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Olanzapine Effective for Bipolar Disorder in Naturalistic Setting: Presented at WCBP

By Jill Stein

PARIS -- June 30, 2009 -- Olanzapine, as monotherapy or combination therapy, significantly improves symptoms in patients with manic or mixed episodes of bipolar affective disorder, according to data reported here at the 9th World Congress of Biological Psychiatry (WCBP) on June 29.

Pavel Vohlidka, MD, Eli Lilly and Company, Basingstoke, United Kingdom, presented 12-week outcomes in 251 patients who received olanzapine as acute-phase treatment either alone or in tandem with other antipsychotics, anticonvulsants and/or lithium, and antidepressants.

All patients were being treated for manic or mixed episodes of bipolar affective disorder and were enrolled in the 24-month Mania and Olanzapine Treatment (MANOLA) study, which examined patterns of clinical use of olanzapine in a natural setting over a recent 4-year period.

In the current analysis, about one-third of patients received olanzapine as monotherapy and about two-thirds received the agent as part of combination therapy. The groups were similar in terms of baseline demographic and clinical characteristics.

The primary objective of the analysis was to evaluate changes in mania symptoms in both groups on the Clinical Global Impression-Bipolar Disorder (CGI-BP) scale: overall, mania, depression, hallucinations, delusions.

Results showed that patients in both treatment groups had significant improvement on multiple efficacy measures at 12 weeks compared with baseline.

The change in the overall CGI-BP was -2.39 in the monotherapy group (P < .0001) and -2.43 in the combination group (P < .001).

The change in CGI-BP mania was -2.68 (P < .0001) and -2.64 (P < .001) for the 2 groups, respectively. The change in depression was -0.06 (NS) and -0.29 (P = .008) for the 2 groups, and the change in hallucinations and delusions was -1.44 (P < .0001) and -1.10 (P < .001) for the 2 groups.

Overall, the data demonstrate that olanzapine alone or in combination yields significant improvement in patients with manic or mixed episodes of bipolar disorder, Dr. Vohlidka said.

He cautioned that the study's observational design may represent a possible limitation.
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Funding for the study was provided by Eli Lilly and Company.

[Presentation title: A Naturalistic Study of Olanzapine in the Treatment of Patients With Manic or Mixed Episodes of Bipolar Disorder: Results From 12-weeks Acute Phase Treatment with Olanzapine in Monotherapy and in Combination. Abstract P-13-008]

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