Efficacy, acceptability, and related outcomes of pharmacological interventions for acute bipolar mania: a systematic review and dose-related network meta-analysis across different age groups.
J Affect DisordJul 29, 2026 (epub)
Clinical ResearchPsychiatry
Michele Fornaro, Chiara Di Lorenzo, Taro Kishi et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated the efficacy and acceptability of pharmacological interventions for acute bipolar mania across various age groups, analyzing 113 randomized controlled trials with 20,666 participants. Risperidone 3 mg/day showed the highest efficacy with a standardized mean difference (SMD) of -7.57, indicating significant improvement in manic symptoms compared to placebo.
Key findings
- Risperidone 3 mg/day had the highest efficacy with an SMD of -7.57.
- Tamoxifen 160 mg/day showed an SMD of -1.73, indicating significant symptom reduction.
- No significant differences were found between treatments and placebo for response or acceptability.
- Larger SMDs correlated with lower study quality, suggesting caution in interpreting efficacy.
Why it matters
Understanding the comparative efficacy of treatments for acute bipolar mania is crucial for clinicians to make informed decisions about pharmacological interventions, especially given the varying responses across different age groups.