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Review: Antipsychotic plus mood stabiliser co-therapy is more effective than mood stabiliser mono-therapy at reducing acute bipolar mania

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 Q How effective is co-therapy (an antipsychotic plus a mood stabiliser) compared with monotherapy (mood stabiliser alone) for people with bipolar mania?

METHOD

Embedded ImageDesign:

Systematic review with meta-analysis.

Embedded ImageData sources:

MEDLINE, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials (searched March 2006).

Embedded ImageStudy selection and analysis:

Included studies were randomised controlled trials (RCTs) comparing co-therapy (an antipsychotic plus a mood stabiliser) versus monotherapy (mood-stabiliser alone) or another co-therapy for acute bipolar mania. Drugs had to be licensed in the UK or US for treatment of bipolar disorder (valproate semisodium, lithium, carbamazepine, lamotrigine, aripiprazole, olanzapine, risperidone, ziprasidone, quetiapine, haloperidol, chlorpromazine, flupentixol, fluphenazine, perphenazine, prochlorperazine and zuclopenthixol). Studies of mixed diagnostic groups were included if randomisation was stratified by bipolar type and data for people with bipolar disorder could be obtained. Meta-analyses were performed using the Mantel–Haenszel method for binary outcomes, and the …

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