PMID- 18294024 OWN - NLM STAT- MEDLINE DCOM- 20080616 LR - 20190902 IS - 1555-2101 (Electronic) IS - 0160-6689 (Linking) VI - 69 IP - 4 DP - 2008 Apr TI - Olanzapine or lamotrigine addition to lithium in remitted bipolar disorder patients with anxiety disorder comorbidity: a randomized, single-blind, pilot study. PG - 609-16 AB - OBJECTIVE: The aim of the present randomized, single-blind, pilot study was to assess the efficacy of the addition of a second mood stabilizer, either olanzapine or lamotrigine, to lithium in patients with remitted bipolar disorder and comorbid anxiety disorder. METHOD: Adult DSM-IV bipolar disorder patients with a current anxiety disorder and a Hamilton Rating Scale for Anxiety (HAM-A) score of 12 or higher, in remission from an affective episode for at least 2 months while on lithium maintenance treatment, were randomly assigned to receive 12 weeks of single-blind olanzapine 5 to 10 mg/day (N = 24) or lamotrigine 50 to 200 mg/day (N = 23) addition to lithium. The primary outcome measure was the HAM-A; secondary outcome measures were the Clinical Global Impressions-Severity of Illness scale and the Global Assessment of Functioning (GAF) scale. Data were collected from July 2005 to February 2007. RESULTS: Twenty-two patients in the olanzapine and 18 in the lamotrigine group completed the trial. Mean +/- SD final doses of olanzapine and lamotrigine were, respectively, 7.7 +/- 4.2 mg/day and 96.7 +/- 46.7 mg/day in the intent-to-treat sample (N = 47). Both olanzapine and lamotrigine were effective in reducing HAM-A scores from baseline to endpoint (paired t test for completers: t = 11.361, df = 21, p < .001 for olanzapine and t = 6.301, df = 17, p < .001 for lamotrigine). Both drugs were also effective on the secondary outcome measures. Olanzapine was more effective than lamotrigine at weeks 6 and 12 with a last-observation-carried-forward analysis on all 3 outcome measures, while such differences disappeared on the HAM-A and GAF at week 12 with the visit-wise analysis. CONCLUSIONS: The addition of a second mood stabilizer (olanzapine or lamotrigine) to lithium is effective in reducing anxiety symptoms in bipolar disorder patients with a co-occurring anxiety disorder. FAU - Maina, Giuseppe AU - Maina G AD - Department of Neurosciences, Mood and Anxiety Disorders Unit, University of Turin, Turin, Italy. giuseppemaina@hotmail.com FAU - Albert, Umberto AU - Albert U FAU - Rosso, Gianluca AU - Rosso G FAU - Bogetto, Filippo AU - Bogetto F LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - United States TA - J Clin Psychiatry JT - The Journal of clinical psychiatry JID - 7801243 RN - 0 (Antipsychotic Agents) RN - 0 (Triazines) RN - 12794-10-4 (Benzodiazepines) RN - 2BMD2GNA4V (Lithium Carbonate) RN - N7U69T4SZR (Olanzapine) RN - U3H27498KS (Lamotrigine) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Antipsychotic Agents/administration & dosage/*therapeutic use MH - Anxiety Disorders/diagnosis/*drug therapy/epidemiology MH - Benzodiazepines/administration & dosage/*therapeutic use MH - Bipolar Disorder/diagnosis/*drug therapy/epidemiology MH - Comorbidity MH - Diagnostic and Statistical Manual of Mental Disorders MH - Drug Administration Schedule MH - Drug Therapy, Combination MH - Female MH - Humans MH - Lamotrigine MH - Lithium Carbonate/administration & dosage/*therapeutic use MH - Male MH - Middle Aged MH - Olanzapine MH - Pilot Projects MH - Single-Blind Method MH - Triazines/administration & dosage/*therapeutic use EDAT- 2008/02/26 09:00 MHDA- 2008/06/17 09:00 CRDT- 2008/02/26 09:00 PHST- 2008/02/26 09:00 [pubmed] PHST- 2008/06/17 09:00 [medline] PHST- 2008/02/26 09:00 [entrez] AID - ej07m03486 [pii] AID - 10.4088/jcp.v69n0413 [doi] PST - ppublish SO - J Clin Psychiatry. 2008 Apr;69(4):609-16. doi: 10.4088/jcp.v69n0413.