Loading...
Patients with mania are slow to improve with standard mood stabilizers (MSs), except, perhaps, with high, yet sedating, initial doses of valproate. Thus, most clinicians begin treatment with an antipsychotic drug and sometimes add a benzodiazepine. Investigators in Germany performed a meta-analysis of 24 controlled studies comparing the efficacy of six atypical antipsychotics with that of placebo, haloperidol, or MSs (valproate or lithium). Comparisons of MSs combined with antipsychotics or placebo were also examined.
The primary outcome was change on a mania rating scale; these scales differed among studies. Because most studies lasted 3 weeks, 3-week data were used. All atypicals were significantly better than placebo in reducing mania sco…