Editorial: A Meta-Analysis of the Treatment of Acute Mania in Youth: Why Do Atypical Antipsychotics Work Better Than Mood Stabilizers?

Randomized controlled trials (RCTs) of youth with mania are very challenging to conduct, given the low base rate of bipolar disorder (BD) and the relative rarity of mania (vs bipolar depression, which tends to be much more common). Thus, many of the RCTs are relatively small, and it may be difficult to clinically interpret results. At the same time, findings about which anti-manic medications are most effective in youth are of critical importance, both because (1) poorly treated mania can lead to substantial negative psychosocial consequences, and (2) these medications can have significant adverse effects. In this setting, network meta-analyses (NMAs) are key to summarize extremely valuable work in a way that is meaningful and relevant to clinicians.