In the intent-to-treat population, 295 patients has a DSM-IV-TR mixed episode
(placebo: 66; olanzapine: 122; asenapine: 107) in the 3-weeks trials.
However, differential diagnosis becomes much more challenging when evaluating the possibility of rapid-cycling bipolar disorder or a mixed episode
Bipolar I Disorder is characterised by the occurrence of one or more Manic Episodes or Mixed Episodes
The Food and Drug Administration has approved risperidone for the treatment of schizophrenia in adolescents aged 13-17 years and for the short-term treatment of bipolar mania associated with manic or mixed episodes
of bipolar I disorder in children and adolescents aged 10-17 years, after years of off-label use by many physicians.
In the bipolar I form, the individual experiences one or more manic episodes, or mixed episodes
and possibly one or more major depressive episodes.
ABILIFY was approved as an adjunct to lithium or valproate for the acute treatment of manic or mixed episodes
associated with Bipolar I Disorder in May 2008.
was approved in May 2008 as an adjunct to lithium or valproate for the acute treatment of manic and mixed episodes
associated with bipolar I disorder.
An atypical antipsychotic for treating acute manic or mixed episodes
associated with bipolar disorder, with or without psychotic features; the third atypical antipsychotic approved for a bipolar indication.
The study involved 238 bipolar I patients aged 6-17 years with a manic or mixed episode
who were randomized 2:1 to ziprasidone (Geodon) at 60-160 mg/day or placebo at 36 US.
Patients who switched were significantly older at bipolar disorder onset; presented less often with a mixed episode
at baseline; and had more depressive episodes, hospital admissions, and suicide attempts in the previous 12 months.
Primary outcomes were recurrence and number of clinical events (for example, a mixed episode
or major depressive episode) assessed by an independent board.
Patients were eligible if they had moderate to severe bipolar I disorder with depression as measured by a baseline MADRS (Montgomery-Asberg Depression Rating Scale) rating greater than or equal to 20 and one previous manic or mixed episode
serious enough to warrant treatment with a mood stabilizer or antipsychotic.
McIntyre observed that one mixed episode
is likely to be followed by others, and that the risk of depression is also heightened.
The data provide strong support for aripipra-zole (Abilify) as a safe and effective long-term mood-stabilizing agent in patients with a recent manic or mixed episode
, said Dr.
VRAYLAR is an oral, once daily atypical antipsychotic approved for the acute treatment of adult patients with manic or mixed episodes
associated with bipolar I disorder, with a recommended dose range of 3 to 6 mg/day and for the treatment of schizophrenia in adults, with a recommended dose range of 1.