PMID- 20128953
OWN - NLM
STAT- MEDLINE
DCOM- 20100929
LR  - 20211020
IS  - 1469-5111 (Electronic)
IS  - 1461-1457 (Print)
IS  - 1461-1457 (Linking)
VI  - 13
IP  - 6
DP  - 2010 Jul
TI  - Level of response and safety of pharmacological monotherapy in the treatment of 
      acute bipolar I disorder phases: a systematic review and meta-analysis.
PG  - 813-32
LID - 10.1017/S1461145709991246 [doi]
AB  - In recent years, combinations of pharmacological treatments have become common 
      for the treatment of bipolar disorder type I (BP I); however, this practice is 
      usually not evidence-based and rarely considers monotherapy drug regimen (MDR) as 
      an option in the treatment of acute phases of BP I. Therefore, we evaluated 
      comparative data of commonly prescribed MDRs for both manic and depressive phases 
      of BP I. Medline, PsycINFO, EMBASE, the Cochrane Library, the 
      ClinicalStudyResults.org and other data sources were searched from 1949 to March 
      2009 for placebo and active controlled randomized clinical trials (RCTs). Risk 
      ratios (RRs) for response, remission, and discontinuation rates due to adverse 
      events (AEs), lack of efficacy, or discontinuation due to any cause, and the 
      number needed to treat or harm (NNT or NNH) were calculated for each medication 
      individually and for all evaluable trials combined. The authors included 31 RCTs 
      in the analyses comparing a MDR with placebo or with active treatment for acute 
      mania, and 9 RCTs comparing a MDR with placebo or with active treatment for 
      bipolar depression. According to the collected evidence, most of the MDRs when 
      compared to placebo showed significant response and remission rates in acute 
      mania. In the case of bipolar depression only quetiapine and, to a lesser extent, 
      olanzapine showed efficacy as MDR. Overall, MDRs were well tolerated with low 
      discontinuation rates due to any cause or AE, although AE profiles differed among 
      treatments. We concluded that most MDRs were efficacious and safe in the 
      treatment of manic episodes, but very few MDRs have demonstrated being 
      efficacious for bipolar depressive episodes.
FAU - Tamayo, Jorge M
AU  - Tamayo JM
AD  - Department of Psychiatry, CES University, Medellin, Colombia. tamayojm@gmail.com
FAU - Zarate, Carlos A Jr
AU  - Zarate CA Jr
FAU - Vieta, Eduard
AU  - Vieta E
FAU - Vazquez, Gustavo
AU  - Vazquez G
FAU - Tohen, Mauricio
AU  - Tohen M
LA  - eng
GR  - Z99 MH999999/ImNIH/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20100204
PL  - England
TA  - Int J Neuropsychopharmacol
JT  - The international journal of neuropsychopharmacology
JID - 9815893
RN  - 0 (Antidepressive Agents)
SB  - IM
MH  - Acute Disease
MH  - Animals
MH  - Antidepressive Agents/*therapeutic use
MH  - Bipolar Disorder/*drug therapy
MH  - Databases, Factual/statistics & numerical data
MH  - *Drug Evaluation
MH  - Humans
MH  - Randomized Controlled Trials as Topic
PMC - PMC3005373
MID - NIHMS256270
EDAT- 2010/02/05 06:00
MHDA- 2010/09/30 06:00
PMCR- 2010/12/21
CRDT- 2010/02/05 06:00
PHST- 2010/02/05 06:00 [entrez]
PHST- 2010/02/05 06:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
PHST- 2010/12/21 00:00 [pmc-release]
AID - S1461145709991246 [pii]
AID - 10.1017/S1461145709991246 [doi]
PST - ppublish
SO  - Int J Neuropsychopharmacol. 2010 Jul;13(6):813-32. doi: 
      10.1017/S1461145709991246. Epub 2010 Feb 4.