Dr Dunner has received grant support from Eli Lilly & Co., Pfizer, GlaxoSmithKline, Wyeth, Cyberonics, Merck, Janssen; consultant/scientific advisory boards for Eli Lilly & Co., Pfizer, GlaxoSmithKline, Wyeth, Bristol-Meyers Squibb, Cypress, Corcept, Janssen, Novartis, Shire, Somerset, Otsuka; and serves on the speakers bureau for Eli Lilly & Co., Pfizer, GlaxoSmithKline, Wyeth, Bristol-Meters Squibb, Organon, Forest.
Safety and tolerability of emerging pharmacological treatments for bipolar disorder
Version of Record online: 15 JUL 2005
Volume 7, Issue 4, pages 307–325, August 2005
How to Cite
Dunner, D. L. (2005), Safety and tolerability of emerging pharmacological treatments for bipolar disorder. Bipolar Disorders, 7: 307–325. doi: 10.1111/j.1399-5618.2005.00235.x
- Issue online: 15 JUL 2005
- Version of Record online: 15 JUL 2005
- Received 4 August 2004, revised and accepted for publication 25 April 2005
- atypical antipsychotics;
- bipolar disorder;
- side effects;
Objectives: Over the past few years numerous new agents have been examined for their efficacy in bipolar disorder (BPD). New antiepileptic agents and atypical antipsychotics currently form the bulk of these emerging agents. As the armamentarium for treating BPD increases, it allows for the possibility of choosing drugs on the basis of their tolerability as well as their efficacy, rather than on efficacy alone.
Methods: Efficacy data for newer antiepileptic drugs (lamotrigine, topiramate, gabapentin, oxcarbazepine) and atypical antipsychotics (olanzapine, clozapine, risperidone, quetiapine, ziprasidone, aripiprazole) are briefly reviewed. The article focuses on relative safety and tolerability of these agents.
Results: In general, most of these newer agents have better side effect and tolerability profiles than older agents commonly used to treat BPD (lithium, valproate, carbamazepine); however, these must be weighed against efficacy demonstrated to date in randomized, controlled trials. Cognitive impairment is a concern with topiramate, weight gain and risk of diabetes with some of the atypical antipsychotic agents, and rash with lamotrigine.
Conclusions: Side effects of newer emerging agents for the treatment of BPD can be effectively managed and the risks reduced by instituting practical strategies early in management.