Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.

Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder. Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy...

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Autores: Cruz, Nuria, Sánchez-Moreno, José, Torres, Ferran, Goikolea, José Manuel, Valentí Ribas, Marc, Vieta i Pascual, Eduard, 1963-
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2010
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/53243
Acceso en línea:https://hdl.handle.net/2445/53243
Access Level:acceso abierto
Palabra clave:Trastorn bipolar
Antipsicòtics
Assaigs clínics de medicaments
Placebos
Manic-depressive illness
Antipsychotic drugs
Drug testing
Placebos (Medicine)
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spelling Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.Cruz, NuriaSánchez-Moreno, JoséTorres, FerranGoikolea, José ManuelValentí Ribas, MarcVieta i Pascual, Eduard, 1963-Trastorn bipolarAntipsicòticsAssaigs clínics de medicamentsPlacebosManic-depressive illnessAntipsychotic drugsDrug testingPlacebos (Medicine)Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder. Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy of modern atypical antipsychotics in bipolar depression. We systematically reviewed published or registered randomized, double-blind, placebo-controlled trials (RCTs) of modern antipsychotics in adult bipolar I and/or II depressive patients (DSM-IV criteria). Efficacy outcomes were assessed based on changes in the Montgomery-Asberg Depression Rating Scale (MADRS) during an 8-wk period. Data were combined through meta-analysis using risk ratio as an effect size with a 95% confidence interval (95% CI) and with a level of statistical significance of 5% (p<0.05). We identified five RCTs; four involved antipsychotic monotherapy and one addressed both monotherapy and combination with an antidepressant. The two quetiapine trials analysed the safety and efficacy of two doses: 300 and 600 mg/d. The only olanzapine trial assessed olanzapine monotherapy within a range of 5-20 mg/d and olanzapine-fluoxetine combination within a range of 5-20 mg/d and 6-12 mg/d, respectively. The two aripiprazole placebo-controlled trials assessed doses of 5-30 mg/d. Quetiapine and olanzapine trials (3/5, 60%) demonstrated superiority over placebo (p<0.001). Only 2/5 (40%) (both aripiprazole trials) failed in the primary efficacy measure after the first 6 wk. Some modern antipsychotics (quetiapine and olanzapine) have demonstrated efficacy in bipolar depressive patients from week 1 onwards. Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression. Comment in The following popper user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.Destroy user interface controlEfficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis--results to be interpreted with caution.Cambridge University Press2014201420102014info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10 p.application/pdfhttps://hdl.handle.net/2445/53243Articles publicats en revistes (Psicologia Clínica i Psicobiologia)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: http://dx.doi.org/10.1017/S1461145710000350International Journal of Neuropsychopharmacology, 2010, vol. 13, num. 7, p. 5-14http://dx.doi.org/10.1017/S1461145710000350(c) CINP (Collegium Internationale Neuro-Psychopharmacologicum) , 2010info:eu-repo/semantics/openAccessoai:recercat.cat:2445/532432026-05-29T05:05:01Z
dc.title.none.fl_str_mv Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
title Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
spellingShingle Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
Cruz, Nuria
Trastorn bipolar
Antipsicòtics
Assaigs clínics de medicaments
Placebos
Manic-depressive illness
Antipsychotic drugs
Drug testing
Placebos (Medicine)
title_short Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
title_full Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
title_fullStr Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
title_full_unstemmed Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
title_sort Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.
dc.creator.none.fl_str_mv Cruz, Nuria
Sánchez-Moreno, José
Torres, Ferran
Goikolea, José Manuel
Valentí Ribas, Marc
Vieta i Pascual, Eduard, 1963-
author Cruz, Nuria
author_facet Cruz, Nuria
Sánchez-Moreno, José
Torres, Ferran
Goikolea, José Manuel
Valentí Ribas, Marc
Vieta i Pascual, Eduard, 1963-
author_role author
author2 Sánchez-Moreno, José
Torres, Ferran
Goikolea, José Manuel
Valentí Ribas, Marc
Vieta i Pascual, Eduard, 1963-
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Trastorn bipolar
Antipsicòtics
Assaigs clínics de medicaments
Placebos
Manic-depressive illness
Antipsychotic drugs
Drug testing
Placebos (Medicine)
topic Trastorn bipolar
Antipsicòtics
Assaigs clínics de medicaments
Placebos
Manic-depressive illness
Antipsychotic drugs
Drug testing
Placebos (Medicine)
description Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder. Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy of modern atypical antipsychotics in bipolar depression. We systematically reviewed published or registered randomized, double-blind, placebo-controlled trials (RCTs) of modern antipsychotics in adult bipolar I and/or II depressive patients (DSM-IV criteria). Efficacy outcomes were assessed based on changes in the Montgomery-Asberg Depression Rating Scale (MADRS) during an 8-wk period. Data were combined through meta-analysis using risk ratio as an effect size with a 95% confidence interval (95% CI) and with a level of statistical significance of 5% (p<0.05). We identified five RCTs; four involved antipsychotic monotherapy and one addressed both monotherapy and combination with an antidepressant. The two quetiapine trials analysed the safety and efficacy of two doses: 300 and 600 mg/d. The only olanzapine trial assessed olanzapine monotherapy within a range of 5-20 mg/d and olanzapine-fluoxetine combination within a range of 5-20 mg/d and 6-12 mg/d, respectively. The two aripiprazole placebo-controlled trials assessed doses of 5-30 mg/d. Quetiapine and olanzapine trials (3/5, 60%) demonstrated superiority over placebo (p<0.001). Only 2/5 (40%) (both aripiprazole trials) failed in the primary efficacy measure after the first 6 wk. Some modern antipsychotics (quetiapine and olanzapine) have demonstrated efficacy in bipolar depressive patients from week 1 onwards. Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression. Comment in The following popper user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.Destroy user interface controlEfficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis--results to be interpreted with caution.
publishDate 2010
dc.date.none.fl_str_mv 2010
2014
2014
2014
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/53243
url https://hdl.handle.net/2445/53243
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: http://dx.doi.org/10.1017/S1461145710000350
International Journal of Neuropsychopharmacology, 2010, vol. 13, num. 7, p. 5-14
http://dx.doi.org/10.1017/S1461145710000350
dc.rights.none.fl_str_mv (c) CINP (Collegium Internationale Neuro-Psychopharmacologicum) , 2010
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) CINP (Collegium Internationale Neuro-Psychopharmacologicum) , 2010
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 10 p.
application/pdf
dc.publisher.none.fl_str_mv Cambridge University Press
publisher.none.fl_str_mv Cambridge University Press
dc.source.none.fl_str_mv Articles publicats en revistes (Psicologia Clínica i Psicobiologia)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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