Bipolar Disorders: Mixed States, Rapid-Cycling, and Atypical Forms

366 R. W. Baker et al.defined by baseline diagnosis confirmed by Structured Clinical Interview forDiagnostic and Statistical Manual IV using Diagnostic and Statistical Manual ofMental Disorders, 4th edn (DSM-IV): American Psychiatric Association (1994)criteria. These data are not available for two of the trials (Berk et al., 1999; Zajeckaet al., 2002). The principal intent of these analyses was to seek an interaction betweendiagnostic subgroup and clinical outcome, that is, is efficacy better among psychoticpatients, thereby suggesting that antimanic effects derive from antipsychotic properties?The answer appears to be no.REFERENCESAmerican Psychiatric Association (1994). Diagnostic and Statistical Manual of MentalDisorders, 4th edn (DSM-IV). Washington, DC: American Psychiatric Association.American Psychiatric Association (2002). Practice guideline for the treatment of patients withbipolar disorder (revision). Am. J. Psychiatry, 159 (suppl. 4), 1–50.Baldessarini, R. J. (2002). Treatment research in bipolar disorder: issues and recommendations.CNS Drugs., 16, 721–9.Berk, M., Ichim, L., and Brook, S. (1999). Olanzapine compared to lithium in mania:a double–blind randomized controlled trial. Int. Clin. Psychopharmacol., 14, 339–43.Brotman, M. A., Post, R. M., Fergus, E. L., and Leverich, G. S. (2000). High exposure to neurolepticsin bipolar patients: a retrospective review. J. Clin. Psychiatry, 61, 68–72.Calabrese, J. R., Kimmel, S. E., Woyshville, M. J., et al. (1996). Clozapine for treatmentrefractorymania. Am. J. Psychiatry, 153, 759–64.DelBello, M. P., Schwiers, M. L., Rosenberg, H. L., et al. (2002). A double-blind, randomized,placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. J. Am.Acad. Child Adolesc. Psychiatry, 41, 1216–23.Garfinkel, P. E., Stancer, H. C., and Persad, E. (1980). A comparison of haloperidol, lithiumcarbonate and their combination in the treatment of mania. J. Affect. Disord., 2, 279–88.Glazer, W. (2000a). Review of incidence studies of tardive dyskinesia associated with typicalantipsychotics. J. Clin. Psychiatry, 61, 15–20.Glazer, W. (2000b). Extrapyramidal side effects, tardive dyskinesia, and the concept of atypicality.J. Clin. Psychiatry, 61, 16–21.Glazer, W. M. (2000c). Expected incidence of tardive dyskinesia associated with atypical antipsychotics.J. Clin. Psychiatry, 61, 21–6.Goodwin, F. K. and Jamison, K. R. (1990). Manic–Depressive Illness. New York, NY: OxfordUniversity Press.Green, A. I., Tohen, M., Patel, J. K., et al. (2000). Clozapine in the treatment of refractorypsychotic mania. Am. J. Psychiatry, 157, 982–6.Hirschfeld, R., Keck, P. E., Karcher, K., Kramer, M., and Grossman, F. (2004). Rapid antimaniceffect of risperidone monotherapy: a 3-week multicenter, double-blind, placebo-controlledtrial. Am. J. Psychiatry, 161, 1057–65.