Relapse prevention in bipolar 1 disorder

18-Month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone

M. Tohen, K. N R Chengappa, T. Suppes, R. W. Baker, C. A. Zarate, C. L. Bowden, G. S. Sachs, D. J. Kupfer, S. N. Ghaemi, P. D. Feldman, R. C. Risser, A. R. Evans, J. R. Calabrese

Research output: Contribution to journalArticle

274 Citations (Scopus)

Abstract

Background: Few controlled studies have examined the use of atypical antipsychotic drugs for prevention of relapse in patients with bipolar 1 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, monotherapy 40.5 days; P=0.742), but was significant for symptomatic relapse (combination therapy 163 days, monotherapy 42 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.

Original languageEnglish (US)
Pages (from-to)337-345
Number of pages9
JournalBritish Journal of Psychiatry
Volume184
Issue numberAPR.
DOIs
StatePublished - Apr 2004

Fingerprint

olanzapine
Valproic Acid
Secondary Prevention
Bipolar Disorder
Lithium
Recurrence
Therapeutics
Antipsychotic Agents
Placebos
Depression

ASJC Scopus subject areas

  • Neuroscience(all)
  • Psychiatry and Mental health

Cite this

Tohen, M., Chengappa, K. N. R., Suppes, T., Baker, R. W., Zarate, C. A., Bowden, C. L., ... Calabrese, J. R. (2004). Relapse prevention in bipolar 1 disorder: 18-Month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone. British Journal of Psychiatry, 184(APR.), 337-345. https://doi.org/10.1192/bjp.184.4.337

Relapse prevention in bipolar 1 disorder : 18-Month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone. / Tohen, M.; Chengappa, K. N R; 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.

In: British Journal of Psychiatry, Vol. 184, No. APR., 04.2004, p. 337-345.

Research output: Contribution to journalArticle

Tohen, M, Chengappa, KNR, Suppes, T, Baker, RW, Zarate, CA, Bowden, CL, Sachs, GS, Kupfer, DJ, Ghaemi, SN, Feldman, PD, Risser, RC, Evans, AR & Calabrese, JR 2004, 'Relapse prevention in bipolar 1 disorder: 18-Month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone', British Journal of Psychiatry, vol. 184, no. APR., pp. 337-345. https://doi.org/10.1192/bjp.184.4.337
Tohen, M. ; Chengappa, K. N R ; 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. / Relapse prevention in bipolar 1 disorder : 18-Month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone. In: British Journal of Psychiatry. 2004 ; Vol. 184, No. APR. pp. 337-345.
@article{1a02b3200dbb4f17863b096782471ff7,
title = "Relapse prevention in bipolar 1 disorder: 18-Month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone",
abstract = "Background: Few controlled studies have examined the use of atypical antipsychotic drugs for prevention of relapse in patients with bipolar 1 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, monotherapy 40.5 days; P=0.742), but was significant for symptomatic relapse (combination therapy 163 days, monotherapy 42 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.",
author = "M. Tohen and Chengappa, {K. N R} and T. Suppes and Baker, {R. W.} and Zarate, {C. A.} and Bowden, {C. L.} and Sachs, {G. S.} and Kupfer, {D. J.} and Ghaemi, {S. N.} and Feldman, {P. D.} and Risser, {R. C.} and Evans, {A. R.} and Calabrese, {J. R.}",
year = "2004",
month = "4",
doi = "10.1192/bjp.184.4.337",
language = "English (US)",
volume = "184",
pages = "337--345",
journal = "British Journal of Psychiatry",
issn = "0007-1250",
publisher = "Royal College of Psychiatrists",
number = "APR.",

}

TY - JOUR

T1 - Relapse prevention in bipolar 1 disorder

T2 - 18-Month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone

AU - Tohen, M.

AU - Chengappa, K. N R

AU - Suppes, T.

AU - Baker, R. W.

AU - Zarate, C. A.

AU - Bowden, C. L.

AU - Sachs, G. S.

AU - Kupfer, D. J.

AU - Ghaemi, S. N.

AU - Feldman, P. D.

AU - Risser, R. C.

AU - Evans, A. R.

AU - Calabrese, J. R.

PY - 2004/4

Y1 - 2004/4

N2 - Background: Few controlled studies have examined the use of atypical antipsychotic drugs for prevention of relapse in patients with bipolar 1 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, monotherapy 40.5 days; P=0.742), but was significant for symptomatic relapse (combination therapy 163 days, monotherapy 42 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.

AB - Background: Few controlled studies have examined the use of atypical antipsychotic drugs for prevention of relapse in patients with bipolar 1 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, monotherapy 40.5 days; P=0.742), but was significant for symptomatic relapse (combination therapy 163 days, monotherapy 42 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.

UR - http://www.scopus.com/inward/record.url?scp=11144354711&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=11144354711&partnerID=8YFLogxK

U2 - 10.1192/bjp.184.4.337

DO - 10.1192/bjp.184.4.337

M3 - Article

VL - 184

SP - 337

EP - 345

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

SN - 0007-1250

IS - APR.

ER -