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Second Generation Antipsychotics Monotherapy as Maintenance Treatment for Bipolar Disorder: a Systematic Review of Long-Term Studies

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Abstract

Atypical or so called second generation antipsychotics (SGA) are playing a role of increasing importance in treatment of bipolar disorder (BD). This study is aimed towards a systematic review of their efficacy when used as monotherapy in order to prevent relapses in the long term treatment. Publications about this subject were identified after a thorough bibliographic research in Medline, The Cochrane Library and Web of Science, employing the PICO method for the creation of a database search strategy and carrying out a critical read and analysis of the found evidence. 14 studies were found which informed about the results of randomized and controlled clinical trials (RCT) about the efficacy of these SGA in monotherapy for BD, when it comes to prevention of relapse, in adult patients diagnosed with either type I or II BD, with a minimum follow-up time of 6 months. Evidence of the use of SGAs for maintenance treatment in BD is limited. Amongst all antipsychotics assessed only aripiprazole, olanzapine, lurasidone, risperidone and quetiapine have been found to be competent for their use in monotherapy, according to RCT.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Bipolar Disorders Unit, Psychiatry Service, Hospital General Universitario de Elche, Elche, Spain

    Miguel Alfonso García Escudero

  2. Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, Granada, Spain

    Luis Gutiérrez-Rojas

  3. Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain

    Luis Gutiérrez-Rojas

  4. Department of Psychiatry, School of Medicine, tower A, floor 9, E-18071, Granada, Spain

    Luis Gutiérrez-Rojas

  5. Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain

    Guillermo Lahera

  6. Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain

    Guillermo Lahera

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  1. Miguel Alfonso García Escudero
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  2. Luis Gutiérrez-Rojas
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  3. Guillermo Lahera
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Correspondence to Luis Gutiérrez-Rojas.

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Conflict of Interest

MAGE has been a consultant to or has received honoraria from Janssen-Cilag Otsuka-Lundbeck, Lilly, Astra-Zeneca, Sanofi and Servier. LGR has been a consultant to or has received honoraria or grants from Janssen-Cilag, Lundbeck, Otsuka, Exeltis and Pfizer. GL has been a consultant to or has received honoraria or grants from Janssen-Cilag, Otsuka-Lundbeck, Lilly, Astra-Zeneca, CIBERSAM and Instituto de Salud Carlos III.

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Escudero, M.A.G., Gutiérrez-Rojas, L. & Lahera, G. Second Generation Antipsychotics Monotherapy as Maintenance Treatment for Bipolar Disorder: a Systematic Review of Long-Term Studies. Psychiatr Q 91, 1047–1060 (2020). https://doi.org/10.1007/s11126-020-09753-2

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