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Patient Insight Affects the Efficacy of Antipsychotics in Acute Mania

Patient Insight Affects the Efficacy of Antipsychotics in Acute Mania

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Bipolar disorder patients who have acute manic episodes often lack insight into their condition. These authors examined whether insight at the start of treatment affects the efficacy of antipsychotic treatment in patients with acute mania, using individual patient data from 7 randomized, double-blind, placebo-controlled registration studies of 4 antipsychotic agents in 1,904 patients with acute mania.

The authors measured insight using an 11-item rating scale at baseline and 3 weeks later. Treatment outcome was defined by mean change in score; response, which was defined as 50% or more improvement on the rating scale; and remission defined by a low rating score at study endpoint.

At initiation of treatment, nearly two-thirds (63.5%) of the patients had impaired or no insight into their condition. Their level of insight significantly modified the efficacy of treatment, with greater improvement in patients with more impaired insight.

The authors recommend that patients experiencing acute mania should be treated immediately and not be delayed until patients regain insight.

RESULT: Does Insight Affect the Efficacy of Antipsychotics in Acute Mania?: An Individual Patient Data Regression Meta-Analysis Journal of Clinical Psychopharmacology | Feb 1, 2016 (Free abstract. Full text $53.35)



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