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Review: risperidone, olanzapine and haloperidol are the most effective drugs for acute mania in adults with bipolar I disorder

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What is the efficacy and acceptability of antimanic pharmacotherapy for acute mania?


Primary outcomes: change in manic symptoms (mean change on the Young Mania Rating Scale, YMRS); drop-out rates during the first 3 weeks of treatment.



Systematic review and meta analysis.

Data sources

Medline, Embase, Cumulative Index to Nursing and Allied Health (CINAHL), PsycInfo, the Cochrane Central Register of Controlled Trials and main regulatory agency databases were searched for publications between 1980 and November 2010. Study authors and main manufacturers were contacted to identify unpublished studies and additional data on published studies.

Study selection and analysis

All randomised, double-blind trials comparing an antimanic oral drug with another antimanic drug or placebo in people with acute mania. Participants had to be above the age of 18 years, with a primary diagnosis of bipolar I disorder (manic or mixed episode), defined using standardised criteria. Trials utilising either fixed or flexible doses were included. Only trials with data on both primary outcomes were included in the multiple-treatments meta analysis. STATA 10.0 was used to conduct pair-wise meta analysis …

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  • Sources of funding None.


  • Competing interests None.

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