 139–56PubMedCrossRefGoogle Scholar
  3. 3.
    Swann AC, Bowden CL, Calabrese JR, et al. Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry 1999 Aug; 156(8): 1264–6PubMedGoogle Scholar
  4. 4.
    Goodwin FK, Jamison KR. Manic-depressive illness. New York: Oxford University Press, 1990Google Scholar
  5. 5.
    Swann AC, Bowden CL, Morris D, et al. Depression during mania: treatment response to lithium or divalproex. Arch Gen Psychiatry 1997 Jan; 54(1): 37–42PubMedCrossRefGoogle Scholar
  6. 6.
    Strakowski S, McElroy S, Keck P. Clinical efficacy of valproate in bipolar illness: comparisons and contrasts with lithium. In: Halbreich U, Montgomery S, editors. Pharmacotherapy for mood, anxiety and cognitive disorders. Washington, DC: American Psychiatric Press Inc., 2000: 143–57Google Scholar
  7. 7.
    Berk M, Ichim L, Brook S. Olanzapine compared to lithium in mania: a double-blind randomized controlled trial. Int Clin Psychopharmacol 1999; 14(6): 339–43PubMedCrossRefGoogle Scholar
  8. 8.
    Segal J, Berk M, Brook S. Risperidone compared with both lithium and haloperidol in mania: a double-blind randomized controlled trial. Clin Neuropharmacol 1998 May–Jun; 21(3): 176–80PubMedGoogle Scholar
  9. 9.
    Zornberg GL, Pope Jr HG. Treatment of depression in bipolar disorder: new directions for research. J Clin Psychopharmacol 1993 Dec; 13(6): 397–408PubMedCrossRefGoogle Scholar
  10. 10.
    Davis JM, Janicak PG, Hogan DM. Mood stabilizers in the prevention of recurrent affective disorders: a meta-analysis. Acta Psychiatr Scand 1999; 100: 406–17PubMedCrossRefGoogle Scholar
  11. 11.
    Baldessarini RJ, Tondo L, Hennen J. Effects of lithium treatment and its discontinuation on suicidal behavior in bipolar manic-depressive disorders. J Clin Psychiatry 1999; 60Suppl. 2: 77–84PubMedGoogle Scholar
  12. 12.
    Lerer B, Moore N, Meyendorff E, et al. Carbamazepine versus lithium in mania: a double-blind study. J Clin Psychiatry 1987 Mar; 48(3): 89–93PubMedGoogle Scholar
  13. 13.
    Small J, Klapper M, Milstein V, et al. Carbamazepine compared with lithium in the treatment of mania. Arch Gen Psychiatry 1991 Oct; 48(10): 915–21PubMedCrossRefGoogle Scholar
  14. 14.
    Lusznat RM, Murphy DP, Nunn CMH. Carbamazepine vs lithium in the treatment and prophylaxis of mania. Br J Psychiatry 1988; 153: 198–204PubMedCrossRefGoogle Scholar
  15. 15.
    Greil W, Mayerhofer W, Erazo N, et al. Lithium versus carbamazepine in the maintenance treatment of bipolar disorders — a randomised study. J Affect Disord 1997; 43(2): 151–61PubMedCrossRefGoogle Scholar
  16. 16.
    Coxhead N, Silverstone T, Cookson J. Carbamazepine versus lithium in the prophylaxis of bipolar disorder. Acta Psychiatr Scand 1992; 85: 114–8PubMedCrossRefGoogle Scholar
  17. 17.
    Denicoff KD, Smith-Jackson EE, Disney ER, et al. Comparative prophylactic efficacy of lithium, carbamazepine, and the combination in bipolar disorder. J Clin Psychiatry 1997; 58: 470–8PubMedCrossRefGoogle Scholar
  18. 18.
    Freeman T, Clothier J, Pazzaglia P, et al. A double-blind comparison of valproate and lithium in the treatment of acute mania. Am J Psychiatry 1992 Jan; 149(1): 108–11PubMedGoogle Scholar
  19. 19.
    Bowden C, Brugger A, Swann A, et al. Efficacy of divalproex vs lithium and placebo in the treatment of mania. JAMA 1994 Mar 23–30; 271(12): 918–24PubMedCrossRefGoogle Scholar
  20. 20.
    Bowden C, Calabrese JR, McElroy S, et al. A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Arch Gen Psychiatry May 2000; 57: 481–9CrossRefGoogle Scholar
  21. 21.
    Prien R, Point P, Caffey E, et al. Comparison of lithium carbonate and chlorpromazine in the treatment of mania. Arch Gen Psychiatry 1972 Feb; 26: 146–53PubMedCrossRefGoogle Scholar
  22. 22.
    Takahashi R, Sakuma A, Itoh K, et al. Comparison of efficacy of lithium carbonate and chlorpromazine in mania. Arch Gen Psychiatry 1975 Oct; 32: 1310–8PubMedCrossRefGoogle Scholar
  23. 23.
    Shopsin B, Gershon S, Thompson H, et al. Psychoactive drugs in mania. Arch Gen Psychiatry 1975 Jan; 32: 34–42PubMedCrossRefGoogle Scholar
  24. 24.
    Ichim L, Berk M, Brook S. Lamotrigine compared with lithium in mania: a double-blind randomized controlled trial. Ann Clin Psychiatry 2000 Mar; 12(1): 5–10PubMedGoogle Scholar
  25. 25.
    Post RM, Pazzaglia PJ, Ketter TA, et al. Carbamazepine and nimodipine in refractory bipolar illness: efficacy and mechanisms. In: Halbreich U, Montgomery S, editors. Pharmacotherapy for mood, anxiety and cognitive disorders. Washington, DC: American Psychiatric Press Inc., 2000: 77–110Google Scholar
  26. 26.
    Keck Jr PE, McElroy SL, Strakowski SM. Anticonvulsants and antipsychotics in the treatment of bipolar disorder. J Clin Psychiatry 1998; 59Suppl. 6: 74–81PubMedGoogle Scholar
  27. 27.
    McElroy SL, Keck Jr PE. Pharmacologic agents for the treatment of acute bipolar mania. Biol Psychiatry 2000; 48: 539–57PubMedCrossRefGoogle Scholar
  28. 28.
    Emrich HM. Studies with oxcarbazepine (Trileptal) in acute mania. In: Emrich H, Schiwy W, Silverstone T, editors. Carbamazepine and oxcarbazepine in psychiatry. London: CNS Publishers, 1990: 83–8Google Scholar
  29. 29.
    Müller AA, Stoll KD. Carbamazepine and oxcarbazepine in the treatment of manic syndromes: studies in Germany. In: ai]Emrich_HM, Okuma T, Muller AA, editors. Anticonvulsants in affective disorders. Amsterdam: Elsevier Science Publishers, 1984: 134–47Google Scholar
  30. 30.
    Emrich HM, Dose M, vonZerssen D. The useof sodium valproate, carbamazepine and oxcarbazepine in patients with affective disorders. J Affect Disord 1985; 8: 243–50PubMedCrossRefGoogle Scholar
  31. 31.
    Schatzberg AF, Cole JO, DeBattista C. Manual of clinical psychopharmacology. Washington, DC: American Psychiatric Press Inc., 1997Google Scholar
  32. 32.
    Britton JW, So EL. Selection of antiepileptic drugs: a practical approach. Mayo Clin Proc 1996; 71: 778–6PubMedCrossRefGoogle Scholar
  33. 33.
    Gandelman MS. Review of carbamazepine-induced hyponatremia. Prog Neuropsychopharmacol Biol Psychiatry 1994 Mar; 8(2): 211–33CrossRefGoogle Scholar
  34. 34.
    Albani F, Riva R, Baruzzi A. Carbamazepine clinical pharmacology: a review. Pharmacopsychiatry 1995; 28: 235–44PubMedCrossRefGoogle Scholar
  35. 35.
    Sobotka JL, Alexander B, Cook BL. A review of carbamazepine’s hematologic reactions and monitoring recommendations. DICP 1990 Dec; 24(12): 1214–9PubMedGoogle Scholar
  36. 36.
    Van Amelsvoort T, Bakshi T, Devaux CB, et al. Hyponatremia associated with carbamazepine and oxcarbazepine therapy: a review. Epilepsia 1994 Jan–Feb; 35(1): 181–8PubMedCrossRefGoogle Scholar
  37. 37.
    Shorvon S. Oxcarbazepine: a review. Seizure 2000 Mar; 9(2): 75–9PubMedCrossRefGoogle Scholar
  38. 38.
    Okuma T, Inanaga K, Otsuki S, et al. Comparison of the anti-manic efficacy of carbamazepine and chlorpromazine: a double-blind controlled study. Psychopharmacology (Berl) 1979; 66(3): 211–7CrossRefGoogle Scholar
  39. 39.
    Grossi E, Sacchetti E, Vita A, et al. Carbamazepine versus chlorpromazine in mania: a double blind trial. In: Emrich HM, Okuma T, Muller AA, editors. Anticonvulsants in affective disorders. Amsterdam: Elsevier Science Publishers, 1984: 177–87Google Scholar
  40. 40.
    Pope Jr HG, McElroy SL, Keck Jr PE, et al. Valproate in the treatment of acute mania: a placebo-controlled study. Arch Gen Psychiatry 1991; 48: 62–8PubMedCrossRefGoogle Scholar
  41. 41.
    Keck Jr PE, McElroy SL, Tugrul KC, et al. Valproate oral loading in the treatment of acute mania. J Clin Psychiatry 1993 Aug; 54(8): 305–8PubMedGoogle Scholar
  42. 42.
    Isojärvi JI, Laatikainen TJ, Pakarinen AJ, et al. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med 1993 Nov 4; 329(19): 1383–8PubMedCrossRefGoogle Scholar
  43. 43.
    Bauer J, Jarre A, Klingmuller D, et al. Polycystic ovary syndrome in patients with focal epilepsy: a study in 93 women. Epilepsy Res 2000 Sep; 41(2): 163–7PubMedCrossRefGoogle Scholar
  44. 44.
    Rasgon N, Altshuler L, Gudeman D, et al. Medication status and polycystic ovary syndrome in women with bipolar disorder: a preliminary report. J Clin Psychiatry 2000 Mar; 61(3): 173–8PubMedCrossRefGoogle Scholar
  45. 45.
    Jennings H, Romanelli F. The use of valproic acid in HIV-positive patients. Ann Pharmacother 1999 Oct; 33: 1113–6PubMedCrossRefGoogle Scholar
  46. 46.
    McElroy SL, Keck P, Stanton S, et al. Arandomized comparison of divalproex oral loading versus haloperidol in the initial treatment of acute psychotic mania. J Clin Psychiatry 1996 Apr; 57(4): 142–6PubMedGoogle Scholar
  47. 47.
    Tohen M, Baker RW, Altshuler L, et al. Olanzapine versus divalproex for the treatment of acute mania [abstract]. European College of Neuropsychopharmacology Annual Meeting; 2000 Sep 9–13; MunichGoogle Scholar
  48. 48.
    Labbate L, Rubey R. Lamotrigine for treatment-refractory bipolar disorder [letter]. Am J Psychiatry 1997; 154: 1317PubMedGoogle Scholar
  49. 49.
    Fatemi SH, Rapport DJ, Calabrese JR, et al. Lamotrigine in rapid-cycling bipolar disorder. J Clin Psychiatry 1997 Dec; 58(12): 522–7PubMedCrossRefGoogle Scholar
  50. 50.
    Calabrese J, Fatemi S, Woyshville M. Antidepressant effects of lamotrigine in rapid cycling bipolar disorder [letter]. Am J Psychiatry 1996; 153: 1236PubMedGoogle Scholar
  51. 51.
    Calabrese JR, Rapport DJ, Shelton MD, et al. Clinical studies on the use of lamotrigine in bipolar disorder. Neuropsychobiology 1998 Oct; 38(3): 185–91PubMedCrossRefGoogle Scholar
  52. 52.
    Kusumakar V, Yatham L. Lamotrigine treatment of rapid cycling bipolar disorder [letter]. Am J Psychiatry 1997; 154: 1171–2PubMedGoogle Scholar
  53. 53.
    Waiden J, Hesslinger B, van Calker D, et al. Addition of lamotrigine to valproate may enhance efficacy in the treatment of bipolar affective disorder. Pharmacopsychiatry 1996 Sep; 29(5): 193–5CrossRefGoogle Scholar
  54. 54.
    Fogelson D, Sternbach H. Lamotrigine treatment of refractory bipolar disorder. J Clin Psychiatry 1997; 58: 271–3PubMedCrossRefGoogle Scholar
  55. 55.
    Sporn J, Sachs G. The anticonvulsant lamotrigine in treatment-resistant manic-depressive illness. J Clin Psychopharmacol 1997; 17: 185–9PubMedCrossRefGoogle Scholar
  56. 56.
    Kotier M, Matar M. Lamotrigine in the treatment of resistant bipolar disorder. Clin Neuropharmacol 1998; 21: 65–7Google Scholar
  57. 57.
    Calabrese JR, Bowden CL, McElroy SL, et al. Spectrum of activity of lamotrigine in treatment-refractory bipolar disorder. Am J Psychiatry 1999 Jul; 156: 1019–23PubMedGoogle Scholar
  58. 58.
    Weisler R, Risner ME, Ascher J, et al. Use of lamotrigine in the treatment of bipolar disorder [abstract]. In: The American Psychiatric Association Annual Meeting New Research Program and Abstracts. Washington, DC: American Psychiatric Association, 1994 May: 216Google Scholar
  59. 59.
    Suppes T, Brown E, McElroy S, et al. Lamotrigine for the treatment of bipolar disorder: a clinical case series. J Affect Disord 1999; 53: 95–8PubMedCrossRefGoogle Scholar
  60. 60.
    Bowden CL, Calabrese JR, McElroy SL, et al. The efficacy of lamotrigine in rapid cycling and non-rapid cycling patients with bipolar disorder. Biol Psychiatry 1999; 45: 953–8PubMedCrossRefGoogle Scholar
  61. 61.
    Frye MA, Ketter TA, Kimbrell TA, et al. A placebo controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders. J Clin Psychopharmacol 2000; 20: 607–14PubMedCrossRefGoogle Scholar
  62. 62.
    Anand A, Oren DA, Berman RM, et al. Lamotrigine treatment of lithium failure in outpatient mania — a double-blind, placebo-controlled trial [abstract]. In: Soares JC, Gershon S, editors. Bipolar disorders abstract book. Third International Conference on Bipolar Disorder; 1999 Jun 17–19; Pittsburgh (PA).Copenhagen: Munksgaard, 1999: 23Google Scholar
  63. 63.
    Calabrese JR, Bowden CL, Sachs GS, et al. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Am J Psychiatry 1999 Feb; 60: 79–88Google Scholar
  64. 64.
    Sabers A, Gram L. Newer anticonvulsants: comparative review of drug interactions and adverse effects. Drugs 2000 Jul; 60(1): 23–33PubMedCrossRefGoogle Scholar
  65. 65.
    Messenheimer JA. Rash in adult and pediatric patients treated with lamotrigine. Can J Neurol Sci 1998 Nov; 25(4): S14–8PubMedGoogle Scholar
  66. 66.
    Gilman JT. Lamotrigine: an antiepileptic agent for the treatment of partial seizures. Ann Pharmacother 1995 Feb; 29(2): 144–51PubMedGoogle Scholar
  67. 67.
    Bozikas V, Vartzopoulos D, Phocas C, et al. Lamotrigine-induced rash after sun exposure [letter]. Am J Psychiatry 1999; 156: 2015–6PubMedGoogle Scholar
  68. 68.
    Isojärvi JI, Tapanainen JS. Valproate, hyperandrogenism, and polycystic ovaries: a report of 3 cases. Arch Neurol 2000 Jul; 57(7): 1064–8PubMedCrossRefGoogle Scholar
  69. 69.
    Husain AM, Carwile ST, Miller PP, et al. Improved sexual function in three men taking lamotrigine for epilepsy. South Med J 2000 Mar; 93(3): 335–6PubMedGoogle Scholar
  70. 70.
    Marcotte D. Use of topiramate, a new anti-epileptic as a mood stabilizer. J Affect Disord 1998; 50: 245–51PubMedCrossRefGoogle Scholar
  71. 71.
    Chengappa KNR, Rathore D, Levine J, et al. Topiramate as add-on treatment for patients with bipolar mania. Bipolar Disord 1999; 1:42–53PubMedCrossRefGoogle Scholar
  72. 72.
    Gordon A, Price L. Mood stabilization and weight loss with topiramate [letter]. Am J Psychiatry 1999; 156: 968–9PubMedGoogle Scholar
  73. 73.
    Calabrese JR, Keck Jr PE, McElroy SL, et al. Topiramate in severe treatment-refractory mania [abstract]. In: The American Psychiatric Association Annual Meeting; 1998 May 30–Jun 4; Toronto, Canada. Washington, DC: American Psychiatric Association, 1998: 121–2Google Scholar
  74. 74.
    Normann C, Langosch J, Schaerer L, et al.Treatmentof acute mania with topiramate [letter]. Am J Psychiatry 1999; 156: 2014PubMedGoogle Scholar
  75. 75.
    Kusumakar V, Kakshmi N, Yatham MB, et al. Topiramate in rapid cycling bipolar women [abstract]. In: The American Psychiatric Association Annual Meeting; 1999 May 15–20; Washington, DC. Washington, DC: American Psychiatric Association, 1999: 200Google Scholar
  76. 76.
    McElroy S, Suppes T, Keck P, et al. Open-label adjunctive topiramate in the treatment of bipolar disorders. Biol Psychiatry 2000; 47: 1025–33PubMedCrossRefGoogle Scholar
  77. 77.
    Hussain M. Treatment of bipolar depression with topiramate [abstract]. 38th Annual Meeting of American College of Neuropsychopharmacology; 1999 Dec 12–16; AcapulcoGoogle Scholar
  78. 78.
    Shorvon SD. Safety of topiramate: adverse events and relationships to dosing. Epilepsia 1996; 37Suppl. 2: S18–22PubMedCrossRefGoogle Scholar
  79. 79.
    Shapira NA, Goldsmith TD, McElroy SL. Treatment of binge-eating disorder with topiramate: a clinical case series. J Clin Psychiatry 2000 May; 61(5): 368–72PubMedCrossRefGoogle Scholar
  80. 80.
    Ketter TA, Post RM, Theodore WH. Positive and negative psychiatric effects of antiepileptic drugs in patients with seizure disorders. Neurology 1999; 53(5 Suppl. 2): S53–67PubMedGoogle Scholar
  81. 81.
    Rosenfeld WE. Topiramate: a review of preclinical, pharmacokinetic, and clinical data. Clin Ther 1997 Nov–Dec; 19(6): 1294–308PubMedCrossRefGoogle Scholar
  82. 82.
    Crawford P. An audit of topiramate use in a general neurology clinic. Seizure 1998 Jun; 7(3): 207–11PubMedCrossRefGoogle Scholar
  83. 83.
    Hamer HM, Knake S, Schomburg U, et al. Valproate-induced hyperammonemic encephalopathy in the presence of topiramate. Neurology 2000 Jan 11; 54(1): 230–2PubMedCrossRefGoogle Scholar
  84. 84.
    Solomon GE. Valproate-induced hyperammonemic encephalopathy in the presence of topiramate. Neurology 2000 Aug 22; 55(4): 606PubMedCrossRefGoogle Scholar
  85. 85.
    Pande AC, Crockatt JG, Janney CA, et al. Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Bipolar Disord 2000; 2 (3 Pt 2): 249–55PubMedCrossRefGoogle Scholar
  86. 86.
    Schaffer LC, Schaffer CB. Tiagabine and the treatment of refractory bipolar disorder. Am J Psychiatry 1999 Dec; 156(12): 2014–5PubMedGoogle Scholar
  87. 87.
    Grunze H, Erfurth A, Marcuse A, et al. Tiagabine appears not to be efficacious in the treatment of acute mania. J Clin Psychiatry 1999; 60: 759–62PubMedCrossRefGoogle Scholar
  88. 88.
    Kanba S, Yagi G, Kamijima K, et al. The first open study of zonisamide, a novel anticonvulsant, shows efficacy in mania. Prog Neuropsychopharmacol Biol Psychiatry 1994; 18: 707–15PubMedCrossRefGoogle Scholar
  89. 89.
    Miyamoto T, Kohsaka M, Koyama T. Psychotic episodes during zonisamide treatment. Seizure 2000 Jan; 9(1): 65–70PubMedCrossRefGoogle Scholar
  90. 90.
    Charles CL, Stoesz L, Tollefson G. Zonisamide-induced mania. Psychosomatics 1990; 31(2): 214–7PubMedCrossRefGoogle Scholar
  91. 91.
    Keck Jr PE, McElroy SL, Strakowski SM, et al. Antipsychotics in the treatment of mood disorders and risk of tardive dyskinesia. J Clin Psychiatry 2000; 61Suppl. 4: 33–8PubMedGoogle Scholar
  92. 92.
    McElroy SL, Keck Jr PE, Strakowski SM. Mania, psychosis, and antipsychotics. J Clin Psychiatry 1996; 57 Suppl. 3: 14–26Google Scholar
  93. 93.
    Müller-Oerlinghausen B, Retzow A, Henn FA, et al. Valproate as an adjunct to neuroleptic medication for the treatment of acute episodes of mania: a prospective, randomized, double-blind, placebo-controlled multicenter study. J Clin Psychopharmacol 2000; 20: 195–203PubMedCrossRefGoogle Scholar
  94. 94.
    Ahlfors UG, Baastrup PC, Dencker SJ, et al. Flupenthixol decanoate in recurrent manic-depressive illness. Acta Psychiatr Scand 1981; 64: 226–37PubMedCrossRefGoogle Scholar
  95. 95.
    Yassa R, Nair V, Schwartz G. Tardive dyskinesia and the primary psychiatric diagnosis. Psychosomatics 1984; 25: 135–8PubMedCrossRefGoogle Scholar
  96. 96.
    Tohen M, Sanger TM, McElroy SL, et al. Olanzapine versus placebo in the treatment of acute mania. Am J Psychiatry 1999 May; 156(5): 702–9PubMedGoogle Scholar
  97. 97.
    Tohen M, Jacobs TG, Grundy SL, et al. Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. Arch Gen Psychiatry 2000; 57: 841–9PubMedCrossRefGoogle Scholar
  98. 98.
    Tohen M, Chengappa KNR, Suppes TR, et al. Efficacy of olanzapine added to valproate or lithium in the treatment of bipolar I disorder [abstract]. American Psychiatric Association Annual Meeting; 2000 May 13–18; Chicago (IL). Washington, DC: American Psychiatric Association, 2000Google Scholar
  99. 99.
    Tohen MF, Jacobs TG, Gannon KS, et al. Olanzapine: acute and long-term efficacy in bipolar I patients. Eur Neuropsychopharmacol 1999; 9Suppl. 5: S247Google Scholar
  100. 100.
    Wirshing DA, Spellberg BJ, Erhart SM, et al. Novel antipsychotics and new onset diabetes. Biol Psychiatry 1998 Oct 15; 44(8): 778–83PubMedCrossRefGoogle Scholar
  101. 101.
    Beasley CM, Dellva MA, Tamura RN, et al. Randomised double-blind comparison of the incidence of tardive dyskinesia in patients with schizophrenia during long-term treatment with olanzapine or haloperidol. Br J Psychiatry 1999 Jan; 174: 23–30PubMedCrossRefGoogle Scholar
  102. 102.
    Sachs GS. Safety and efficacy of risperidone vs. placebo vs. haloperidol as add-on therapy to mood stabilizers in treatment of the manic phase of bipolar disorder [abstract; board 35]. 38th Annual Meeting of American College of Neuropsychopharmacology; 1999 Dec 12–16; AcapulcoGoogle Scholar
  103. 103.
    Jibson MD, Tandon R. New atypical antipsychotic medications. J Psychiatr Res 1998; 32: 215–28PubMedCrossRefGoogle Scholar
  104. 104.
    Davis JM, Janicak PG. Risperidone: a new, novel (and better?) antipsychotic. Psychiatric Ann 1996 Feb; 26(2): 1–10Google Scholar
  105. 105.
    Leucht S, Pitschel-Walz G, Abraham D, et al. Efficacy and extrapyramidal side-effects of the new antipsychotics olanzapine, quetiapine, risperidone, and sertindole compared to conventional antipsychotics and placebo: a meta-analysis of randomized controlled trials. Schizophr Res 1999; 35: 51–68PubMedCrossRefGoogle Scholar
  106. 106.
    Frye MA, Ketter TA, Altshuler LL, et al. Clozapine in bipolar disorder: treatment implications for other atypical antipsychotics. J Affect Disord 1998; 48: 91–110PubMedCrossRefGoogle Scholar
  107. 107.
    Suppes T, Webb A, Paul B, et al. Clinical outcome in a randomized 1-year trial of clozapine versus treatment as usual for patients with treatment-resistant illness and a history of mania. Am J Psychiatry 1999 Aug; 156(8): 1164–9PubMedGoogle Scholar
  108. 108.
    Zarate Jr CA, Tohen M, Baldessarini RJ. Clozapine in severe mood disorders. J Clin Psychiatry 1995; 56: 411–7PubMedGoogle Scholar
  109. 109.
    Barbini B, Scherillo P, Benedetti F, et al. Response to clozapine in acute mania is more rapid than that of chlorpromazine. Int Clin Psychopharmacol 1997; 12: 109–12PubMedCrossRefGoogle Scholar
  110. 110.
    Calabrese JR, Kimmel SA, Woyshville MJ, et al. Clozapine for treatment-refractory mania. Am J Psychiatry 1996; 153:759–64PubMedGoogle Scholar
  111. 111.
    Green AI, Tohen M, Patel JK, et al. Clozapine in the treatment of refractory psychotic mania. Am J Psychiatry 2000 Jun; 157(6): 982–6PubMedCrossRefGoogle Scholar
  112. 112.
    Lieberman J, Safferman A. Clinical profile of clozapine: adverse reactions and agranulocytosis. In: Lapierre Y, Jones B, editors. Clozapine in treatment-resistant schizophrenia. Royal Society of Medicine Services International Congress and Symposium Series, No. 185. London: Royal Society of Medicine Services Ltd., 1992 JunGoogle Scholar
  113. 113.
    Munro J, O’Sullivan D, Andrews C, et al. Active monitoring of 12,760 clozapine recipients in the UK and Ireland: beyond pharmacovigilance. Br J Psychiatry 1999 Dec; 175: 576–80PubMedCrossRefGoogle Scholar
  114. 114.
    Henderson DC, Cagliero E, Gray C, et al. Clozapine, diabetes mellitus, weight gain, and lipid abnormalities: a five-year naturalistic study. Am J Psychiatry 2000 Jun; 157(6): 975–81PubMedCrossRefGoogle Scholar
  115. 115.
    Ghaemi SN, Katzow JJ. The use of quetiapine for treatment-resistant bipolar disorder: a case series. Ann Clin Psychiatry 1999; 11: 137–40PubMedGoogle Scholar
  116. 116.
    Dunayevich E, Strakowski SM. Seroquel in treatment-resistant mania. Am J Psychiatry 2000; 157: 1341PubMedCrossRefGoogle Scholar
  117. 117.
    Zarate Jr CA, Rothschild A, Fletcher KE, et al. Clinical predictors of acute response with quetiapine in psychotic mood disorders. J Clin Psychiatry 2000 Mar; 61(3): 185–9PubMedCrossRefGoogle Scholar
  118. 118.
    Allison DB, Mentore JL, Heo M, et al. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry 1999 Nov; 156(11): 1686–96PubMedGoogle Scholar
  119. 119.
    Keck Jr PE, Ice K. A three-week, double-blind, randomized trial of ziprasidone in the acute treatment of mania [abstract]. The American Psychiatric Association Annual Meeting; 2000 May 13–18; Chicago (IL). Washington, DC: American Psychiatric Association, 2000: 116–7Google Scholar
  120. 120.
    Altshuler LL, Cohen L, Szuba MP, et al. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Am J Psychiatry 1996 May; 153(5): 592–606PubMedGoogle Scholar
  121. 121.
    Ortho-McNeil Pharmaceuticals. Topamax® product insert. Raritan (NJ): Ortho-McNeil Pharmaceuticals, 1999Google Scholar
  122. 122.
    Reiff-Eldridge R, Heffner CR, Ephross SA, et al. Monitoring pregnancy outcomes after prenatal drug exposure through prospective pregnancy registries: a pharmaceutical company commitment. Am J Obstet Gynecol 2000 Jan; 182: 159–63PubMedCrossRefGoogle Scholar
  123. 123.
    Goldstein DJ, Corbin LA, Fung MC. Olanzapine-exposed pregnancies and lactation: early experience. J Clin Psychopharmacol 2000; 20: 399–403PubMedCrossRefGoogle Scholar
  124. 124.
    Trixler M, Tenyi T. Antipsychotic use in pregnancy: what are the best treatment options? Drug Saf 1997 Jun; 16(6): 403–10PubMedCrossRefGoogle Scholar
  125. 125.
    Sachs GS, Printz DJ, Kahn DA, et al. The Expert Consensus Guidelines Series: medication treatment of bipolar disorder 2000. Postgrad Med 2000 Apr; Spec. No.: 1–104Google Scholar
  126. 126.
    Freeman MP, Stoll AL. Mood stabilizer combinations: a review of safety and efficacy. Am J Psychiatry 1998 Jan; 155(1): 12–21PubMedGoogle Scholar
  127. 127.
    Viguera AC, Cohen LS. The course and management of bipolar disorder during pregnancy. Psychopharmacol Bull 1998; 34: 339–46PubMedGoogle Scholar
  128. 128.
    Leibenluft E. Women and bipolar disorder: an update. Bull Menninger Clin 2000; 64: 5–17PubMedGoogle Scholar

Copyright information

© Adis International Limited 2001

Authors and Affiliations

  • Stephen M. Strakowski
    • 1
  • Melissa P. DelBello
    • 1
  • Caleb M. Adler
    • 1
  1. 1.Bipolar and Psychotic Disorders Research Program, Department of PsychiatryUniversity of Cincinnati College of MedicineCincinnatiUSA

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