Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cycling

Todd M. Sanger, Mauricio Tohen, Eduard Vieta, David L. Dunner, Charles L. Bowden, Joseph R. Calabrese, Peter D. Feldman, Thomas G. Jacobs, Alan Breier

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Abstract

Background: A substantial proportion of patients with bipolar disorder are characterized by a rapidly cycling course and are particularly resistant to conventional treatment. Methods: This secondary analysis, defined a priori, was conducted on a larger data set from patients with bipolar I disorder to determine the efficacy of a 3-week treatment with the atypical antipsychotic olanzapine (5-20 mg/day, n=19) versus placebo (n=26) in patients with ≥4 episodes in the preceding year. Results: Significantly fewer placebo patients completed treatment (34.6 vs. 73.7%, P=0.016), and more than half discontinued due to lack of efficacy (53.8 vs. 21.1%, P=0.035). Olanzapine reduced Young Mania Rating Scale (YMRS) total scores significantly more than placebo (-13.9 vs. -4.1, P=0.011). Clinical responses, defined as ≥50% improvement in YMRS, were achieved in 58% of olanzapine patients, compared with 28% of placebo patients (P=0.066). Extrapyramidal symptoms were not significantly changed in either group. Somnolence was the most common adverse event in both groups (olanzapine: 52.6%, placebo: 23.1%; P=0.060). No event occurred significantly more frequently with olanzapine than with placebo. No patients discontinued due to an adverse event. Limitations: The duration of this study was limited to 3 weeks, precluding conclusions about long-term efficacy of olanzapine. Moreover, a sizeable placebo effect was obtained, possibly masking optimal therapeutic effect. Despite these limitations, treatment differences in efficacy were highly significant. Conclusions: These results indicate that olanzapine was effective in reducing symptoms of mania and well tolerated in patients with bipolar I disorder with a rapid-cycling course.

Original languageEnglish (US)
Pages (from-to)155-161
Number of pages7
JournalJournal of Affective Disorders
Volume73
Issue number1-2
DOIs
StatePublished - Jan 2003

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olanzapine
Bipolar Disorder
Placebos
Therapeutics
Placebo Effect
Therapeutic Uses
Antipsychotic Agents

Keywords

  • Bipolar disorder
  • Mania
  • Olanzapine
  • Rapid cycling

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Biological Psychiatry
  • Neurology
  • Psychology(all)

Cite this

Sanger, T. M., Tohen, M., Vieta, E., Dunner, D. L., Bowden, C. L., Calabrese, J. R., ... Breier, A. (2003). Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cycling. Journal of Affective Disorders, 73(1-2), 155-161. https://doi.org/10.1016/S0165-0327(02)00334-8

Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cycling. / Sanger, Todd M.; Tohen, Mauricio; Vieta, Eduard; Dunner, David L.; Bowden, Charles L.; Calabrese, Joseph R.; Feldman, Peter D.; Jacobs, Thomas G.; Breier, Alan.

In: Journal of Affective Disorders, Vol. 73, No. 1-2, 01.2003, p. 155-161.

Research output: Contribution to journalArticle

Sanger, TM, Tohen, M, Vieta, E, Dunner, DL, Bowden, CL, Calabrese, JR, Feldman, PD, Jacobs, TG & Breier, A 2003, 'Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cycling', Journal of Affective Disorders, vol. 73, no. 1-2, pp. 155-161. https://doi.org/10.1016/S0165-0327(02)00334-8
Sanger, Todd M. ; Tohen, Mauricio ; Vieta, Eduard ; Dunner, David L. ; Bowden, Charles L. ; Calabrese, Joseph R. ; Feldman, Peter D. ; Jacobs, Thomas G. ; Breier, Alan. / Olanzapine in the acute treatment of bipolar I disorder with a history of rapid cycling. In: Journal of Affective Disorders. 2003 ; Vol. 73, No. 1-2. pp. 155-161.
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