Comparative efficacy and tolerability of pharmacological treatments in the maintenance treatment of bipolar disorder: a systematic review and network meta-analysis

Miura, Tomofumi; Noma, Hisashi; Furukawa, Toshi A; Mitsuyasu, Hiroshi; Tanaka, Shiro; Stockton, Sarah; Salanti, Georgia; Motomura, Kinsi; Shimano-Katsuki, Satomi; Leucht, Stefan; Cipriani, Andrea; Geddes, John; Kanba, Shigenobu

doi:10.1016/s2215-0366(14)70314-1

Cited by 309 publications

(285 citation statements)

References 27 publications

Supporting

Mentioning

259

Contrasting

Unclassified

Order By: Relevance

“…Although there have not been maintenance studies for quetiapine, risperidone, or ziprasidone in this population, clinical experience and open‐label studies indicate that continuation and maintenance treatment with these medications is another option, particularly for those patients who have responded well to acute treatment (level 4) 591, 609, 610. Further, there is evidence that oral quetiapine and long‐acting injectable risperidone monotherapy and adjunctive therapy and oral ziprasidone adjunctive therapy are effective in preventing mood episodes in adults with BD 369, 370, 383, 384, 387…”

Section: Specific Populationsmentioning

confidence: 95%

“…Lithium (level 1),368, 369 quetiapine (level 1),369, 370 divalproex (level 1) 369, 371, 372 (Figure 4) and lamotrigine (level 1)369, 373 monotherapies have the best combination of clinical trials, administrative data, and clinical experience to support their use as first‐line therapies for maintenance treatment of BD. Recent data suggest that asenapine (level 2)374 is effective in preventing both manic and depressive episodes, and thus is recommended as a first‐line treatment.…”

Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

“…In general, lithium is the gold standard for maintenance treatment, as it is effective in preventing both manic and depressive episodes (magnitude of prophylactic efficacy greater against mania vs depression) and appears to have a degree of anti‐suicidal effects 352, 369, 409, 410, 411, 412, 413. Patients who respond well to lithium treatment usually have an episodic remitting pre‐treatment clinical course, a family history of BD (especially BD responsive to lithium), low rates of comorbidity (especially anxiety and substance abuse disorders), and a pattern of mania‐depression‐euthymia in biphasic episodes, as well as a typical clinical presentation 414, 415, 416.…”

Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

See 2 more Smart Citations

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

Self Cite

View full text Add to dashboard Cite

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

show abstract

Section: Specific Populationsmentioning

confidence: 95%

Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

Section: Maintenance Therapy For Bipolar Disordermentioning

confidence: 99%

See 1 more Smart Citation

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, the reference lists of review articles relevant to this topic were manually searched to identify potentially eligible papers (Arbaizar et al, 2009;Biederman et al, 2005;Brown et al, 2013;Fountoulakis et al, 2009;Fountoulakis et al, 2011;McKeage, 2014;Meduri et al, 2016;Miura et al, 2014;Perlis, 2007;Perlis et al, 2006;Scherk et al, 2007;Smith et al, 2007;Taylor, 2003;Vieta et al, 2010;Yatham et al, 2013;Yildiz et al, 2015).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

Tseng²,

Stubbs

et al. 2017

Progress in Neuro-Psychopharmacology and Biological Psychiatry

View full text Add to dashboard Cite

-keung Chow , Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Pnp(2017Pnp( ), doi: 10.1016Pnp( /j.pnpbp.2017 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.A C C E P T E D M A N U S C R I P T Aripiprazole was associated with lower relapse rates in bipolar mania when used in combination versus a placebo in maintenance therapy (odds ratio: 0.522, p<0.029). ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P TAripiprazole was also associated with higher levels of high density lipoprotein, lower dropout rates, but no difference in extrapyramidal symptoms in the maintenance phase versus a placebo or in comparison with other medications (haloperidol or lithium). Our results suggest that aripiprazole is effective and safe in treating bipolar mania. Further trials are necessary to evaluate the efficacy and tolerability versus other medications.

show abstract

“…Traditional mood stabilizers, namely lithium, carbamazepine and valproate, and antipsychotics are effective for the treatment of acute manic episodes (Cipriani et al, 2013) and for relapse prevention (Miura et al, 2014), while options for bipolar depression are more limited (ME, 2006). Nevertheless, despite approval of these effective medication treatments, unfortunately up to half of patients have an insufficient response to pharmacotherapy (Calabrese and Delucchi, 1990;Freeman et al, 1992;Pope et al, 1991;Small et al, 1991;Swann et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Acetylcholinesterase inhibitors and memantine in bipolar disorder: A systematic review and best evidence synthesis of the efficacy and safety for multiple disease dimensions

Veronese

Solmi

Luchini

et al. 2016

Journal of Affective Disorders

View full text Add to dashboard Cite

show abstract

Comparative efficacy and tolerability of pharmacological treatments in the maintenance treatment of bipolar disorder: a systematic review and network meta-analysis

Cited by 309 publications

References 27 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Efficacy, safety and tolerability of aripiprazole in bipolar disorder: An updated systematic review and meta-analysis of randomized controlled trials

Acetylcholinesterase inhibitors and memantine in bipolar disorder: A systematic review and best evidence synthesis of the efficacy and safety for multiple disease dimensions

Contact Info

Product

Resources

About