Unlike in the treatment of acute bipolar depression, where the evidence is less straightforward,5,6 there is good evidence in favour of the use of antipsychotics for the treatment of acute mania.1-4
References:
1. NICE. Treatment summaries, Mania and hypomania. Available at: https://bnf.nice.org.uk/treatment-summaries/mania-and-hypomania. Accessed Apr 2024.
2. Nierenberg AA, Agustini B, Köhler-Forsberg O, et al. Diagnosis and treatment of bipolar disorder: a review. JAMA 2023; 330 (14): 1370–1380.
3. Kishi T, Ikuta T, Matsuda Y, et al. Pharmacological treatment for bipolar mania: a systematic review and network meta-analysis of double-blind randomized controlled trials. Mol Psychiatry 2022; 27 (2): 1136–1144.
4. Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord 2018; 20 (2): 97–170.
5. Bahji A, Ermacora D, Stephenson C, et al. Comparative efficacy and tolerability of adjunctive pharmacotherapies for acute bipolar depression: a systematic review and network meta-analysis. Can J Psychiatry 2021; 66 (3): 274–288.
6. Yildiz A, Siafis S, Mavridis D, et al. Comparative efficacy and tolerability of pharmacological interventions for acute bipolar depression in adults: a systematic review and network meta-analysis. Lancet Psychiatry 2023; 10 (9): 693–705.