title: Olanzapine plus carbamazepine v. carbamazepine alone in treating manic episodes.
abstract: BACKGROUND
  Combinations of olanzapine and carbamazepine are often used in clinical practice in the management of mania.
  
  
  OBJECTIVE
  To assess the efficacy and safety of olanzapine plus carbamazepine in mixed and manic bipolar episodes.
  
  
  METHODS
  Randomised, double-blind, 6-week trial of olanzapine (10-30 mg/day) plus carbamazepine (400-1200 mg/day; n=58) v. placebo plus carbamazepine (n=60) followed by open-label, 20-week olanzapine (10-30 mg/day) plus carbamazepine (400-1200 mg/day, n=86), with change in manic symptoms as main outcome measure. Safety and pharmacokinetics were also evaluated.
  
  
  RESULTS
  There were no significant differences (baseline to endpoint) in efficacy measures between treatment groups, but at 6 weeks triglyceride levels were significantly higher (P=0.008) and potentially clinically significant weight gain (>or=7%) occurred more frequently (24.6% v. 3.4%, P=0.002) in the combined olanzapine and carbamazepine group. Carbamazepine reduced olanzapine concentrations but olanzapine had no effect on carbamazepine concentrations.
  
  
  CONCLUSIONS
  The combination of olanzapine and carbamazepine did not have superior efficacy to carbamazepine alone. The increases in weight and triglycerides observed during combination treatment are a matter of concern.
authors.affiliation: Lilly Research Laboratories, Indianapolis, Indiana 46285, USA. m.tohen@lilly.com
authors.forename: Mauricio
authors.initials: M
authors.lastname: Tohen
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bowden
authors.forename: Anatoly B
authors.initials: AB
authors.lastname: Smulevich
authors.forename: Richard
authors.initials: R
authors.lastname: Bergstrom
authors.forename: Tonya
authors.initials: T
authors.lastname: Quinlan
authors.forename: Olawale
authors.initials: O
authors.lastname: Osuntokun
authors.forename: Wei V
authors.initials: WV
authors.lastname: Wang
authors.forename: Heather S
authors.initials: HS
authors.lastname: Oliff
authors.forename: Ferenc
authors.initials: F
authors.lastname: Martenyi
authors.forename: Ludmila A
authors.initials: LA
authors.lastname: Kryzhanovskaya
authors.forename: Waldemar
authors.initials: W
authors.lastname: Greil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D002220:Carbamazepine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D016896:Treatment Outcome
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D002220:Carbamazepine; D000077152:Olanzapine