title: Effectiveness of short-term olanzapine in patients with bipolar I disorder, with or without comorbidity with substance use disorder.
abstract: OBJECTIVE
  Prognosis of comorbid bipolar disorder (BD) and drug abuse is poor. We assessed the efficacy of olanzapine in manic or mixed BD patients, with (SUD) or without (N-SUD) comorbidity with substance use disorder (SUD) and its effect on drug abuse, days of abuse, and craving.
  
  
  METHODS
  Eighty patients with BD-I (40 SUD) were hospitalized for a manic or mixed episode and received add-on olanzapine. Assessments were conducted at admission, discharge, and 4 and 8 weeks after discharge. Primary outcome was the proportion of responders and remitters in each group. We used a logistic regression model to adjust for possible confounders. We assessed craving and drug-abuse days with a visual analog scale and the Timeline Follow-Back.
  
  
  RESULTS
  SUD and N-SUD were similar on response and remission, adjusted for sex, age, years ill, age at first episode, first episode depressive, number of hospitalizations, and duration of hospitalization (odds ratio, 1.09; 95% confidence interval, 1.02-2.29). Mood rating scores dropped significantly from baseline to end point in both groups. Timeline follow-back decreased in SUD from 22.5 to 7.3 at 8 weeks postdischarge, whereas craving dropped from 8.3 to 5.1 (P < 0.03).
  
  
  CONCLUSIONS
  The effectiveness of short-term olanzapine in BD-I mania or mixed mania did not differ according to SUD comorbidity. Treatment was followed by less substance use/abuse and craving in comorbid bipolar-SUD patients.
authors: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), School of Medicine and Psychology, Sapienza University, Sant' Andrea Hospital, Rome, Italy. gabriele.sani@uniroma1.it
authors: Gabriele
authors: G
authors: Sani
authors: Georgios D
authors: GD
authors: Kotzalidis
authors: Paul
authors: P
authors: Vöhringer
authors: Daniela
authors: D
authors: Pucci
authors: Alessio
authors: A
authors: Simonetti
authors: Giovanni
authors: G
authors: Manfredi
authors: Valeria
authors: V
authors: Savoja
authors: Stefano Maria
authors: SM
authors: Tamorri
authors: Lorenzo
authors: L
authors: Mazzarini
authors: Isabella
authors: I
authors: Pacchiarotti
authors: Carla Ludovica
authors: CL
authors: Telesforo
authors: Stefano
authors: S
authors: Ferracuti
authors: Roberto
authors: R
authors: Brugnoli
authors: Elisa
authors: E
authors: Ambrosi
authors: Matteo
authors: M
authors: Caloro
authors: Antonio
authors: A
authors: Del Casale
authors: Alexia E
authors: AE
authors: Koukopoulos
authors: Derick E
authors: DE
authors: Vergne
authors: Paolo
authors: P
authors: Girardi
authors: S Nassir
authors: SN
authors: Ghaemi
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016022:Case-Control Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine