Atypical antipsychotics as "mood stabilizers": a retrospective chart review.

BACKGROUND: Introduction and common usage of atypical antipsychotics in maintenance therapy for bipolar disorders is an innovative perspective. The aim of the present study was to compare the efficacy of atypical antipsychotics (AA) used either as monotherapy or in combination with a mood stabilizer (MS) in the maintenance treatment. METHOD: 55 patients treated with AA either alone or in combination with a MS for bipolar I disorder which were followed up for 6 months were retrospectively evaluated. Clinical status was evaluated with Bech Rafaelsen Mania Rating Scale (BRMRS), 24-item Hamilton Depression Scale (HAMD) and Clinical Global Impressions Scale (CGI). RESULTS: Having similar demographic and clinical backgrounds, patients on with both treatment groups had significant clinical improvement. During the maintenance phase, numbers of total attacks were not significantly different between the two treatment groups. CONCLUSION: Our naturalistic, controlled retrospective observations suggest the potential use of atypical antipsychotics in the long-term management of bipolar I disorder. Larger and prospective studies are needed to determine the role of atypical antipsychotics more clearly in the maintenance treatment of bipolar disorder. To the best of our knowledge this is the first study comparing MS+AA with only AA treatment regimen.

Atypical antipsychotics related metabolic syndrome in bipolar patients.

BACKGROUND: This is the first study in bipolar patients, aimed to evaluate possible roles of the drugs, [atypical antipsychotics (AA) and mood stabilizers (MS)], inducing metabolic syndrome (MetS). METHODS: 125 bipolar patients, diagnosed according to the DSM IV, were assessed cross-sectionally for MetS according to the National Cholesterol Educational Program criteria (NCEP ATP III). Patients included in the study were required to receive medications (AAs: quetiapine, risperidone and olanzapine, and MSs: Lithium, Sodium Valproate, Carbamazepine, Lamotrigine) for at least 3 months. Patients are divided into three groups as only AA users, AA+MS users and only MS users. RESULTS: Of the patients, 32% were MetS, a proportion higher than normal population and similar as previous studies in bipolar patients. AA taking patients had significantly higher MetS rates than the others (chi(2)=10.47 df=2 p=0.005). Also, AA taking patients had significantly higher MetS rates than MS taking patients (chi(2)=8.86 df=1 p=0.003). There was no significant difference among quetiapine, olanzapine, risperidone usage for MetS prevalences (chi(2)=0.38 df=2 p=0.82). CONCLUSIONS: AA taking bipolar patients had higher MetS rates. Despite already existing data on MetS and antipsychotics, this cross-sectional study is the first research, discusses AAs and MSs for inducing MetS in bipolar disorder. Prospectively designed researches should be conducted for further clarification of the role of these drugs in MetS.