Treatment for Bipolar Disorder [entered retrospectively]

Project Summary Title and Description

Title
Treatment for Bipolar Disorder [entered retrospectively]
Description
Objective. Assess the effect of drug and nondrug interventions for treating acute symptoms associated with bipolar disorder (BD) and preventing relapse. Data sources. Ovid MEDLINE® and PsychInfo, the Cochrane Central Register of Controlled Trials, and Ovid Embase® bibliographic databases; hand searches of references of relevant systematic reviews through May, 2017. Review methods. Eligible studies included randomized controlled trials and prospective cohorts with comparator arms enrolling adults with BD of any type with 3 weeks followup for acute mania, 3 months for depression, and 6 months for maintenance treatments. We excluded acute mania and depression studies with greater than 50 percent attrition. Results. We synthesized evidence from 181 unique studies, 117 studies for 28 drugs, 64 studies for nondrug interventions. All drug findings with at least low-strength evidence were based on studies almost exclusively enrolling adults with BD-I. Asenapine, cariprazine, quetiapine, and olanzapine improved acute mania symptoms compared to placebo (low-strength evidence). However, improvements were of modest clinical significance, with values that were less than the minimally important difference, but still large enough that a reasonable proportion of participants likely received a benefit. Unpooled evidence indicated an overall beneficial effect of risperidone and ziprasidone on acute mania symptoms compared to placebo (low-strength evidence). Participants using antipsychotics, except quetiapine, reported more extrapyramidal symptoms compared to placebo, and those using olanzapine reported more clinically significant weight gain. Lithium improved acute mania in the short-term and prolonged time to relapse in the long-term compared to placebo (low-strength evidence). No difference was found between olanzapine and divalproex/valproate (low-strength evidence). For drugs not approved for BD, paliperidone also improved acute mania compared to placebo (low-strength evidence), while topiramate and allopurinol showed no benefit (low-strength evidence). Further, lithium improved acute mania better than topiramate, although withdrawals for adverse events were lower for topiramate. Only lithium reached a minimally important difference. All other drug comparisons to placebo or active controls for acute mania, depression, and maintenance had insufficient evidence. For psychosocial interventions, cognitive behavioral training (CBT) was no better for depression or mania symptoms than psychoeducation or other active psychosocial comparators (low-strength evidence). Systematic/collaborative care had no effect on relapse compared to inactive comparators (low-strength evidence). Evidence was insufficient for all other nondrug interventions. Conclusions. We found no high- or moderate-strength evidence for any intervention to effectively treat any phase of any type of BD compared with placebo or an active comparator. Low-strength evidence showed improved mania symptoms for all FDA-approved antipsychotics, except aripiprazole, when compared with placebo for adults with BD-I. Low-strength evidence also showed benefit from lithium for acute mania in the short-term and resulted in longer periods of maintenance versus placebo in adults with BD-I. Participants using atypical antipsychotics, except quetiapine, reported more extrapyramidal symptoms compared with placebo, and those using olanzapine reported more clinically significant weight gain. Evidence was insufficient for most nondrug interventions. Low-strength evidence showed no benefit for CBT on mood symptoms compared with active controls or systematic/collaborative care compared with inactive controls on relapse. Information on harms was limited across all drug and nondrug studies. Future studies of BD treatments will require innovative ways to increase study completion rates.
Attribution
N/A
Authors of Report
N/A
Methodology description
N/A
PROSPERO
N/A
DOI
10.26300/mmzg-em58
Notes
Data entered retrospectively. Data available for download in attached Word Documents. Each file contains study demographics, risk of bias assessments, and study outcomes organized by intervention type (12 intervention types total).
Funding Source
AHRQ

Key Questions

1. Key Question 1: What is the efficacy and comparative effectiveness of pharmacologic and nonpharmacologic treatments for adults with bipolar disorder? a. How do pharmacologic treatments (monotherapy or combination therapies) affect patient centered outcomes when compared with placebo? b. How do pharmacologic treatments (monotherapy or combination therapies) affect patient centered outcomes when compared with other active pharmacologic treatment? c. How do behavioral health treatments (psychotherapy, psychosocial interventions) affect patient centered outcomes when compared with usual care? d. How do behavioral health treatments (psychotherapy, psychosocial interventions, chronotherapy) affect patient centered outcomes when compared with other active treatment? e. How do somatic treatments (electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) affect patient-centered outcomes when compared with other active treatment? f. How do comprehensive programs affect patient centered outcomes when compared with usual care?
2. Key Question 2: What are the harms from pharmacologic and nonpharmacologic treatments for adults with bipolar disorder? a. What are the harms from pharmacologic treatments? b. What are the harms from behavioral health treatments? c. What are the harms from somatic treatments? d. What are the harms from comprehensive programs?
3. Key Question 3: What is the effectiveness of treatments to reduce the metabolic change (metabolic syndrome, glucose dysregulation, weight gain) side effects of first line pharmacologic treatments?
4. Key Question 4: Which patient characteristics predict the effectiveness and harms of pharmacologic and nonpharmacologic treatments for people with bipolar disorder, including disease-specific characteristics such as bipolar type, state severity, pediatric onset, new onset, treatment resistant, types of depression, and other comorbidities and patient characteristics such as substance use, other psychiatric comorbidities, medical comorbidities, age, sex, race/ethnicity, socioeconomic status?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Effectiveness of individual psychoeducation on recurrence in bipolar disorder; a controlled study.2015
Psychoeducation and online mood tracking for patients with bipolar disorder: A randomised controlled trial.2016
A negative double-blind controlled trial of sequential bilateral rTMS in the treatment of bipolar depression.2016
The long-term outcomes of an effectiveness trial of group versus individual psychoeducation for bipolar disorders.2016
Clinical effectiveness and acceptability of structured group psychoeducation versus optimised unstructured peer support for patients with remitted bipolar disorder (PARADES): a pragmatic, multicentre, observer-blind, randomised controlled superiority trial.2016
Integrated family and individual therapy for bipolar disorder: results of a treatment development study.
Suicide attempts in patients with bipolar I disorder during acute and maintenance phases of intensive treatment with pharmacotherapy and adjunctive psychotherapy.2002
A randomized controlled trial of cognitive therapy for bipolar disorder: focus on long-term change.2006
A web-based preventive intervention program for bipolar disorder: outcome of a 12-months randomized controlled trial.
Collaborative care for bipolar disorder: Part II. Impact on clinical outcome, function, and costs.2006
Group-based psychosocial intervention for bipolar disorder: randomised controlled trial.2010
A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission.
Psychoeducation efficacy in bipolar disorders: beyond compliance enhancement.
Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial.2009
Efficacy of psychoeducation on symptomatic and functional recovery in bipolar disorder.
Do comorbid anxiety disorders moderate the effects of psychotherapy for bipolar disorder? Results from STEP-BD.2014
Augmenting psychoeducation with a mobile intervention for bipolar disorder: a randomized controlled trial.
A brief dyadic group based psychoeducation program improves relapse rates in recently remitted bipolar disorder: a pilot randomised controlled trial.2010
Enhancing outcomes in patients with bipolar disorder: results from the Bipolar Disorder Center for Pennsylvanians Study.2009
Daily electronic self-monitoring in bipolar disorder using smartphones - the MONARCA I trial: a randomized, placebo-controlled, single-blind, parallel group trial.2015
The sequential combination of cognitive behavioral treatment and well-being therapy in cyclothymic disorder.
Inducing lifestyle regularity in recovering bipolar disorder patients: results from the maintenance therapies in bipolar disorder protocol.1997
Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder.2005
The role of interpersonal and social rhythm therapy in improving occupational functioning in patients with bipolar I disorder.2008
Adjunctive psychotherapy for bipolar disorder: effects of changing treatment modality.
A randomized controlled trial of cognitive behavioral group therapy for bipolar disorder.2011
Psychoeducation and cognitive-behavioral therapy for patients with refractory bipolar disorder: a 5-year controlled clinical trial.2014
Prospective rates of suicide attempts and nonsuicidal self-injury by young people with bipolar disorder participating in a psychotherapy study.2016
How effective is a psychological intervention program for patients with refractory bipolar disorder? A randomized controlled trial.2010
The impact of a simple individual psycho-education program on quality of life, rate of relapse and medication adherence in bipolar disorder patients.2013
Recovery-focused cognitive-behavioural therapy for recent-onset bipolar disorder: randomised controlled pilot trial.2015
Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder: randomised clinical trial.2013
Life Goals Collaborative Care for patients with bipolar disorder and cardiovascular disease risk.2012
Improving medical and psychiatric outcomes among individuals with bipolar disorder: a randomized controlled trial.2008
Relapse prevention in patients with bipolar disorder: cognitive therapy outcome after 2 years.2005
A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year.2003
Cognitive behaviour therapy and supportive therapy for bipolar disorders: relapse rates for treatment period and 2-year follow-up.2012
A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder.2003
Intensive psychosocial intervention enhances functioning in patients with bipolar depression: results from a 9-month randomized controlled trial.2007
Psychosocial treatments for bipolar depression: a 1-year randomized trial from the Systematic Treatment Enhancement Program.2007
Family-focused treatment of bipolar disorder: 1-year effects of a psychoeducational program in conjunction with pharmacotherapy.2000
Family treatment for bipolar disorder: family impairment by treatment interactions.2008
Does adjunctive family therapy enhance recovery from bipolar I mood episodes?2004
A randomized controlled trial of psychoeducation or cognitive-behavioral therapy in bipolar disorder: a Canadian Network for Mood and Anxiety treatments (CANMAT) study CME.2012
A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder.2013
Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment.1999
Family-focused treatment versus individual treatment for bipolar disorder: results of a randomized clinical trial.2003
A comparison of the life goals program and treatment as usual for individuals with bipolar disorder.2009
Cognitive-behavioural therapy for severe and recurrent bipolar disorders: randomised controlled trial.2006
Long-term effectiveness and cost of a systematic care program for bipolar disorder.2006
Randomized trial of a population-based care program for people with bipolar disorder.2005
Bipolar disorder and family communication: effects of a psychoeducational treatment program.1999
Beating Bipolar: exploratory trial of a novel Internet-based psychoeducational treatment for bipolar disorder.-- Not Found --
Preventing recurrence of bipolar I mood episodes and hospitalizations: family psychotherapy plus pharmacotherapy versus pharmacotherapy alone.2008
A web-based self-management intervention for Bipolar Disorder 'living with bipolar': a feasibility randomised controlled trial.2014
Collaborative care for patients with bipolar disorder: randomised controlled trial.2015
Collaborative care for patients with bipolar disorder: Effects on functioning and quality of life.2015
Group therapy for patients with bipolar disorder and substance dependence: results of a pilot study.2000
A "community-friendly" version of integrated group therapy for patients with bipolar disorder and substance dependence: a randomized controlled trial.2009
A randomized trial of integrated group therapy versus group drug counseling for patients with bipolar disorder and substance dependence.2007
Is cognitive-behavioural therapy more effective than psychoeducation in bipolar disorder?2008
Treating insomnia improves mood state, sleep, and functioning in bipolar disorder: a pilot randomized controlled trial.2015
Randomized, controlled trial of Interpersonal and Social Rhythm Therapy for young people with bipolar disorder.2015
Adjunctive psychosocial intervention following Hospital discharge for Patients with bipolar disorder and comorbid substance use: A pilot randomized controlled trial.2015
Patient-reported outcomes in meta-analyses-part 2: methods for improving interpretability for decision-makers.2013
Long-term safety and tolerability of asenapine: A double-blind, uncontrolled, long-term extension trial in adults with an acute manic or mixed episode associated with bipolar I disorder.2017
Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort.2016
Adverse Renal, Endocrine, Hepatic, and Metabolic Events during Maintenance Mood Stabilizer Treatment for Bipolar Disorder: A Population-Based Cohort Study.2016
Self-harm, Unintentional Injury, and Suicide in Bipolar Disorder During Maintenance Mood Stabilizer Treatment: A UK Population-Based Electronic Health Records Study.2016
Use of lithium and cancer risk in patients with bipolar disorder: population-based cohort study.2016
Suicide-related events in patients treated with antiepileptic drugs.2010
A population-based study of the comparative effectiveness of second-generation antipsychotics vs older antimanic agents in bipolar disorder.2016
Relationship between antiepileptic drugs and suicide attempts in patients with bipolar disorder.2009
Evaluation of the safety profile of Zolafren®, a generic olanzapine formulation, in patients with bipolar disorder: a post-authorization safety study.2015
Valproate is associated with new-onset oligoamenorrhea with hyperandrogenism in women with bipolar disorder.2006
Quality of life assessment in patients with bipolar disorder treated with olanzapine added to lithium or valproic acid.2004
Switch Rates During Acute Treatment for Bipolar II Depression With Lithium, Sertraline, or the Two Combined: A Randomized Double-Blind Comparison.2017
Safety and effectiveness of continuation antidepressant versus mood stabilizer monotherapy for relapse-prevention of bipolar II depression: A randomized, double-blind, parallel-group, prospective study.2015
Efficacy and safety of long-term fluoxetine versus lithium monotherapy of bipolar II disorder: a randomized, double-blind, placebo-substitution study.2010
Celecoxib adjunctive therapy for acute bipolar mania: a randomized, double-blind, placebo-controlled trial.2015
Topiramate and divalproex in combination with risperidone for acute mania: a randomized open-label study.2005
Efficacy of olanzapine combined with valproate or lithium in the treatment of dysphoric mania.2004
Olanzapine compared to lithium in mania: a double-blind randomized controlled trial.1999
Paliperidone extended-release as adjunctive therapy to lithium or valproate in the treatment of acute mania: a randomized, placebo-controlled study.2011
A randomized, placebo- and active-controlled study of paliperidone extended-release as maintenance treatment in patients with bipolar I disorder after an acute manic or mixed episode.2012
Evaluation of the efficacy and safety of paliperidone extended-release in the treatment of acute mania: a randomized, double-blind, dose-response study.2012
A randomized open comparison of long-acting injectable risperidone and treatment as usual for prevention of relapse, rehospitalization, and urgent care referral in community-treated patients with rapid cycling bipolar disorder.-- Not Found --
A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Divalproex Maintenance Study Group.2000
A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder.2003
A randomized, double-blind, placebo-controlled efficacy and safety study of quetiapine or lithium as monotherapy for mania in bipolar disorder.2005
Efficacy of valproate versus lithium in mania or mixed mania: a randomized, open 12-week trial.2010
A randomized, placebo-controlled, multicenter study of divalproex sodium extended release in the treatment of acute mania.2006
Ziprasidone plus a mood stabilizer in subjects with bipolar I disorder: a 6-month, randomized, placebo-controlled, double-blind trial.2010
A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder.2003
Efficacy and safety of low- and high-dose cariprazine in acute and mixed mania associated with bipolar I disorder: a double-blind, placebo-controlled study.2015
A randomized, 4-week double-blind placebo control study on the efficacy of donepezil augmentation of lithium for treatment of acute mania.2013
Adjunctive topiramate therapy in patients receiving a mood stabilizer for bipolar I disorder: a randomized, placebo-controlled trial.
Extended-release quetiapine as monotherapy for the treatment of adults with acute mania: a randomized, double-blind, 3-week trial.2011
The efficacy and tolerability of cariprazine in acute mania associated with bipolar I disorder: a phase II trial.2015
Allopurinol augmentation in the outpatient treatment of bipolar mania: a pilot study.2012
Lithium versus carbamazepine in the maintenance treatment of bipolar II disorder and bipolar disorder not otherwise specified.
The comparative prophylactic efficacy of lithium and carbamazepine in patients with bipolar I disorder.1999
Differential response to lithium and carbamazepine in the prophylaxis of bipolar disorder.1998
Lithium versus carbamazepine in the maintenance treatment of bipolar disorders--a randomised study.1997
Maintenance efficacy of divalproex in the prevention of bipolar depression.2003
Prophylactic efficacy of lithium versus carbamazepine in treatment-naive bipolar patients.2003
Olanzapine-divalproex combination versus divalproex monotherapy in the treatment of bipolar mixed episodes: a double-blind, placebo-controlled study.2009
Lamotrigine compared with lithium in mania: a double-blind randomized controlled trial.2000
In a double-blind, randomized and placebo-controlled trial, adjuvant allopurinol improved symptoms of mania in in-patients suffering from bipolar disorder.2014
Combination treatment with aripiprazole and valproic acid for acute mania: an 8-week, single-blind, randomized controlled trial.-- Not Found --
A placebo-controlled, double-blind study of the efficacy and safety of aripiprazole for the treatment of acute manic or mixed episodes in Asian patients with bipolar I disorder (the AMAZE study).2014
Efficacy and safety of olanzapine in the treatment of Japanese patients with bipolar I disorder in a current manic or mixed episode: a randomized, double-blind, placebo- and haloperidol-controlled study.2012
A randomized, double-blind, placebo-controlled 26-week trial of aripiprazole in recently manic patients with bipolar I disorder.2006
Lamotrigine as add-on treatment to lithium and divalproex: lessons learned from a double-blind, placebo-controlled trial in rapid-cycling bipolar disorder.2012
Risperidone in the treatment of acute mania: double-blind, placebo-controlled study.
Differential efficacy of lithium and carbamazepine in the prophylaxis of bipolar disorder: results of the MAP study.2000
Carbamazepine versus lithium in mania: a double-blind study.1987
Response and remission rates in Chinese patients with bipolar mania treated for 4 weeks with either quetiapine or lithium: a randomized and double-blind study.2008
A double-blind, randomized, placebo-controlled 4-week study on the efficacy and safety of the purinergic agents allopurinol and dipyridamole adjunctive to lithium in acute bipolar mania.2008
Efficacy of aripiprazole adjunctive to lithium or valproate in the long-term treatment of patients with bipolar I disorder with an inadequate response to lithium or valproate monotherapy: a multicenter, double-blind, randomized study.2011
Placebo-controlled study of quetiapine monotherapy in ambulatory bipolar spectrum disorder with moderate-to-severe hypomania or mild mania.2010
A 3-week, randomized, placebo-controlled trial of asenapine in the treatment of acute mania in bipolar mania and mixed states.2009
Asenapine in the treatment of acute mania in bipolar I disorder: a randomized, double-blind, placebo-controlled trial.2010
Lamotrigine in bipolar disorder: efficacy during pregnancy.
Lithium treatment moderate-dose use study (LiTMUS) for bipolar disorder: a randomized comparative effectiveness trial of optimized personalized treatment with and without lithium.2013
Olanzapine versus lithium in the acute treatment of bipolar mania: a double-blind, randomized, controlled trial.2008
Olanzapine versus risperidone in the treatment of manic or mixed States in bipolar I disorder: a randomized, double-blind trial.2006
Ziprasidone in acute bipolar mania: a 21-day randomized, double-blind, placebo-controlled replication trial.2005
Prophylactic efficacy of lithium carbonate in manic-depressive illness. Report of the Veterans Administration and National Institute of Mental Health collaborative study group.1973
Divalproex sodium versus olanzapine in the treatment of acute mania in bipolar disorder: health-related quality of life and medical cost outcomes.2003
Aripiprazole in the treatment of acute manic or mixed episodes in patients with bipolar I disorder: a 3-week placebo-controlled study.2006
Cariprazine in the treatment of acute mania in bipolar I disorder: a double-blind, placebo-controlled, phase III trial.2015
Effectiveness of adjunctive antidepressant treatment for bipolar depression.2007
Adjunctive oral ziprasidone in patients with acute mania treated with lithium or divalproex, part 1: results of a randomized, double-blind, placebo-controlled trial.2012
Risperidone compared with both lithium and haloperidol in mania: a double-blind randomized controlled trial.-- Not Found --
Olanzapine vs. lithium in management of acute mania.2010
Olanzapine versus haloperidol in the treatment of acute mania: clinical outcomes, health-related quality of life and work status.2002
Carbamazepine compared with lithium in the treatment of mania.1991
Acute and continuation risperidone monotherapy in bipolar mania: a 3-week placebo-controlled trial followed by a 9-week double-blind trial of risperidone and haloperidol.2005
Asenapine as adjunctive treatment for acute mania associated with bipolar disorder: results of a 12-week core study and 40-week extension.2012
Olanzapine versus divalproex in the treatment of acute mania.2002
Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine.2006
Efficacy of olanzapine in combination with valproate or lithium in the treatment of mania in patients partially nonresponsive to valproate or lithium monotherapy.2002
A 12-week, double-blind comparison of olanzapine vs haloperidol in the treatment of acute mania.2003
Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. The Olanzipine HGGW Study Group.2000
Carbamazepine and valproate monotherapy: feasibility, relative safety and efficacy, and therapeutic drug monitoring in manic disorder.2000
Effectiveness of aripiprazole v. haloperidol in acute bipolar mania: double-blind, randomised, comparative 12-week trial.
A double-blind, randomized, placebo-controlled prophylaxis trial of oxcarbazepine as adjunctive treatment to lithium in the long-term treatment of bipolar I and II disorder.2008
A double-blind, randomized, placebo-controlled, prophylaxis study of adjunctive gabapentin for bipolar disorder.2006
A randomized, double-blind, placebo-controlled trial to assess prevention of mood episodes with risperidone long-acting injectable in patients with bipolar I disorder.2012
Assessment of safety, tolerability and effectiveness of adjunctive aripiprazole to lithium/valproate in bipolar mania: a 46-week, open-label extension following a 6-week double-blind study.
Efficacy and safety of quetiapine in combination with lithium or divalproex for maintenance of patients with bipolar I disorder (international trial 126).2008
Efficacy of adjunctive aripiprazole to either valproate or lithium in bipolar mania patients partially nonresponsive to valproate/lithium monotherapy: a placebo-controlled study.2008
Allopurinol for mania: a randomized trial of allopurinol versus placebo as add-on treatment to mood stabilizers and/or antipsychotic agents in manic patients with bipolar disorder.2014
Continuation of quetiapine versus switching to placebo or lithium for maintenance treatment of bipolar I disorder (Trial 144: a randomized controlled study).2011
Aripiprazole plus divalproex for recently manic or mixed patients with bipolar I disorder: a 6-month, randomized, placebo-controlled, double-blind maintenance trial.2011
Olanzapine-valproate combination versus olanzapine or valproate monotherapy in the treatment of bipolar I mania: a randomized controlled study in a Chinese population group.
Mood stabilisers plus risperidone or placebo in the treatment of acute mania. International, double-blind, randomised controlled trial.2003
A double blind, randomized, placebo-controlled trial of quetiapine as an add-on therapy to lithium or divalproex for the treatment of bipolar mania.2007
Protein kinase C inhibition in the treatment of mania: a double-blind, placebo-controlled trial of tamoxifen.2008
Aripiprazole monotherapy in acute mania: 12-week randomised placebo- and haloperidol-controlled study.2009
Double-blind comparison of the continued use of antipsychotic treatment versus its discontinuation in remitted manic patients.2004
Adjunctive treatment with gabapentin in bipolar patients during acute mania.2012
Add-on memantine to valproate treatment increased HDL-C in bipolar II disorder.2013
Olanzapine or chlorpromazine plus lithium in first episode psychotic mania: An 8-week randomised controlled trial.2015
Asenapine: Efficacy and safety of 5 and 10mg bid in a 3-week, randomized, double-blind, placebo-controlled trial in adults with a manic or mixed episode associated with bipolar I disorder.2016
Bipolar CHOICE (Clinical Health Outcomes Initiative in Comparative Effectiveness): a pragmatic 6-month trial of lithium versus quetiapine for bipolar disorder.2016
Endoxifen, a New Treatment Option for Mania: A Double-Blind, Active-Controlled Trial Demonstrates the Antimanic Efficacy of Endoxifen.2016
Short-term venlafaxine v. lithium monotherapy for bipolar type II major depressive episodes: effectiveness and mood conversion rate.2016
Rapid versus non-rapid cycling bipolar II depression: response to venlafaxine and lithium and hypomanic risk.2016
Efficacy and Safety of Aripiprazole Once-Monthly in the Maintenance Treatment of Bipolar I Disorder: A Double-Blind, Placebo-Controlled, 52-Week Randomized Withdrawal Study.2017
Olanzapine versus divalproex versus placebo in the treatment of mild to moderate mania: a randomized, 12-week, double-blind study.2008
Venlafaxine versus lithium monotherapy of rapid and non-rapid cycling patients with bipolar II major depressive episode: a randomized, parallel group, open-label trial.2009
Characterizing relapse prevention in bipolar disorder with adjunctive ziprasidone: clinical and methodological implications.2013
Quetiapine versus placebo in combination with lithium or divalproex for the treatment of bipolar mania.2004
Risperidone long-acting injectable monotherapy in the maintenance treatment of bipolar I disorder.2010
Olanzapine plus carbamazepine v. carbamazepine alone in treating manic episodes.2008
Comparison of short-term venlafaxine versus lithium monotherapy for bipolar II major depressive episode: a randomized open-label study.2008
A randomized, placebo- and active-controlled study of paliperidone extended release for the treatment of acute manic and mixed episodes of bipolar I disorder.2010
A randomized, double-blind, placebo-controlled study of maintenance treatment with adjunctive risperidone long-acting therapy in patients with bipolar I disorder who relapse frequently.2009
Maintenance treatment for patients with bipolar I disorder: results from a north american study of quetiapine in combination with lithium or divalproex (trial 127).2009
Ziprasidone in the treatment of acute bipolar mania: a three-week, placebo-controlled, double-blind, randomized trial.2003
Olanzapine versus lithium in the maintenance treatment of bipolar disorder: a 12-month, randomized, double-blind, controlled clinical trial.2005
Quetiapine or haloperidol as monotherapy for bipolar mania--a 12-week, double-blind, randomised, parallel-group, placebo-controlled trial.2005
Topiramate monotherapy in the management of acute mania: results of four double-blind placebo-controlled trials.2006
A comparison of the efficacy, safety, and tolerability of divalproex sodium and olanzapine in the treatment of bipolar disorder.2002
Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomised open-label trial.2010
Extended-release carbamazepine capsules as monotherapy in bipolar disorder : pooled results from two randomised, double-blind, placebo-controlled trials.2006
Genotype variant associated with add-on memantine in bipolar II disorder.2014
Aripiprazole in combination with lamotrigine for the long-term treatment of patients with bipolar I disorder (manic or mixed): a randomized, multicenter, double-blind study (CN138-392).2012
Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE): a pragmatic trial of complex treatment for a complex disorder.2014

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