Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Comparative Efficacy of Typical and Atypical Anti Psychotics in the Treatment of Acute Mania


Affiliations
1 Department of Pharmacology, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem-636008, Tamil Nadu, India
     

   Subscribe/Renew Journal


Objective: The study assessed the efficacy of typical and atypical antipsychotics as combination therapy with mood stabilizers in the treatment of acute mania in a tertiary care hospital in Salem District of Tamil Nadu. Method: A retrospective observational study was carried out among 52 acute mania patients who received combination therapy with either atypical antipsychotics or typical antipsychotics with mood stabilizers. The primary efficacy measures were severity and improvement score with Clinical Global Impression scale (CGI) and Extrapyramidal side effects (EPS). Results: The study was conducted in 52 acute mania patients, in which 31 patients treated with atypical antipsychotics + mood stabilizers and 21 patients treated with typical antipsychotics + mood stabilizers. On analyzing the patients with the CGI-S scale, patients treated with atypical antipsychotics and mood stabilizers showed a significant reduction in the severity. Further, when analyzing with CGI-I Scale and EPS, it showed significant improvement in the clinical condition and less EPS in the patients treated with atypical antipsychotics with mood stabilizers. Conclusion: Atypical antipsychotics can be considered as the first choice for combination therapy with a mood stabilizer for the treatment of acute mania compared to typical antipsychotics due to their better efficacy, less extrapyramidal side-effects and shortens the duration of hospital stay.

Keywords

Mania, Antipsychotics, Mood Stabilizers, Extrapyramidal Side Effects.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Don. H. Hockenburg. Text Book of Discovering Psychology 5th Ed: Worth Publishers, 2011
  • Nuziba Begum R. Dipsomania. Asian J. Nur. Edu. and Research. 2011, 1(3): 98.
  • Rachana Rani and Sudeep Mishra. Synthesis of Diaryl Heptanoid Based Ketene Dithioacetals as Novel Antileishmanial Agents. Asian J. Research Chem. 2011, 4(7): 1188-1193.
  • Nitin S Chapekar, Sunil R Bavaskar and Fahim J Sayyad. Bipolar Disorder and Role of Lithium in Its Management: An Overview. Research J. Pharmacology and Pharmacodynamics. 2010, 2(2): 111-116.
  • Shanthakumar J, Tamilselvan T, Arunagiri P, Rajeshwaran K and Balamurugan E. Role of caffeine intake in lithium-treated methylphenidate-induced oxidative stress in an animal model of mania. Asian J. Pharm. Res. 2013, 3(4): 166-171.
  • Roger Walker and Cate Whittlesea. Text Book of Clinical Pharmacy and Therapeutics 5th Ed.: Psychiatric Disorders: Churchill Livingstone. 2012.465-467.
  • Michael W and Adamowicz LICSW. Introduction to Bipolar Disorder and Mood Disorder. Journal of Mental Health.2009, 7: 31-33.
  • Martin Letmaier and Seigfried Kasper. Typical Neuroleptics Vs Atypical Antipsychotics in the Treatment of Acute Mania in Natural setting. International Journal of Neuropsychopharmacol. 2006, 9: 529-537.
  • World Health Organisation.ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. 1992
  • Joan Busner and Steven D Targum. CGI –Guidelines: The Clinical Global Impression Scale. Psychiatry. Edgmont, 2007, 4(7): 28-37.
  • Menaka K, Sarumathy S and Sivakumar T. Study on the adverse reactions of antipsychotics and therapeutic drug monitoring of olanzapine in psychiatric patients. Research J. Pharm. and Tech. 2016, 9(6): 687-690.
  • Sayali Devidas Dambhe and Muniyandi S. Effectiveness of Planned Teaching about Knowledge Regarding side Effects of Typical Antipsychotics among the Primary care givers of Psychiatric Patient in selected Hospital. Asian J. Nursing Education and Research. 2018, 8(1): 81-93.
  • Kussum Sharma and Monika Rangi. A Novel Ion-Selective Electrode Based on Methyl-2-Pyridylketone-Thiosemicarbazide for Potentiometric Determination of Ca (II) Ions. Asian J. Research Chem. 2011; 4(8): 1269-1271.
  • Licht RW. Drug treatment of mania: acritical review.ActaPsychiatricaScandinavica.1998:387–397.
  • Shinkar DM, Pandya DB and Saudagar RB. Kleptomania: An overview. Asian J. Pharm. Tech. 2016; 6(2): 127-130.
  • American Psychiatric Association. Practice guidelines for the treatment of patients with bipolar disorder. American Journal of Psychiatry;151 Suppl 12: 1–36.
  • Sanjib Das, Das RC, Bhosale SH and Ashish A Gawai. Synthesis and Pharmacological Evaluation of Atypical Antipsychotic Activity of New Coumarinoacetamides. Asian J. Research Chem. 2010; 3(1): 166-171.
  • Gawai Ashish, Das Sanjib, Nemade M and Wathore S. Synthesis of New 7-(3-(benzo[d]thiazol-2-ylamino) propoxy)-4-methyl-2H-chromen-2-one derivatives with Atypical Antipsychotic activity. Asian J. Research Chem. 2011; 4(4): 591-596.
  • Grunze H, Kasper S, Goodwin G, Bowden C, Baldwin D, Licht R, Vieta E and Moller HJ. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders Part II: Treatment of Mania. World Journal of Biological Psychiatry 2003; 4:5–13.
  • Kasper S, Haushofer M, Zapotoczky HG, Aschauer H, Wolf R, Hinterhuber H, Bonelli M and Wuschitz A. Consensus statement: diagnosis and therapy of bipolar disorders. Neuropsychiatrie 2000; 13Suppl 3: 100–108.
  • Sachs GS, Printz DJ and Carpenter D. The Expert Consensus Guideline Series: Medication treatment of bipolar disorder. Postgraduate Medicine (Special Issue) 2000; 4:1–104.
  • Miller DS, Yatham LN and Lam RW. Comparative efficacy of typical and atypical antipsychotics as add-on therapy to mood stabilizers in the treatment of acute mania. Journal of Clinical Psychiatry. 2001; 62: 975–980.
  • Mukherjee S, Rosen AM, Caracci G and Shukla S. Persistent tardive dyskinesia in bipolar patients. Archives of General Psychiatry 1986;Suppl 4: 342–346.
  • Nasrallah HA, Churchill CM, Hamdan-Allan GA. Higher frequency of neuroleptic-induced dystonia in mania than in schizophrenia. American Journal of Psychiatry. 1988 Suppl 11: 1455–1456.

Abstract Views: 158

PDF Views: 0




  • Comparative Efficacy of Typical and Atypical Anti Psychotics in the Treatment of Acute Mania

Abstract Views: 158  |  PDF Views: 0

Authors

Arul Balasubramanian
Department of Pharmacology, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem-636008, Tamil Nadu, India
Kothai Ramalingam
Department of Pharmacology, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem-636008, Tamil Nadu, India
Rahul Radhakrishanan
Department of Pharmacology, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem-636008, Tamil Nadu, India
Rini John
Department of Pharmacology, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem-636008, Tamil Nadu, India
Y. Nadeem Arafath
Department of Pharmacology, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation (Deemed to be University), Salem-636008, Tamil Nadu, India

Abstract


Objective: The study assessed the efficacy of typical and atypical antipsychotics as combination therapy with mood stabilizers in the treatment of acute mania in a tertiary care hospital in Salem District of Tamil Nadu. Method: A retrospective observational study was carried out among 52 acute mania patients who received combination therapy with either atypical antipsychotics or typical antipsychotics with mood stabilizers. The primary efficacy measures were severity and improvement score with Clinical Global Impression scale (CGI) and Extrapyramidal side effects (EPS). Results: The study was conducted in 52 acute mania patients, in which 31 patients treated with atypical antipsychotics + mood stabilizers and 21 patients treated with typical antipsychotics + mood stabilizers. On analyzing the patients with the CGI-S scale, patients treated with atypical antipsychotics and mood stabilizers showed a significant reduction in the severity. Further, when analyzing with CGI-I Scale and EPS, it showed significant improvement in the clinical condition and less EPS in the patients treated with atypical antipsychotics with mood stabilizers. Conclusion: Atypical antipsychotics can be considered as the first choice for combination therapy with a mood stabilizer for the treatment of acute mania compared to typical antipsychotics due to their better efficacy, less extrapyramidal side-effects and shortens the duration of hospital stay.

Keywords


Mania, Antipsychotics, Mood Stabilizers, Extrapyramidal Side Effects.

References