Treatment of bipolar mixed state with olanzapine.
OBJECTIVE
An open trial was conducted to determine the efficacy of olanzapine in the treatment of bipolar mixed state.


METHODS
Nine inpatients at a provincial psychiatric hospital who met the DSM-IV criteria for bipolar I disorder, most recent episode mixed.


METHODS
Olanzapine was added to the existing drug regime in patients who had failed to respond to adequate trials of mood stabilizers used alone or in combination with neuroleptics.


METHODS
Patients were administered the Clinical Global Impression (CGI) Scale, the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF) Scale before the initiation of olanzapine. These scales were repeated and patients were rated on the improvement subscale of the CGI at the time of discharge.


RESULTS
Pretreatment means (and standard deviations [SD]) for the CGI scale, BPRS and GAF were 5.7 (1.1), 60.7 (13.7) and 17.8 (7.5), respectively. Post-treatment means and SD for the scales were 1.9 (0.6), 6.3 (3.3) and 71.7 (5.6), respectively. Paired t-tests on all measures indicated significant improvement in symptoms with t = 9.43, p < 0.001 for CGI; t = -13.28, p < 0.001 for BPRS; t = -21.83, p < 0.001 for GAF. The mean improvement subscale score of the CGI was 1.3 (SD 0.5) at discharge.


CONCLUSIONS
Olanzapine was well-tolerated and was effective in the acute treatment of bipolar mixed state.
Sharma
V
V
Mood Disorders Unit, London Psychiatric Hospital, ON. vsharma@julian.uwo.ca
Pistor
L
L
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome