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Olanzapine as Maintenance Therapy in Patients with Bipolar I Disorder

Published online by Cambridge University Press:  28 November 2006

Mauricio Tohen
Affiliation:
Lilly Research Laboratories, Indianapolis, IN; Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, MA, USA; Email: [email protected]
Daniel Yen Lin
Affiliation:
Lilly Research Laboratories, Indianapolis, IN, USA; Email: [email protected]

Extract

ABSTRACT

Effective treatments for the prevention of relapse and recurrence of mood episodes in patients with bipolar disorder are essential to reduce the high mortality associated with this condition, and to improve long-term outcomes. While lithium is considered to be effective as a first line maintenance treatment, additional treatment options would provide clinicians with tools to address the needs of individual patients. The efficacy of olanzapine, an atypical antipsychotic, for the prevention of relapse in bipolar disorder has been demonstrated in several randomized controlled double-blind clinical trials, both as monotherapy and in combination with other agents. The data reviewed herein suggest a more robust efficacy of treatment with olanzapine in the prevention of relapse into manic episodes than into depressive episodes. The adverse events observed most frequently in patients treated with olanzapine relative to comparators were related to somnolence (somnolence, fatigue, or hypersomnia) and weight gain (weight gain, or increased appetite). Moreover, a larger proportion of olanzapine-treated patients than comparator-treated patients experienced clinically important weight gain.

Type
Review Article
Copyright
© 2007 Cambridge University Press

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References

Geddes, J.R., Burgess, S., Hawton, K., Jamison, K., & Goodwin, G.M. (2004). Long-term lithium therapy for bipolar disorder: systematic review and meta-analysis of randomized controlled trials. American Journal of Psychiatry, 161 (2), 217222.CrossRefGoogle Scholar
Hamilton, M. (1967). Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6 (4), 278296.CrossRefGoogle Scholar
Lin, D., Mok, H., & Yatham, L.N. (2006). Polytherapy in bipolar disorder. CNS.Drugs, 20 (1), 2942.CrossRefGoogle Scholar
Tohen, M., Bowden, C.L., Calabrese, J.R., Lin, D., Frye, M., Forrester, T.D., Sachs, G.S., Koukopoulos, A., Yatham, L.N., & Grunze, H. (2006a). Factors associated with increased time with subsyndromal symptoms in bipolar patients after remission from a manic or mixed episode. British Journal of Psychiatry, in press.Google Scholar
Tohen, M., Calabrese, J.R., Sachs, G.S., Banov, M.D., Detke, H.C., Risser, R., Baker, R.W., Chou, J.C., & Bowden, C.L. (2006b). Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine. American Journal of Psychiatry, 163 (2), 247256.Google Scholar
Tohen, M., Chengappa, K.N., Suppes, T., Baker, R.W., Zarate, C.A., Bowden, C.L., Sachs, G.S., Kupfer, D.J., Ghaemi, S.N., Feldman, P.D., Risser, R.C., Evans, A.R., & Calabrese, J.R. (2004). Relapse prevention in bipolar I disorder: 18-month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone. British Journal of Psychiatry, 184, 337345.CrossRefGoogle Scholar
Tohen, M., Greil, W., Calabrese, J.R., Sachs, G.S., Yatham, L.N., Oerlinghausen, B.M., Koukopoulos, A., Cassano, G.B., Grunze, H., Licht, R.W., Dell'Osso, L., Evans, A.R., Risser, R., Baker, R.W., Crane, H., Dossenbach, M.R., & Bowden, C.L. (2005). Olanzapine versus lithium in the maintenance treatment of bipolar disorder: a 12-month, randomized, double-blind, controlled clinical trial. American Journal of Psychiatry, 162 (7), 12811290.CrossRefGoogle Scholar
Tohen, M., Jacobs, T.G., Grundy, S.L., McElroy, S.L., Banov, M.C., Janicak, P.G., Sanger, T., Risser, R., Zhang, F., Toma, V., Francis, J., Tollefson, G.D., & Breier, A. (2000). Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. The Olanzipine HGGW Study Group [see comment][erratum appears in Archives of General Psychiatry 2002 Jan; 59 (1): 91]. Archives of General Psychiatry, 57(9), 841849.CrossRefGoogle Scholar
Tohen, M., Ketter, T.A., Zarate, C.A., Suppes, T., Frye, M., Altshuler, L., Zajecka, J., Schuh, L.M., Risser, R.C., Brown, E., & Baker, R.W. (2003a). Olanzapine versus divalproex sodium for the treatment of acute mania and maintenance of remission: a 47-week study. American Journal of Psychiatry, 160 (7), 12631271.Google Scholar
Tohen, M., Sanger, T.M., McElroy, S.L., Tollefson, G.D., Chengappa, K.N., Daniel, D.G., Petty, F., Centorrino, F., Wang, R., Grundy, S.L., Greaney, M.G., Jacobs, T.G., David, S.R., & Toma, V. (1999). Olanzapine versus placebo in the treatment of acute mania. Olanzapine HGEH Study Group. American Journal of Psychiatry, 156 (5), 702709.Google Scholar
Tohen, M., Vieta, E., Calabrese, J., Ketter, T.A., Sachs, G., Bowden, C., Mitchell, P.B., Centorrino, F., Risser, R., Baker, R.W., Evans, A.R., Beymer, K., Dube, S., Tollefson, G.D., & Breier, A. (2003b). Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Archives of General Psychiatry, 60 (11), 10791088.Google Scholar