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Relapse prevention in bipolar I disorder: 18-month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone

  • Mauricio Tohen (a1), K. N. Roy Chengappa (a2), Trisha Suppes (a3), Robert W. Baker (a4), Carlos A. Zarate (a5), Charles L. Bowden (a6), Gary S. Sachs (a7), David J. Kupfer (a8), S. Nassir Ghaemi (a9), Peter D. Feldman (a4), Richard C. Risser (a10), Angela R. Evans (a10) and Joseph R. Calabrese (a10)...

Extract

Background

Few controlled studies have examined the use of atypical antipsychotic drugs for prevention of relapse in patients with bipolar I disorder.

Aims

To evaluate whether olanzapine plus either lithium or valproate reduces the rate of relapse, compared with lithium or valproate alone.

Method

Patients achieving syndromic remission after 6 weeks'treatment with olanzapine plus either lithium (0.6–1.2 mmol/l) or valproate (50–125 μg/ml) received lithium or valproate plus either olanzapine 5–20 mg/day (combination therapy) or placebo (monotherapy), and were followed in a double-masked trial for 18 months.

Results

The treatment difference in time to relapse into either mania or depression was not significant for syndromic relapse (median time to relapse: combination therapy 94 days, monotherapy40.5 days; P=0.742), but was significant for symptomatic relapse (combination therapy 163 days, monotherapy42 days; P=0.023).

Conclusions

Patients taking olanzapine added to lithium or valproate experienced sustained symptomatic remission, but not syndromic remission, for longer than those receiving lithium or valproate monotherapy.

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Copyright

Corresponding author

Dr M. Tohen, Lilly Research Laboratories, Indianapolis IN46285, USA. Tel: (317)277 9585; fax: (317)433 5101; e-mail: m.tohen@lilly.com

Footnotes

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Declaration of interest

M.T., R.W.B., P.D.F., A.R.E. and R.C.R. are stockholders in Eli Lilly & Company the sponsor of this study.

Footnotes

References

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Relapse prevention in bipolar I disorder: 18-month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone

  • Mauricio Tohen (a1), K. N. Roy Chengappa (a2), Trisha Suppes (a3), Robert W. Baker (a4), Carlos A. Zarate (a5), Charles L. Bowden (a6), Gary S. Sachs (a7), David J. Kupfer (a8), S. Nassir Ghaemi (a9), Peter D. Feldman (a4), Richard C. Risser (a10), Angela R. Evans (a10) and Joseph R. Calabrese (a10)...
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