TYPICAL NEUROLEPTICS

Typical neuroleptics are effective in acute mania. The onset of action is quicker than with Lithium in acute mania, although there has been no real comparison with an oral loading dose of Divalproex. Clearly, in acute mania with severe behavioural disturbance, the ability to use typical neuroleptics parenterally can be an advantage. The risk and discomfort of acute extrapyramidal side effects should not be underestimated. The evidence for the prophylactic effects of typical neuroleptics is less robust and the clinician should bear in mind the potential increased risk of tardive dyskinesia particularly in patients with a mood disorder. Typical neuroleptics are also known to provoke or maintain depression in bipolar patients. (McElroy et al, 1996)

References
McElroy SL, Keck PE, Strakowski SM. 1996. Mania, psychosis and antipsychotics. J Clin Psychiatry. 57 (Suppl 3). 14-26.