Acute mania best treated with antipsychotics

ANTIPSYCHOTIC drugs are significantly more effective than mood stabilisers when treating acute mania in adults, a meta-analysis shows.

The study included 68 randomised controlled trials involving more than 16,000 patients, and found that haloperidol was the most effective anti-mania drug when used over a mean of 3.4 weeks. Risperidone and olanzapine were also far more effective than other antipsychotics and mood stabilisers. Along with quetiapine, they were also among the agents least likely to result in treatment discontinuation.

In an editorial, two Australian psychiatrists cautioned long-term stability and prophylaxis, rather than management of acute episodes, should be the overriding therapeutic imperative for mania management.

Professor David Castle, chair of psychiatry at the University of Melbourne and St Vincent’s Hospital, agreed, saying avoidance of depression, which is associated with disability and suicide, was the “real issue

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