Antipsychotic adjunctive therapy to mood stabiliser should be continued for 6months after remission of a manic episode

One hundred and seventy-eight patients from academic centres in Canada and Brazil with bipolar I disorder and aged ≥17 years, who recently remitted from an acute manic or mixed episode with a combination of mood stabiliser (lithium or valproate) and atypical antipsychotic (risperidone or olanzapine) were randomised to one of the three following groups: (1) discontinue risperidone or olanzapine over 2 weeks beg inning on the day of randomisation and receive placebo substitution for the remaining 50 weeks; (2) receive risperidone or olanzapine for 24 weeks, followed by tapering and discontinuation of the antipsychotic over the next 2 weeks and placebo substitution for the remaining 26 weeks; and (3) continu e risperidone or olanzapine for 52 weeks. All patients continued the same mood stabiliser (lithium or valproate) they were taking at study entry for the 52-week duration of the study. The primary outcome measure was the time to any mood episode, defined as: (1) Young Mania Rating Scale score of 15 o r greater, (2) Hamilton Rating Scale for Depression (HAM-D) 21-item score of 15 or greater or HAM-D suicide item score of 3 or greater, (3) Clinical Global Impression Severity score of 3 or greater, (4) hospitalisation for treatment of mood symptoms; or (5) suicide or suicide attempt. Secondary outc ome measures were time to a manic episode, time to a depressive episode and time to premature discontinuation from the study for any clinical reason. Randomisation was stratified by...
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news