Treatment for Bipolar Disorder in Adults: A Systematic Review
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Purpose of Review
- To assess the effectiveness of drug and nondrug therapies for treating acute mania or depression symptoms and preventing relapse in adults with bipolar disorder (BD) diagnoses, including bipolar I disorder (BD-I), bipolar II disorder (BD-II), and other types.
Key Messages
- Acute mania treatment: Lithium, asenapine, cariprazine, olanzapine, quetiapine, risperidone, and ziprasidone may modestly improve acute mania symptoms in adults with BD-I. Participants on atypical antipsychotics, except for quetiapine, reported more extrapyramidal symptoms, and those on olanzapine reported more weight gain, compared with placebo.
- Maintenance treatment: Lithium may prevent relapse into acute episodes in adults with BD-I.
- Depression treatment: Evidence was insufficient for drug treatments for depressive episodes in adults with BD-I and BD-II.
- For adults with any BD type, cognitive behavioral therapy may be no better than other psychotherapies for improving acute bipolar symptoms and systematic/collaborative care may be no better than other behavioral therapies for preventing relapse of any acute symptoms.
- Stronger conclusions were prevented by high rates of participants dropping out.
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