Quetiapine or haloperidol as monotherapy for bipolar mania—a 12-week, double-blind, randomised, parallel-group, placebo-controlled trial

Aripiprazole monotherapy in acute mania: 12-week randomised placebo- and haloperidol-controlled study

“…Response rates reported here with aripiprazole at week 3 are similar to those seen in similar trials with risperidone (risperidone 48% v. placebo 33%) 26 and quetiapine (quetiapine 43% v. placebo 35%), although response rates for haloperidol in this second study were higher (56%). 25 Furthermore, although completion rates reported here were similar between treatment arms at week 3, similar completion rates between treatment arms have also been observed in previous studies of this design with risperidone (risperidone 89%; placebo 85%; haloperidol 90%). 26 There was a low rate of emergent depression over the 12-week study for both aripiprazole-and haloperidol-treated patients.…”

Treating Bipolar Disorder in the Primary Care Setting

“…66,[93][94][95]97,106 Compared with haloperidol, atypical antipsychotics (olanzapine and quetiapine) were associated with lower rates of akathisia in monotherapy trials of 12 weeks. 101,106 Atypical antipsychotics (olanzapine, risperidone, and aripiprazole) were also associated with greater improvements in EPS rating scales (Simpson-Angus Scale and Barnes Akathisia Scale SAS and BAS for olanzapine 106 and aripiprazole 95 and EPS rating scale for risperidone 100 ) than haloperidol in 12-week trials. The remainder of this review focuses on the safety and tolerability data for aripiprazole, with a final section on practical considerations when administering this treatment for bipolar disorder.…”

“…The AE profiles of quetiapine and olanzapine in the bipolar depression studies reflect those already established in the bipolar mania studies, with the exception that quetiapine is associated with EPS significantly more often than placebo in depression trials. In terms of effects on metabolic parameters, all of the atypical antipsychotics have been associated with weight gain [92][93][94][95][96][97][98][99][100][101][102]104,106 ; however, levels varied according to the different atypical antipsychotics. 66,[93][94][95]97,106 Compared with haloperidol, atypical antipsychotics (olanzapine and quetiapine) were associated with lower rates of akathisia in monotherapy trials of 12 weeks.…”

“…94,95,[100][101][102]105,106 Data from studies longer than 12 weeks are limited. A total of 4 studies have reported on monotherapy with atypical antipsychotics for a period greater than 12 weeks, 3 with olanzapine and 1 with aripiprazole, with 26-week and 100-week results being reported separately.…”

“…A total of 13, short-term, randomized, placebo-controlled trials, ranging from 3 to 4 weeks, have been conducted using atypical antipsychotic monotherapy in patients with bipolar disorder in acute manic or mixed episodes (4 studies with aripiprazole, 3 studies with risperidone, and 2 studies each with olanzapine, quetiapine, and ziprasidone) [92][93][94][95][96][97][98][99][100][101][102][103][104] (Table 4). At 3 weeks, treatment with atypical antipsychotics was shown to be efficacious in reducing manic symptoms, assessed using either the change in Young Mania Rating Scale (YMRS) total score or, for the studies using ziprasidone, the change in Mania Rating Scale scores.…”