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Antipsychotic Drug Side Effect Issues in Bipolar Manic Patients

Carlos A. Zarate, Jr., MD

Published: May 30, 2000

Article Abstract

While the efficacy of antipsychotics as a maintenance treatment for bipolar patients has not beensystematically studied, these drugs are commonly used in the long-term treatment of bipolar patients,and it is not unusual for a bipolar patient to be taking 3 to 4 medications, including antipsychotics.Conventional antipsychotics may be comparable to lithium for acute mania, but have limitations whenused in the long-term treatment of bipolar disorder. Their adverse effects, which include extrapyramidalside effects, tardive dyskinesia, weight gain, sedation, and sexual dysfunction, often lead to noncompliance;their use may have a negative impact on the overall course of illness; and they may not beas effective as lithium in treating the core manic symptoms over the long term. Atypical antipsychoticsmay prove useful for bipolar patients who require antipsychotic treatment because of their favorableside effect profile, thymoleptic properties, and positive effect on overall functioning.

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