Antipsychotic Drugs
Key points
- Antipsychotic drugs were some of the first drugs used to treat acute mania, and numerous studies have shown their effectiveness.
- Although the onset of action of antipsychotic drugs is often more rapid than that of lithium, carbamazepine, and valproic acid, there are serious potential side effects that limit their use.
- The most serious side effect is the potential for development of tardive dyskinesia.
- Tardive dyskinesia may occur more frequently in patients with mood disorders than in those with schizophrenia, and in patients with intermittent exposure than in those with continuous exposure, placing patients with bipolar disorder at higher risk.
Antidepressant and Antimanic Medications: Antipsychotic Drugs
Antipsychotic drugs were some of the first drugs used to treat acute mania, and numerous studies have shown their effectiveness. Although the onset of action of antipsychotic drugs is often more rapid than that of lithium, carbamazepine, and valproic acid, there are serious potential side effects that limit their use.
The most serious side effect is the potential for development of tardive dyskinesia. Tardive dyskinesia may occur more frequently in patients with mood disorders than in those with schizophrenia, and in patients with intermittent exposure than in those with continuous exposure, placing patients with bipolar disorder at higher risk. Because of this higher risk and the availability of safer and better-tolerated drugs, antipsychotic medications should only be used in manic patients for the management of acute agitation, excitement, or psychosis or in those few patients who clearly relapse on gradual discontinuation of antipsychotics.
Studies suggest that the atypical antipsychotic drug clozapine may be effective in the treatment of dysphoric mania. In one study of 14 bipolar patients with psychotic features, 12 (86%) showed significant improvement, and 7 of these patients were observed for an additional 3-5 years with no further hospitalizations. Because of the risk of potentially fatal agranulocytosis, clozapine should not be used unless other first-line agents or traditional antipsychotic drugs have failed.
Antidepressant and Antimanic Medications Introduction Diagnostic Indications and Contraindications
Written and revised by
David Cohen, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.
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