If this is not your name, click here.
| | If this is not your name, click here. | | |
| | Contact Us | Order Now | Journals | Bookstore | Register a colleague | | |
| |  DG DISPATCH - ECNP: Olanzapine Highly Effective In Bipolar Disorder By Cameron Johnston Special to DG News LONDON, UK -- September 22, 1999 -- Studies show that olanzapine (Zyprexa, Lilly) can be used effectively in the treatment of the manic phase of bipolar disorder. What’s more, researcher reported at this week’s 12th European College of Neuropsychopharmacology (ECNP) Congress, in London, UK, the drug is also proving beneficial in alleviating the depressive episodes that follow the manic phase of the condition.
Dr. Mauricio Tohen, an associate professor of psychiatry at Harvard University, presented the results of several studies showing that olanzapine offers substantial benefits to people with the condition. Dr. Tohen is also medical director for Eli Lilly and Company of Indianapolis, Indiana, which makes olanzapine. Using antipsychotics to treat mania is not a new concept, he explained, and actually some of the oldest antipsychotics available (clorpromazine and lithium) were used many years ago to treat the condition. However, their very slow onset of action and their severe side effects meant these older drugs were seldom used as indicated. In a four-week, double-blind, placebo-controlled trial involving 26 sites throughout the US, 115 patients were given 15 mg of olanzapine per day - which is more than the dose people with psychotic disorders would normally receive. Patients in the olanzapine group showed significantly greater improvement on the Y-MRS (Young Mental Rating Scale): a 14.78 point improvement versus an 8.13 point improvement, which was statistically significant. In an interview with Doctor’s Guide, Dr. Tohen said that of particular importance is the fact that patients experienced significantly greater improvement in resolution of psychotic symptoms - Y-MRS scores improved by a mean of just over three points in the olanzapine group versus one point in the placebo group. There was also a statistically significantly difference in improvement shown under the category of "elevated mood", and resolution of "disruptive/aggressive behavior". Importantly, there was no significant difference between the improvement seen in patients with or without psychotic features. Valproate is very good at treating the symptoms of mixed mania, whereas lithium is useful for treating pure mania, but olanzapine was equally effective with both, Dr. Tohen said. Dr. Tohen said that another well-known antipsychotic, haloperidol, actually induces depression as it treats the mania, whereas olanzapine produced statistically significant improvements on the Hamilton Depression rating scale, which is a well known tool for measuring a patient’s level of depression. "This finding suggests that olanzapine improves symptoms of depression in patients with mania and mixed episodes which would suggest that it has mood stabilizing properties." It’s clinically relevant that the drug can be used to treat one pole of bipolar disorder (ie, the mania) without worsening the other, the depression, he said. "It shows that the drug can be used to treat the acute episodes of mania, and that it does not cause depression during those acute episodes. Not only is there no worsening, but there is actually an improvement," he added. The positive benefit of olanzapine was observed after the first week of the study and continued out to week three. This suggests that people using olanzapine might be started out on the 15 mg/day dose for faster onset of action, then tapered back to 10 mg/day once the symptoms have resolved. Despite its benefits though, olanzapine did lead to significantly greater weight gains among patients in the study. Fourteen percent gained between 5-10 kg over the course of the four-week study, while the average weight gain was 2.1 kg.
Related Links: Olanzapine.
|
