Efficacy of olanzapine combined with valproate or lithium in the treatment of dysphoric mania. Academic Article uri icon

start page

  • 472

end page

  • 478

abstract

  • Few controlled studies examine the treatment of depressive features in mania.To evaluate the efficacy of olanzapine, in combination with lithium or valproate, for treating depressive symptoms associated with mania.Secondary analysis of a 6-week, double-blind, randomised study of olanzapine (5-20 mg/day) or placebo combined with ongoing valproate or lithium open treatment for 344 patients in mixed or manic episodes. This analysis focused on a dysphoric subgroup with baseline Hamilton Rating Scale for Depression (HRSD) total scores of 20 or over contrasted with non-dysphoric patients.In the dysphoric subgroup (n=85) mean HRSD total score improvement was significantly greater in olanzapine co-therapy patients than in those receiving placebo plus lithium or valproate (P<0.001). Substantial contributors to this superiority included the HRSD Maier sub-scale (P=0.013) and the suicide item (P=0.001). Total Young Mania Rating Scale improvement was also superior with olanzapine co-therapy.In patients with acute dysphoric mania, addition of olanzapine to ongoing lithium or valproate monotherapy significantly improved depressive symptom, mania and suicidality ratings.

date/time value

  • December 2004

Digital Object Identifier (DOI)

  • 10.1192/bjp.185.6.472

PubMed Identifier

  • 15572737

volume

  • 185

number

keywords

  • Adult
  • Antimanic Agents
  • Antipsychotic Agents
  • Benzodiazepines
  • Bipolar Disorder
  • Depressive Disorder
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lithium Carbonate
  • Male
  • Treatment Outcome
  • Valproic Acid