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Both antipsychotic and mood-stabilizing medications have antimanic efficacy. In this meta-analysis, researchers examined the relative effectiveness of 14 antipsychotics and mood stabilizers by computing direct and indirect effect sizes and odds ratios. All drugs had at least one direct placebo-controlled comparison; most had at least three direct comparisons with other drugs. The researchers computed dichotomous outcomes from change scores at 3 weeks on the Young Mania Rating Scale and used study dropout rates to track tolerability.
On the primary efficacy outcome, only gabapentin and topiramate failed to beat placebo. In drug–drug comparisons, haloperidol fared the best; it was significantly more effective than all other treatments except r…