Antipsychotika druhé generace v lécbé mánie

The first generation antipsychotics are effective in the treatment of manic symptoms, agitation and aggression in acute mania. Most of the second generation antipsychotic drugs have been found to be effective in clinical controlled trials as monotherapy in bipolar mania or as an add-on treatment with mood stabilizers. A small number of patients treated with risperidone, olanzapine, quetiapine or ziprasidone experience an induction of hypomania or mania. It is not apparent if this is a true drug-induced event or accidental one. The second generation antipsychotic drugs possess a number of advantages, including significantly less extrapyramidal symptoms, diminished risk of tardive dyskinesia, lack of increase in serum prolactin levels (with the exception of risperidone), and improvement in cognition. Data indicate that second generation antipsychotics can serve as adjunctive as well as alternative agents in the treatment of drug-resistant manic states. Although there are differences in the side effect profiles of the various second generation antipsychotics, their use is limited by adverse effects such as extrapyramidal symptoms, weight gain, and sexual dysfunction.