Meta-analysis Names Most Effective Atypicals in Bipolar Depression

May 7, 2018

NEW YORK CITY—Cariprazine, lurasidone, olanzapine, combination olanzapine-fluoxetine, and quetiapine are significantly more effective than placebo in easing symptoms of acute bipolar depression, according to a meta-analysis.

The research was presented during a May 7 poster session at the American Psychiatric Association’s annual meeting. Poster presenter Katsuhiko Hagi reached the finding after evaluating 22 randomized controlled trials spanning 8823 patients treated with any of 7 different atypical antipsychotic medications or placebo.

Cariprazine, lurasidone, olanzapine, combination olanzapine-fluoxetine, and quetiapine all demonstrated significant symptom improvement, reflected in scores on the Montgomery-Åsberg Depression Rating Scale and Clinical Global Impressions-Bipolar Scale, according to the poster. All 5 atypical antipsychotics generated response and remission rates significantly higher than those with placebo.

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“Conversely,” Hagi pointed out, “aripiprazole and ziprasidone were not significantly different from placebo in depressive symptom improvement, treatment response, nor remission.”

To optimize bipolar depression treatment, the findings of the meta-analysis should be considered along with each medication’s adverse effect profile and individual patient characteristics, such as adverse effect sensitivity and clinical urgency, the researcher advised.

—Jolynn Tumolo


“Efficacy of atypical antipsychotics in the treatment of bipolar depression: a systematic review and meta-analysis.” Abstract presented at: the American Psychiatric Association Annual Meeting; May 7, 2018; New York, NY.