Author:
Baker Robert W.,Brown Eileen,Akiskal Hagop S.,Calabrese Joseph R.,Ketter Terence A.,Schuh Leslie M.,Trzepacz Paula T.,Watkin John G.,Tohen Mauricio
Abstract
BackgroundFew controlled studies examine the treatment of depressive features in mania.AimsTo evaluate the efficacy of olanzapine, in combination with lithium or valproate, for treating depressive symptoms associated with mania.MethodSecondary 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.ResultsIn 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.ConclusionsIn patients with acute dysphoric mania, addition of olanzapine to ongoing lithium or valproate monotherapy significantly improved depressive symptom, mania and suicidality ratings.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Cited by
50 articles.
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