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Olanzapine plus carbamazepine v. carbamazepine alone in treating manic episodes

Published online by Cambridge University Press:  02 January 2018

Mauricio Tohen ,
Charles L. Bowden ,
Anatoly B. Smulevich ,
Richard Bergstrom ,
Tonya Quinlan ,
Olawale Osuntokun ,
Wei V. Wang ,
Heather S. Oliff ,
Ferenc Martenyi  and
Ludmila A. Kryzhanovskaya
...Show all authors
Mauricio Tohen*
Affiliation:
Lilly Research Laboratories, Indianapolis, Indiana, and McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
Charles L. Bowden
Affiliation:
Department of Psychiatry, University of Texas Health Science Center, San Antonio, Texas, USA
Anatoly B. Smulevich
Affiliation:
National Mental Health Research Center, Moscow, Russia
Richard Bergstrom
Affiliation:
Lilly Research Laboratories, Indianapolis, Indiana, USA
Tonya Quinlan
Affiliation:
Lilly Research Laboratories, Indianapolis, Indiana, USA
Olawale Osuntokun
Affiliation:
Lilly Research Laboratories, Indianapolis, Indiana, USA
Wei V. Wang
Affiliation:
Eli Lilly Canada, Danforth, Canada
Heather S. Oliff
Affiliation:
Science Consulting Group, North Tustin, California, USA
Ferenc Martenyi
Affiliation:
Eli Lilly and Company, Area Medical Center, Vienna, Austria
Ludmila A. Kryzhanovskaya
Affiliation:
Lilly Research Laboratories, Indianapolis, Indiana, USA
Waldemar Greil
Affiliation:
University of Munich, Germany
*
Dr M. Tohen, Lilly Research Laboratories, Indianapolis, IN 46285, USA. Email: [email protected]
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Abstract

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Background

Combinations of olanzapine and carbamazepine are often used in clinical practice in the management of mania.

Aims

To assess the efficacy and safety of olanzapine plus carbamazepine in mixed and manic bipolar episodes.

Method

Randomised, double-blind, 6-week trial of olanzapine (10–30 mg/day) plus carbamazepine (400–1200 mg/day; n=58) v. placebo plus carbamazepine (n=60) followed by open-label, 20-week olanzapine (10–30 mg/day) plus carbamazepine (400–1200 mg/day, n=86), with change in manic symptoms as main outcome measure. Safety and pharmacokinetics were also evaluated.

Results

There were no significant differences (baseline to endpoint) in efficacy measures between treatment groups, but at 6 weeks triglyceride levels were significantly higher (P=0.008) and potentially clinically significant weight gain (⩾7%) occurred more frequently (24.6% v. 3.4%, P=0.002) in the combined olanzapine and carbamazepine group. Carbamazepine reduced olanzapine concentrations but olanzapine had no effect on carbamazepine concentrations.

Conclusions

The combination of olanzapine and carbamazepine did not have superior efficacy to carbamazepine alone. The increases in weight and triglycerides observed during combination treatment are a matter of concern.

Type
Papers
Information
The British Journal of Psychiatry , Volume 192 , Issue 2 , February 2008 , pp. 135 - 143
Copyright
Copyright © Royal College of Psychiatrists, 2008 

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