Atypical Antipsychotics: Efficacy Across Bipolar Disorder Subpopulations

Atypical antipsychotic medications, used as monotherapy or as adjunctive therapy with mood stabilizers,have shown efficacy and tolerability for 4 subpopulations of patients with bipolar disorder:patients with mixed mania, patients with psychotic episodes, children and adolescents, and the elderly.Patients experiencing mixed mania generally respond poorly to lithium therapy and are moredifficult to treat than patients with pure mania. Atypical antipsychotics are increasingly being consideredfor this bipolar subpopulation because of their efficacy as antimanic agents, and because they areless likely to cause as many or as severe adverse events as conventional antipsychotics. Atypical antipsychoticshave also demonstrated beneficial effects as monotherapy and adjunctive therapy for bipolarI disorder patients experiencing psychotic states. In addition, they have shown effectiveness andtolerability in small-scale and open-label trials and case studies with pediatric and geriatric bipolarpatients.