SynthesisEuropean archives of psychiatry and clinical neuroscience2012
Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry.
Synthesis in European archives of psychiatry and clinical neuroscience, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 132 citations in OpenAlex.
- The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder.The international journal of neuropsychopharmacology · 2020Pooled it
- Prevalence and treatment of panic disorder in bipolar disorder: systematic review and meta-analysis.Evidence-based mental health · 2018Pooled it
- Valproate for schizophrenia.The Cochrane database of systematic reviews · 2016Pooled it
- The Pharmacogenomics of Bipolar Disorder study (PGBD): identification of genes for lithium response in a prospective sample.BMC psychiatry · 2016Trial
- Trial
- P2RX7 Dynamics in CNS Disorders: Molecular Insights and Therapeutic Perspectives.Molecular neurobiology · 2025Review
- Perceived cognitive loss, symptomology, and psychological well-being with bipolar disorder.International journal of bipolar disorders · 2024Article
- KIOS: A smartphone app for self-monitoring for patients with bipolar disorder.Bipolar disorders · 2024Article
- The Purinergic System as a Target for the Development of Treatments for Bipolar Disorder.CNS drugs · 2022Review
- Pilot Testing in the Wild: Feasibility, Acceptability, Usage Patterns, and Efficacy of an Integrated Web and Smartphone Platform for Bipolar II Disorder.JMIR formative research · 2022Article
- Lithium bidirectionally regulates depression- and mania-related brain functional alterations without worsening cognitive function in patients with bipolar disorder.Frontiers in psychiatry · 2022Article
- Combined Use of Web-Based and In-Person Education on Ill Health Self-management Skills in Adults With Bipolar Disorder: Protocol for a Mixed Methods Study.JMIR research protocols · 2021Article
- Development of an Emotion-Sensitive mHealth Approach for Mood-State Recognition in Bipolar Disorder.JMIR mental health · 2020Article
- Immunophenotypes associated with bipolar disorder and lithium treatment.Scientific reports · 2019Article
- Lithium and GADL1 regulate glycogen synthase kinase-3 activity to modulate KCTD12 expression.Scientific reports · 2019Article
- Effects of GADL1 overexpression on cell migration and the associated morphological changes.Scientific reports · 2019Article
- Pharmacological treatment of adult bipolar disorder.Molecular psychiatry · 2019Review
- A History of the Pharmacological Treatment of Bipolar Disorder.International journal of molecular sciences · 2018Review
- Ebselen has lithium-like effects on central 5-HTBritish journal of pharmacology · 2018Article
- The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 10 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The current statement is a systematic review of the available data concerning the efficacy of medication treatment of bipolar disorder (BP). A systematic MEDLINE search was made concerning the treatment of BP (RCTs) with the names of treatment options as keywords. The search was updated on 10 March 2012. The literature suggests that lithium, first and second generation antipsychotics and valproate and carbamazepine are efficacious in the treatment of acute mania. Quetiapine and the olanzapine-fluoxetine combination are also efficacious for treating bipolar depression. Antidepressants should only be used in combination with an antimanic agent, because they can induce switching to mania/hypomania/mixed states/rapid cycling when utilized as monotherapy. Lithium, olanzapine, quetiapine and aripiprazole are efficacious during the maintenance phase. Lamotrigine is efficacious in the prevention of depression, and it remains to be clarified whether it is also efficacious for mania. There is some evidence on the efficacy of psychosocial interventions as an adjunctive treatment to medication. Electroconvulsive therapy is an option for refractory patients. In acute manic patients who are partial responders to lithium/valproate/carbamazepine, adding an antipsychotic is a reasonable choice. The combination with best data in acute bipolar depression is lithium plus lamotrigine. Patients stabilized on combination treatment might do worse if shifted to monotherapy during maintenance, and patients could benefit with add-on treatment with olanzapine, valproate, an antidepressant, or lamotrigine, depending on the index acute phase. A variety of treatment options for BP are available today, but still unmet needs are huge. Combination therapy may improve the treatment outcome but it also carries more side-effect burden. Further research is necessary as well as the development of better guidelines and algorithms for the step-by-step rational treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.