Bipolar Disorder

The newer atypical antipsychotic drugs such as risperidone, quetiapine, and olanzapine are often used in acutely manic patients, because these medications have a rapid onset of psychomotor inhibition, which may be lifesaving in the case of a violent or psychotic patient. Parenteral and orally disintegrating (in particular, Zydis wafers) forms are favoured in emergency room settings. These drugs can also be used as adjunctives to lithium or anticonvulsants in refractory bipolar disorder and in prevention of mania recurrence.

In light of recent evidence, olanzapine (Zyprexa) has been FDA approved as an effective monotherapy for the maintenance of bipolar disorder. A head-to-head randomized control trial in 2005 has also shown olanzapine monotherapy to be just as effective and safe as lithium in prophylaxis. Eli Lilly and Company also offers Symbyax, a combination of olanzapine and fluoxetine.

Ziprasidone (Geodon) and aripriprazole (Abilify) also show promise according to Gary Sachs M.D. of Harvard’s Massachusetts General Hospital Bipolar Clinic and Research Program.