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Olanzapine alone or in combination for acute mania
The Cochrane Database of Systematic Reviews
|August 15, 2003
Summary
Olanzapine effectively treats mania, outperforming placebo and divalproex in reducing manic symptoms. However, it is associated with increased weight gain and somnolence compared to other treatments.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Olanzapine is an atypical antipsychotic used for mania treatment.
- It can be used as monotherapy or in combination with other medications.
Purpose of the Study:
- To review the efficacy and tolerability of olanzapine in acute mania treatment.
- Compare olanzapine with placebo and other drugs like divalproex and haloperidol.
Main Methods:
- Systematic review of randomized controlled trials.
- Searched multiple databases including Cochrane, EMBASE, MEDLINE, CINAHL, and PsycINFO.
- Data extracted by two independent reviewers.
Main Results:
- Olanzapine superior to placebo in reducing manic (YMRS) and psychotic (PANSS) symptoms.
- Olanzapine showed greater efficacy than divalproex for manic symptoms (SMD: -0.29).
- Olanzapine led to more weight gain and somnolence but fewer discontinuations than placebo.
Conclusions:
- Olanzapine is an effective treatment for acute mania.
- Consider olanzapine's efficacy and adverse effects (weight gain, somnolence) in treatment decisions.
- Olanzapine may be more efficacious than divalproex, but with a higher incidence of weight gain.