Certain atypical antipsychotics—including cariprazine, lurasidone, olanzapine, combination olanzapine-fluoxetine, and quetiapine—are significantly better than placebo at alleviating symptoms of acute bipolar depression, according to results of a yet-unpublished meta-analysis presented at the 2018 Annual Meeting of the American Psychiatry Association in New York, NY, May 5–9.
Katsuhiko Hagi, PhD, of Sumitomo Dainippon Pharma, Tokyo, Japan, presented the findings of the meta-analysis, which assessed 22 randomized controlled trials involving 8,823 patients administered 1 of 7 different types of atypical antipsychotic medications or placebo.
Results from the Montgomery-Åsberg Depression Rating Scale and Clinical Global Impressions-Bipolar Scale indicated that 5 of the atypical antipsychotics—cariprazine, lurasidone, olanzapine, combination olanzapine-fluoxetine, and quetiapine—all demonstrated clinical improvement, resulting in increased response and remission rates.
Two of 7 atypical antipsychotics analyzed—aripiprazole and ziprasidone—did not significantly help with depressive symptom response, treatment response, or remission rates, the study results showed.
Dr. Hagi recommended that when prescribing treatment for bipolar depression, the findings of the current meta-analysis be considered along with drug adverse effects and individual patient factors, including drug sensitivity and urgency.