PMID- 12640214
OWN - NLM
STAT- MEDLINE
DCOM- 20030801
LR  - 20190910
IS  - 0271-0749 (Print)
IS  - 0271-0749 (Linking)
VI  - 23
IP  - 2
DP  - 2003 Apr
TI  - Acute dysphoric mania: treatment response to olanzapine versus placebo.
PG  - 132-7
AB  - A substantial number of patients with mania have significant concomitant 
      depressive features, and they may respond differently to mood stabilizers than 
      patients with pure mania. This post-hoc analysis explored the response 
      characteristics of olanzapine versus placebo in bipolar I manic patients with 
      dysphoric and nondysphoric mania (differentiated by baseline Hamilton Depression 
      Rating Scale [HAM-D] score of >20). Two similar, double-blind, randomized trials 
      comparing olanzapine, 5-20 mg, to placebo were pooled for these analyses (N = 
      246). Mean changes in Young-Mania Rating Scale (Y-MRS) and HAM-D scores during 3 
      weeks of treatment were examined. Twenty-eight percent of patients had dysphoric 
      mania (olanzapine, n = 33; placebo, n = 35). Among these patients, 
      olanzapine-treated patients had greater improvement within 1 week than did 
      placebo-treated patients on both mania ratings (Y-MRS: -9.7 vs. -3.0 points; = 
      0.011) and depressive symptom ratings (HAM-D: -9.9 vs. -5.4 points; = 0.025). 
      Among those manic subjects without prominent depressive symptoms (olanzapine, n = 
      91; placebo, n = 87), mean Y-MRS improvement from baseline to endpoint with 
      olanzapine (-11.5 points) versus placebo (-6.13 points) was comparable to the 
      improvement seen with olanzapine versus placebo in the dysphoric mania subgroup ( 
      = 0.476, test of interaction). In acutely ill manic patients with significant 
      depressive symptoms, olanzapine demonstrated a broad spectrum of efficacy, 
      effectively treating both manic and depressive symptoms. The magnitude of the 
      antimanic response appears similar, regardless of baseline depressive features. 
      Additional experience with putative mood stabilizers and atypical agents in mixed 
      mania should include an exploration of their efficacy in treating both manic and 
      depressive mood symptoms.
FAU - Baker, Robert W
AU  - Baker RW
AD  - Lilly Research Laboratories, Indianapolis, Indiana 46285, USA. BAKER@Lilly.com
FAU - Tohen, Mauricio
AU  - Tohen M
FAU - Fawcett, Jan
AU  - Fawcett J
FAU - Risser, Richard C
AU  - Risser RC
FAU - Schuh, Leslie M
AU  - Schuh LM
FAU - Brown, Eileen
AU  - Brown E
FAU - Stauffer, Virginia L
AU  - Stauffer VL
FAU - Shao, Lixin
AU  - Shao L
FAU - Tollefson, Gary D
AU  - Tollefson GD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Psychopharmacol
JT  - Journal of clinical psychopharmacology
JID - 8109496
RN  - 0 (Antipsychotic Agents)
RN  - 12794-10-4 (Benzodiazepines)
RN  - 3G0285N20N (Pirenzepine)
RN  - N7U69T4SZR (Olanzapine)
SB  - IM
MH  - Acute Disease
MH  - Affect/drug effects
MH  - Antipsychotic Agents/*therapeutic use
MH  - Benzodiazepines
MH  - Bipolar Disorder/diagnosis/*drug therapy/psychology
MH  - Humans
MH  - Olanzapine
MH  - Pirenzepine/*analogs & derivatives/*therapeutic use
MH  - Psychiatric Status Rating Scales
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
EDAT- 2003/03/18 04:00
MHDA- 2003/08/02 05:00
CRDT- 2003/03/18 04:00
PHST- 2003/03/18 04:00 [pubmed]
PHST- 2003/08/02 05:00 [medline]
PHST- 2003/03/18 04:00 [entrez]
AID - 10.1097/00004714-200304000-00005 [doi]
PST - ppublish
SO  - J Clin Psychopharmacol. 2003 Apr;23(2):132-7. doi: 
      10.1097/00004714-200304000-00005.