The Use of Atypical Antipsychotics in Bipolar Disorder

Cho, Hyun Sang; Shin, Won Cheol

Abstract

Atypical antipsychotics are the more effective and safer alternative to the common practice of maintenance adjunctive treatment as well as acute adjuvant treatment with traditional antipsychotics in patients with bipolar disorder. A few double-blind controlled studies of acute mania found olanzapine or ziprasidone monotherapy to be more effective than placebo, and the combination treatment of risperidone and mood stabilizer was also more effective than placebo. Furthermore, clozapine has antimanic and mood stabilizing effect for the treatment-refractory patients in acute manic and maintenance phase. Olanzapine and risperidone are reported that they have long-term mood stabilizing effect when they are used with mood stabilizers. At present, combination treatment of atypical antipsychotics and mood stabilizer is generally used. However, because each drug of such combinations causes sometimes bothersome and potentially dangerous events as well as their interactions, the consideration for their risk are needed.