{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:07:12Z","timestamp":1789981632287,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the efficacy and safety of different combination therapies in the treatment of mania in bipolar disorder, and to provide evidence\u2010based support for individualized clinical treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Web of Science, Cochrane Library, CNKI, VIP, and Wanfang databases were systematically searched from inception to July 2025. Randomized controlled trials comparing ziprasidone or olanzapine combined with mood stabilizers (lithium carbonate or sodium valproate) for the treatment of manic episodes in bipolar disorder were included. Two reviewers independently performed literature screening, data extraction, and quality assessment. Meta\u2010analysis was conducted using RevMan 5.4 software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 10 RCTs involving 842 patients were included. Meta\u2010analysis showed no significant difference between the two groups in overall clinical efficacy (OR\u00a0=\u00a01.18, 95% CI: 0.80\u20131.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.41). Ziprasidone was superior to olanzapine in reducing YMRS scores (MD\u00a0=\u00a0\u22121.47, 95% CI: \u22121.97\u20130.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001). The incidence of adverse reactions was significantly lower in the ziprasidone group compared to the olanzapine group (OR\u00a0=\u00a00.16, 95% CI: 0.08\u20130.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.00001). Furthermore, ziprasidone was associated with significantly greater increases in BDNF and T\n                      <jats:sub>3<\/jats:sub>\n                      levels after treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although the efficacy of ziprasidone plus mood stabilizers is comparable to that of olanzapine plus mood stabilizers in the treatment of manic episodes of bipolar disorder, ziprasidone offers advantages in improving manic symptoms (YMRS scores), reducing adverse events, and enhancing neuroendocrine indicators. It may serve as a favorable alternative in clinical practice. Further high\u2010quality, multicenter, large\u2010sample studies are needed to confirm its efficacy and safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71139","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T07:10:54Z","timestamp":1766473854000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of Different Combination Therapies for Mania in Bipolar Disorder: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"15","author":[{"given":"Peiling","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Psychosomatic Disorders Huzhou Third People's Hospital  Huzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingan","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Disorders Huzhou Third People's Hospital  Huzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqin","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Disorders Huzhou Third People's Hospital  Huzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"issue":"29","key":"e_1_2_11_2_1","first-page":"46","article-title":"Efficacy of Ziprasidone Combined With Sodium Valproate in the Treatment of Bipolar Disorder Manic Episodes","volume":"19","author":"Chen X. E.","year":"2021","journal-title":"Guide of China Medicine"},{"issue":"5","key":"e_1_2_11_3_1","first-page":"682","article-title":"Ziprasidone Combined With Mood Stabilizers in the Treatment of Bipolar Manic Episodes","volume":"12","author":"Chen Z. X.","year":"2014","journal-title":"Chinese Journal of General Practice"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.12740\/PP\/OnlineFirst\/92740"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S313840"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2012.0029"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40345-020-00219-9"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/pha0000243"},{"issue":"1","key":"e_1_2_11_9_1","first-page":"137","article-title":"Effects of Ziprasidone Combined With Sodium Valproate on Serum T3 and BDNF Levels in Patients With Bipolar Disorder Manic Episodes","volume":"35","author":"Gao Y. 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