
ABSTRACT Bipolar disorder (BD) is a chronic and debilitating mental health condition characterized by recurrent episodes of mania, hypomania, and depression. The management of BD often requires long-term pharmacological intervention, with atypical antipsychotics (AAPs) playing a central role in both acute and maintenance treatment. While older AAPs, such as olanzapine and risperidone, have been widely used for decades, newer AAPs, including lurasidone, cariprazine, and asenapine, have emerged with claims of improved efficacy and tolerability. This systematic review aims to compare the efficacy, safety, and tolerability of newer AAPs versus older AAPs in treating bipolar disorder, with a focus on acute episodes (mania, depression, and mixed states) and long-term maintenance therapy. A comprehensive search of PubMed, Cochrane Library, and Embase was conducted for studies published between 2000 and 2023. Thirty-five studies meeting the inclusion criteria were analyzed, focusing on efficacy in managing manic, depressive, and mixed episodes, as well as long-term maintenance outcomes. Results indicate that newer AAPs, particularly lurasidone and cariprazine, demonstrate superior efficacy in treating bipolar depression, with fewer metabolic side effects compared to older AAPs. However, older AAPs like olanzapine remain highly effective for acute mania. This review highlights the need for personalized treatment approaches based on symptom profiles, side effect considerations, and patient-specific factors. Keywords: Bipolar disorder, atypical antipsychotics, lurasidone, cariprazine, olanzapine, risperidone, efficacy, safety, tolerability, metabolic side effects.
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 0 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Average |
