PMID- 26107820
OWN - NLM
STAT- MEDLINE
DCOM- 20160321
LR  - 20220408
IS  - 1744-764X (Electronic)
IS  - 1474-0338 (Linking)
VI  - 14
IP  - 8
DP  - 2015 Aug
TI  - Safety and tolerability of antipsychotic-mood stabilizer co-treatment in the 
      management of acute bipolar disorder: results from a systematic review and 
      exploratory meta-analysis.
PG  - 1181-99
LID - 10.1517/14740338.2015.1053457 [doi]
AB  - INTRODUCTION: Mood stabilizer (MS) plus antipsychotic (AP) co-treatment is common 
      in patients with acute bipolar disorder (BD), but adverse effects (AEs) of this 
      strategy have not been systematically reviewed. AREAS COVERED: We conducted a 
      systematic review searching PubMed/MEDLINE and PsycINFO on April 1, 2015 for 
      randomized trials in >/= 20 adults with acute manic/mixed or depressed BD comparing 
      MS or AP monotherapy with their combination that reported quantitative AE data. 
      Pooled together, MS+AP versus MS monotherapy (studies = 18, n = 4419) was 
      associated with significantly higher burden regarding 21/53 (39.6%) individual 
      AEs, particularly weight gain-related (5/5 = 100%), extrapyramidal (5/12 = 41.7%) 
      and glucose/lipid-related AEs (3/8 = 37.5%). AP+MS versus AP monotherapy (studies 
      = 3, n = 397) was associated with significantly higher burden regarding 4/21 
      (19.0%) individual AEs (>/= 1 AE, tremor, sedation/somnolence, vomiting). EXPERT 
      OPINION: Efficacy advantages of AP+MS co-treatment versus monotherapy should be 
      balanced with its greater AE burden. AE risk is higher for adding AP to MS (17 
      additional AEs) than adding MS to an AP, including the particularly concerning 
      cardiometabolic AEs. More data are needed, as only one or two studies provided 
      data for 21/21 (100%) AEs of MS augmentation of AP, and 13/53 (24.5%) AEs of AP 
      augmentation of MS, and as sparse data suggest clinically relevant AE differences 
      across individual AP+MS combinations.
FAU - Galling, Britta
AU  - Galling B
AD  - The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island 
      Jewish Health System , Glen Oaks, New York , USA.
FAU - Garcia, Maryam A
AU  - Garcia MA
FAU - Osuchukwu, Uzoma
AU  - Osuchukwu U
FAU - Hagi, Katsuhiko
AU  - Hagi K
FAU - Correll, Christoph U
AU  - Correll CU
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20150624
PL  - England
TA  - Expert Opin Drug Saf
JT  - Expert opinion on drug safety
JID - 101163027
RN  - 0 (Antimanic Agents)
RN  - 0 (Antipsychotic Agents)
SB  - IM
MH  - Acute Disease
MH  - Antimanic Agents/administration & dosage/*adverse effects
MH  - Antipsychotic Agents/administration & dosage/*adverse effects
MH  - Bipolar Disorder/*drug therapy
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Treatment Outcome
OTO - NOTNLM
OT  - adverse effects
OT  - antipsychotic
OT  - augmentation
OT  - bipolar disorder
OT  - co-treatment
OT  - combination
OT  - meta-analysis
OT  - mood stabilizer
OT  - safety
OT  - tolerability
EDAT- 2015/06/25 06:00
MHDA- 2016/03/22 06:00
CRDT- 2015/06/25 06:00
PHST- 2015/06/25 06:00 [entrez]
PHST- 2015/06/25 06:00 [pubmed]
PHST- 2016/03/22 06:00 [medline]
AID - 10.1517/14740338.2015.1053457 [doi]
PST - ppublish
SO  - Expert Opin Drug Saf. 2015 Aug;14(8):1181-99. doi: 10.1517/14740338.2015.1053457. 
      Epub 2015 Jun 24.