title: Olanzapine discontinuation emergent recurrence in bipolar disorder.
abstract: OBJECTIVE
  The efficacy of atypical antipsychotics including olanzapine in acute treatment of manic episode has been established, whereas its role in maintenance treatment is not clear.
  
  
  METHODS
  Thirteen patients of bipolar disorder who were on regular treatment with mood stabilizer and subsequently relapsed into mania or depressive episode after discontinuation of olanzapine were studied for various socio-demographic and clinical factors using retrospective chart review.
  
  
  RESULTS
  There was no correlation found between the period of tapering olanzapine, time to recurrence of episode after discontinuation, and the dosage of olanzapine at the time of discontinuation. The predominant early signs of relapse after discontinuation of olanzapine included sleep disturbance (72.7%), lack of insight for change in behavior (72.7%), irritability (54.5%), and elevated mood (45.5%).
  
  
  CONCLUSIONS
  Mood stabilizer alone as a maintenance therapy of bipolar disorder may be inadequate for long-term management. A low dose of olanzapine along with mood stabilizers might be useful for prevention of recurrence in bipolar disorder.
authors.affiliation: Department of Psychiatry, Government Medical College, Psychiatric Diseases Hospital, Jammu, Jammu and Kashmir, India.
authors.forename: Manu
authors.initials: M
authors.lastname: Arora
authors.affiliation: Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Samir Kumar
authors.initials: SK
authors.lastname: Praharaj
keywords: Bipolar disorder; depression; mania; olanzapine; recurrence