Olanzapine vs. lithium in management of acute mania.
Author(s): Shafti SS.
Affiliation(s): University of Social Welfare and Rehabilitation Sciences, Razi Psychiatric
Hospital, Amin Abad, Shahre Rey, Tehran, Iran. ssshafti@yahoo.com
Publication date & source: 2010, J Affect Disord. , 122(3):273-6
OBJECTIVE: Among the available mood stabilizers, it appears that lithium may
share an important role for treatment of acute mania. In a study from Sep. 2007
to Apr. 2008 at Razi Psychiatric Hospital we evaluated the efficiency of
olanzapine vs. lithium.
METHODS: Forty (40) female inpatients meeting DSM-IV-TR criteria for acute mania
were entered into a 3-week parallel group, double-blind study for random
assignment to olanzapine or lithium carbonate in a 1:1 ratio. Primary outcome
measurements were the changes in Manic State Rating Scale (MSRS) at baseline and
weekly intervals up to the third week. Similarly, overall illness severity was
rated using the Clinical Global Impression-Severity of illness scale (CGI-S) at
baseline and at the end of the third week. Analysis of the data was accomplished
by means of split-plot (mixed) and repeated measures analysis of variance (ANOVA)
and t test.
RESULTS: While both olanzapine and lithium were found to be significantly helpful
in the improvement of manic symptoms (p<0.05), lithium was considerably more
successful by the end of the third week (p<0.0002 and p<0.003, for frequency and
intensity of the symptoms). CGI-S also showed important improvements with both
olanzapine and lithium (p<0.043 and p<0.015 for olanzapine and lithium).
CONCLUSION: Though both olanzapine and lithium were effective in the improvement
of manic symptoms, lithium was more beneficial.
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