In maintenance trials atypical antipsychotics had significantly fewer relapses to depression or mania than placebo or active comparator .
Conclusion Atypical antipsychotics are effective in treating both phases of bipolar disorder compared with placebo , and as effective as established drug therapies .
Atypical antipsychotics produce fewer extrapyramidal symptoms , but weight gain is more common ( with olanzapine ) .
There is insufficient data confidently to distinguish between different atypical antipsychotics
Background Atypical antipsychotics are increasingly used for treatment of mental illnesses like schizophrenia and bipolar disorder , and considered to have fewer extrapyramidal effects than older antipsychotics .
Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine.
OBJECTIVE In a placebo-controlled , double-blind study , the authors investigated the efficacy and safety of olanzapine as monotherapy in relapse prevention in bipolar I disorder . METHOD Patients achieving symptomatic remission from a manic or mixed episode of bipolar I disorder ( Young Mania Rating Scale [ YMRS ] total score < or = 12 and 21-item Hamilton Depression Rating Scale [ HAM-D ] score < or = 8) at two consecutive weekly visits following 6 - 12 weeks of open-label acute treatment with 5 - 20 mg/day of olanzapine were r and omly assigned to double-blind maintenance treatment with olanzapine ( N=225 ) or placebo ( N=136 ) for up to 48 weeks . The primary measure of efficacy was time to symptomatic relapse into any mood episode ( YMRS score > or = 15 , HAM-D score > or = 15 , or hospitalization ) . RESULTS Time to symptomatic relapse into any mood episode was significantly longer among patients receiving olanzapine ( a median of 174 days , compared with a median of 22 days in patients receiving placebo ) . Times to symptomatic relapse into manic , depressive , and mixed episodes were all significantly longer among patients receiving olanzapine than among patients receiving placebo . The relapse rate was significantly lower in the olanzapine group ( 46.7 % ) than in the placebo group ( 80.1 % ) . During olanzapine treatment , the most common emergent event was weight gain ; during the open-label phase , patients who received olanzapine gained a mean of 3.1 kg ( SD=3.4 ) . In double-blind treatment , placebo patients lost a mean of 2.0 kg ( SD=4.4 ) and patients who continued to take olanzapine gained an additional 1.0 kg ( SD=5.2 ) . CONCLUSIONS Compared to placebo , olanzapine delays relapse into subsequent mood episodes in bipolar I disorder patients who responded to open-label acute treatment with olanzapine for a manic or mixed episode
In maintenance trials atypical antipsychotics had significantly fewer relapses to depression or mania than placebo or active comparator .
Conclusion Atypical antipsychotics are effective in treating both phases of bipolar disorder compared with placebo , and as effective as established drug therapies .
Atypical antipsychotics produce fewer extrapyramidal symptoms , but weight gain is more common ( with olanzapine ) .
There is insufficient data confidently to distinguish between different atypical antipsychotics
Background Atypical antipsychotics are increasingly used for treatment of mental illnesses like schizophrenia and bipolar disorder , and considered to have fewer extrapyramidal effects than older antipsychotics .