Strengths:

• Effective in the treatment of manic and mixed states, either as monotherapy or add-on therapy to a mood stabilizer.
• Rapid onset of antimanic effect which is independent of antipsychotic effects.
• Broad spectrum – it controls mania in a variety of populations (psychotic/non-psychotic, and manic/mixed) and also reduces associated depressive symptoms.
• Does not cause weight gain or QTc prolongation.
• Superior to haloperidol in terms of rates of EPS.

Weaknesses:

• Never studied in patients with bipolar depression.
• Assoiciated with higher rates of EPS compared with other atypical antipsychotics.

Guidelines

Supporting data