Conference paper
ATYPICAL ANTI-PSYCHOTICS IN ADULT BIPOLAR DISORDER: URRENT EVIDENCE AND UPDATES IN THE NICE GUIDELINES
Stephanie Xiu Wern Poo
; School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom ; Newnham College Cambridge, Cambridge, Cambridge, United Kingdom
Mark Agius
; South Essex University Partnership Foundation Trust, Cambridge, United Kingdom ; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom ; Clare College, University of Cambridge, Cambridge, United Kingdom
Abstract
Background: The introduction of atypical antipsychotics in the management of adult bipolar disorder has been increasingly
adopted in clinical setting. While new studies continue to emerge, NICE has recently updated the guidelines on the assessment and
management of bipolar disorder.
Aim: To review the efficacy and tolerability profiles of atypical antipsychotics used to treat adult bipolar disorder in clinical
practice, in relation to the latest NICE guidelines.
Methods: The recent NICE guidelines (CG185), published in September 2014 was analysed to identify second generation
antipsychotics (SGA) for the various presentations of bipolar disorder in adults. A qualitative literature search was conducted to
review the evidence to support these changes, and identify randomized controlled trials on off-label and newer SGAs.
Results and conclusions: With respect to atypical antipsychotics, NICE guidelines introduced olanzapine and fluoxetine
combination therapy as first line treatment for moderate to severe bipolar depression; and improved clarity on the treatment of
mania, hypomania and rapid cycling bipolar disorder. Evidence from our literature search favour these changes; and recognized
other atypical antipsychotics such as aripiprazole, asenapine, lurasidone, ziprasidone and clozapine which could be of potential
clinical benefit.
Keywords
atypical antipsychotics; bipolar disorder; quetiapine; olanzapine; fluoxetine; risperidone; aripiprazole; asenapine; lurasidone; ziprasidone; clozapine; adult; NICE guidelines
Hrčak ID:
265737
URI
Publication date:
5.11.2014.
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