The medication that is ‘best for treating bipolar disorder’

The medication that is  ‘best for treating bipolar disorder’

By Liz Lockhart

When people with bipolar disorder have episodes of mania, not all mood stabilising drugs are effective according to a new analysis.

An article published in the Pulse says that NICE guidelines currently do not recommend using any particular drug for acute mania.  But in data the researchers say may change clinical guidelines, they found antipsychotics such as risperidone, haloperidol and planzapine were the most effective at treating acute mania, compared with placebo.

Published in The Lancet the systematic review looked at 68 randomised controlled trials of thirteen anti-mania drugs and compared their efficacy with placebo.  The trials took place over a 20 year period and ended in 2010.  It included male and female patients who were over the age of 18 and who had been diagnosed with bipolar disorder according to the standard diagnostic criteria.

The researched measured the mean change in scores on the Young Mania Rating Scale  to gauge the efficiency of the different drugs.  They also calculated the patient tolerability to the drugs by recording the number of patients who dropped out of the allocated treatment within the first three weeks.  For each of these criteria the drugs were allotted a comparative score out of 50.

Antipsychotic drugs averaged a combined score of 84 whilst other mood stabilisers averaged 31.  This indicated that antipsychotic drugs are significantly more effective in the treatment of acute mania.  The drugs risperidone, haloperidol and planzapine proved to be the most effective.  These drugs were the top scoring with a score of 87, 79 and 75 respectively.

The study authors said that these results have potential clinical implications that should be considered in the development of clinical practice guidelines.  They added that the results from this study emphasise the need for new treatment to show either greater efficacy or acceptability than the existing best standard treatments.


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