Antipsychotic drugs in bipolar disorder

被引:28
作者
Ertugrul, A
Meltzer, HY
机构
[1] Vanderbilt Univ, Sch Med, Dept Psychiat, Nashville, TN 37212 USA
[2] Hacettepe Univ, Sch Med, Ankara, Turkey
关键词
antipsychotic drugs; bipolar disorder; mania;
D O I
10.1017/S1461145703003560
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Antipsychotic drugs are useful in the treatment of acute mania and as maintenance treatment. While both typical and atypical antipsychotic drugs are able to diminish manic symptoms, agitation and aggression in acute mania, the atypical antipsychotic drugs enjoy a number of advantages, including significantly less extrapyramidal symptoms, diminished risk of tardive dyskinesia, lack of increase in serum prolactin levels (with the exception of risperidone), improvement in cognition, and possible decrease in suicidality. Most of the atypical antipsychotic drugs have been found to be effective as an add-on treatment (with mood stabilizers and antidepressant drugs) and sometimes as monotherapy in treatment-resistant bipolar patients. Long-acting typical neuroleptic drugs may be useful in the treatment of non-compliant bipolar patients. A small number of patients with schizophrenia treated with risperidone, olanzapine, or quetiapine experience a first episode of hypomania or mania. It is not apparent if this is a true drug-induced event or coincidental. Side-effects of note with the atypical antipsychotic drugs are weight gain (most prominently with olanzapine and clozapine), sedation, and agranulocytosis (clozapine). Atypical antipsychotic drugs are recommended for use in bipolar disorder for acute treatment, maintenance treatment, and for treatment-resistant patients.
引用
收藏
页码:277 / 284
页数:8
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