Atypical antipsychotic augmentation of mood stabilizer therapy in bipolar disorder.
Although monotherapy with lithium or divalproex is the recommended initial therapy for bipolar disorder, these agents are associated with prolonged favorable outcomes in only 30% of patients. Increasingly, the medical literature is demonstrating that augmentation of mood stabilizers with atypical antipsychotics is a more effective therapy. This form of combination therapy is recommended as first-line treatment for severe bipolar mania. Recent clinical studies have shown that augmentation therapy with the atypical antipsychotics risperidone, olanzapine, quetiapine, and ziprasidone is effective in long-term maintenance treatment, and preliminary evidence is emerging that use of atypicals with mood stabilizers can help control the depressive phase of bipolar disorder. The atypical antipsychotics also have relatively mild side effect profiles, although augmentation therapy with some antipsychotics and mood stabilizers has been associated with excessive weight gain.
Bowden
Charles L
CL
Department of Psychiatry, The University of Texas Health Science Center at San Antonio, TX 78229-3900, USA. bowdenc@uthscsa.edu
D000208:Acute Disease; D000927:Anticonvulsants / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use; D015430:Weight Gain
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D014635:Valproic Acid; D008094:Lithium