QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Extracto Full Text PDF For Our Patients Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Marken, P. A Articles by Pies, R. W Search for Related Content PubMed PubMed Citation Articles by Marken, P. A Articles by Pies, R. W

PSYCHIATRY

Emerging Treatments for Bipolar Disorder: Safety and Adverse Effect Profiles

Professor and Chair, Division of Pharmacy Practice; Professor of Psychiatry, Schools of Pharmacy and Medicine, University of Missouri—Kansas City, Kansas City, MO

Ronald W Pies, MD

Clinical Professor of Psychiatry, Department of Psychiatry, Tufts University School of Medicine, Boston, MA

Reprints: Dr. Marken, Schools of Pharmacy and Medicine, University of Missouri—Kansas City, M3-C19 Medical School Bldg., 2411 Holmes St., Kansas City, MO 64108-2792, fax 816/235-1776, markenp{at}umkc.edu

OBJECTIVE: To provide an overview of the safety and tolerability of newer agents used to treat bipolar disorder (BPD) and provide clinicians with management strategies for drug-related toxicity and adverse effects.

DATA SOURCES: MEDLINE was searched through July 2005 for BPD treatment, adverse effects, tolerability, safety, emerging agents, atypical antipsychotics, new antiepileptic drugs (AEDs), risperidone, quetiapine, clozapine, ziprasidone, aripiprazole, lamotrigine, topiramate, gabapentin, oxcarbazepine, and olanzapine.

STUDY SELECTION AND DATA EXTRACTION: Results from randomized controlled trials, open-label studies, and reviews are described.

DATA SYNTHESIS: Emerging agents recently approved for BPD include atypical antipsychotics and new AEDs. Safety and tolerability are as important as efficacy because poor adherence in BPD worsens outcome; metabolic and other comorbidities pose specific challenges; and manic patients often require combination therapy, which increases adverse effects. Most atypical antipsychotics cause fewer extrapyramidal symptoms than conventional antipsychotics, but may cause more weight gain and metabolic complications. The newer AEDs generally cause less weight gain than the older agents, and some even promote weight loss. Several newer AEDs used in BPD also offer the advantages of fewer drug interactions and less need for therapeutic drug monitoring compared with older AEDs.

CONCLUSIONS: Pending the results of ongoing controlled studies, several emerging agents may be useful additions to the therapeutic arsenal for BPD.

Key Words: adverse effects, bipolar disorder treatment, tolerability

Published Online, January 10, 2006. www.theannals.com, DOI 10.1345/aph.1G112

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-06-004-H01

This article has been cited by other articles:

				C. A. Tamminga and J. M. Davis The Neuropharmacology of Psychosis Schizophr Bull, July 1, 2007; 33(4): 937 - 946. [Abstract] [Full Text] [PDF]