title: Relapse prevention in bipolar I 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 I disorder. Aims To evaluate whether olanzapine plus either lithium or valproate reduces the rate of relapse, compared with lithium or valproate alone.
  
  
  METHODS
  Patients achieving syndromic remission after 6 weeks'treatment with olanzapine plus either lithium (0.6-1.2 mmol/l) or valproate (50-125 microg/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.
authors.affiliation: Lilly Research Laboratories, Indianapolis, Indiana 46285, USA. m.tohen@lilly.com
authors.forename: Mauricio
authors.initials: M
authors.lastname: Tohen
authors.forename: K N Roy
authors.initials: KN
authors.lastname: Chengappa
authors.forename: Trisha
authors.initials: T
authors.lastname: Suppes
authors.forename: Robert W
authors.initials: RW
authors.lastname: Baker
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Zarate
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bowden
authors.forename: Gary S
authors.initials: GS
authors.lastname: Sachs
authors.forename: David J
authors.initials: DJ
authors.lastname: Kupfer
authors.forename: S Nassir
authors.initials: SN
authors.lastname: Ghaemi
authors.forename: Peter D
authors.initials: PD
authors.lastname: Feldman
authors.forename: Richard C
authors.initials: RC
authors.lastname: Risser
authors.forename: Angela R
authors.initials: AR
authors.lastname: Evans
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Calabrese
mesh_terms: D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000517:prevention & control*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008094:Lithium / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D012008:Recurrence; D013997:Time Factors; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D014635:Valproic Acid; D008094:Lithium; D000077152:Olanzapine