Efficacy of Antimanic Treatments: Meta-analysis of Randomized, Controlled Trials

We conducted meta-analyses of findings from randomized, placebo-controlled, short-term trials for acute mania in manic or mixed states of DSM (III–IV) bipolar I disorder in 56 drug–placebo comparisons of 17 agents from 38 studies involving 10 800 patients. Of drugs tested, 13 (76%) were more effecti...

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Bibliographic Details
Published in:Neuropsychopharmacology (New York, N.Y.) N.Y.), 2011-01, Vol.36 (2), p.375-389
Main Authors: Yildiz, Ayşegül, Vieta, Eduard, Leucht, Stefan, Baldessarini, Ross J
Format: Article
Language:English
Subjects:
631/92/436/108
692/699/476/1333
Adult and adolescent clinical studies
Antimanic Agents - pharmacology
Antimanic Agents - therapeutic use
Antipsychotic Agents - pharmacology
Antipsychotic Agents - therapeutic use
Behavioral Sciences
Biological and medical sciences
Biological Psychology
Bipolar Disorder - drug therapy
Humans
Mania
Medical sciences
Medicine
Medicine & Public Health
Mood disorders
Neuropharmacology
Neurosciences
Original
original-article
Outcome Assessment (Health Care) - methods
Pharmacology. Drug treatments
Pharmacotherapy
Placebo Effect
Psychiatry
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psycholeptics: tranquillizer, neuroleptic
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychopharmacology
Randomized Controlled Trials as Topic - methods
Randomized Controlled Trials as Topic - trends
Systematic review
Time Factors
Treatment Outcome
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Summary:We conducted meta-analyses of findings from randomized, placebo-controlled, short-term trials for acute mania in manic or mixed states of DSM (III–IV) bipolar I disorder in 56 drug–placebo comparisons of 17 agents from 38 studies involving 10 800 patients. Of drugs tested, 13 (76%) were more effective than placebo: aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperdone, quetiapine, risperidone, tamoxifen, valproate, and ziprasidone. Their pooled effect size for mania improvement (Hedges’ g in 48 trials) was 0.42 (confidence interval (CI): 0.36–0.48); pooled responder risk ratio (46 trials) was 1.52 (CI: 1.42–1.62); responder rate difference (RD) was 17% (drug: 48%, placebo: 31%), yielding an estimated number-needed-to-treat of 6 (all p
ISSN:0893-133X
1740-634X
DOI:10.1038/npp.2010.192