<unk>  is primarily used for the treatment of schizophrenia or bipolar disorder. Schizophrenia The 2016 NICE guidance for treating psychosis and schizophrenia in children and young people recommended<unk>  as a second line treatment after risperidone for people between 15 and 17 who are having an acute exacerbation or recurrence of psychosis or schizophrenia. A 2014 NICE review of the depot formulation of the drug found that it might have a role in treatment as an alternative to other depot formulations of second generation antipsychotics for people who have trouble taking medication as directed or who prefer it. A 2014 Cochrane review comparing<unk>  and other atypical antipsychotics found that it is difficult to determine differences as data quality is poor. A 2011 Cochrane review comparing<unk>  with placebo concluded that high dropout rates in clinical trials, and a lack of outcome data regarding general functioning, behavior, mortality, economic outcomes, or cognitive functioning make it difficult to definitively conclude that<unk>  is useful for the prevention of relapse. A Cochrane review found only low quality evidence of effectiveness in treating schizophrenia. Accordingly, part of its methodology on quality of evidence is based on quantity of qualified studies. A 2013 review found that it is in the middle range of 15 antipsychotics for effectiveness, approximately as effective as haloperidol and quetiapine and slightly more effective than ziprasidone, chlorpromazine, and asenapine, with better tolerability compared to the other antipsychotic drugs (4th best for weight gain, 5th best for extrapyramidal symptoms, best for prolactin elevation, 2nd best for QTc prolongation, and 5th best for sedation). The authors concluded that for acute psychotic episodes<unk>  results in benefits in some aspects of the condition. In 2013 the World Federation of Societies for Biological Psychiatry recommended<unk>  for the treatment of acute exacerbations of schizophrenia as a Grade 1 recommendation and evidence level A. The British Association for Psychopharmacology similarly recommends that all persons presenting with psychosis receive treatment with an antipsychotic, and that such treatment should continue for at least 1–2 years, as "There is no doubt that antipsychotic discontinuation is strongly associated with relapse during this period". The guideline further notes that "Established schizophrenia requires continued maintenance with doses of antipsychotic medication within the recommended range (Evidence level A)". The British Association for Psychopharmacology and the World Federation of Societies for Biological Psychiatry suggest that there is little difference in effectiveness between antipsychotics in prevention of relapse, and recommend that the specific choice of antipsychotic be chosen based on each person's preference and side effect profile. The latter group recommends switching to<unk>  when excessive weight gain is encountered during treatment with other antipsychotics. Bipolar disorder<unk>  is effective for the treatment of acute manic episodes of bipolar disorder in adults, children, and adolescents. Used as maintenance therapy, it is useful for the prevention of manic episodes, but is not useful for bipolar depression. Thus, it is often used in combination with an additional mood stabilizer; however, co-administration with a mood stabilizer increases the risk of extrapyramidal side effects. Major depression<unk>  is an effective add-on treatment for major depressive disorder; however, there is a greater rate of side effects such as weight gain and movement disorders. The overall benefit is small to moderate and its use appears to neither improve quality of life nor functioning.<unk>  may interact with some antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). There are interactions with fluoxetine and paroxetine and lesser interactions with sertraline, escitalopram, citalopram and fluvoxamine, which inhibit CYP2D6, for which<unk>  is a substrate. CYP2D6 inhibitors increase<unk>  concentrations to 2-3 times their normal level. Autism Short-term data (8 weeks) shows reduced irritability, hyperactivity, inappropriate speech, and stereotypy, but no change in lethargic behaviours. Adverse effects include weight gain, sleepiness, drooling and tremors. It is suggested that children and adolescents need to be monitored regularly while taking this medication, to evaluate if this treatment option is still effective after long-term use and note if side effects are worsening. Further studies are needed to understand if this drug is helpful for children after long term use. Tic disorders<unk>  is approved for the treatment of Tourette's syndrome. It is effective, safe, and well-tolerated for this use per systematic reviews and meta-analyses. Obsessive–compulsive disorder A 2014 systematic review and meta-analysis concluded that add-on therapy with low dose<unk>  is an effective treatment for obsessive–compulsive disorder (OCD) that does not improve with selective serotonin reuptake inhibitors (SSRIs) alone. The conclusion was based on the results of two relatively small, short-term trials, each of which demonstrated improvements in symptoms. Risperidone, another second-generation antipsychotic, appears to be superior to<unk>  for this indication, and is recommended by the 2007 American Psychiatric Association guidelines. However,<unk>  is cautiously recommended by a 2017 review on antipsychotics for OCD.<unk>  is not currently approved for the treatment of OCD and is instead used off-label for this indication.
Aripiprazole
Electroconvulsive therapy
Risperidone
Clozapine
Olanzapine
Asenapine
Ziprasidone
Lorpiprazole