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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?


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Systematic review with meta-analysis.

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

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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 …

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  • For correspondence: Dr David Taylor, Pharmacy Department, Maudsley Hospital, South London and Maudsley NHS Trust, London, SE5 8AZ, UK; david.taylor{at}

  • Source of funding: Sanofi Aventis.


  • Competing interests: None declared.