Risperidone in long-term treatment for bipolar disorder.

BACKGROUND: Risperidone, an atypical antipsychotic, is used to treat acute manic episodes, particularly when psychotic symptoms are present. Drugs used to treat mania are often continued as long-term treatment to prevent relapse. There is a need for evidence of the effectiveness and safety of risperidone as long-term treatment. OBJECTIVES: To assess the randomised evidence for the efficacy and tolerability of risperidone compared with placebo or other active pharmacological treatments as long-term treatment for prevention or attenuation of further episodes of mood disorder in patients with bipolar disorder. SEARCH STRATEGY: The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR-Studies) was search on 12/10/2005, The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, CINAHL and PsycINFO were searched in October 2005. Reference lists and English language textbooks were searched; researchers in the field were contacted. SELECTION CRITERIA: Randomised trials comparing risperidone with placebo or other drug in long-term treatment for prevention of depressive or manic relapses. DATA COLLECTION AND ANALYSIS: Not applicable. MAIN RESULTS: No randomised trials comparing risperidone with other treatments for the prevention of manic and depressive relapses were identified. AUTHORS' CONCLUSIONS: There is a need for randomised controlled trials comparing risperidone and other treatments for the prevention of relapse in bipolar disorder. The trials should involve randomisation of treatment for relapse prevention and involve long-term follow up.