Olanzapine combined with mood stabilizers in prevention of recurrence in bipolar disorder: An 18-month study

Tohen, M.; Suppes, Trisha; Baker, Richard L.; Evans, A.R.; Calabrese, J. R.

doi:10.1016/s0924-977x(02)80450-3

Cited by 13 publications

(11 citation statements)

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“…Patients experience significantly greater impairment and longer times to recovery from depressive than manic episodes and high levels of residual depressive symptoms between episodes. [1][2][3][4][5][6][7] The limited efficacy of pharmacotherapy alone [8][9][10][11] has motivated the study of adjunctive psychosocial interventions. Randomized controlled trials support the efficacy of adjunctive cognitive behavior therapy (CBT), 12,13 family-focused treatment (FFT) or similar forms of family psychoeducation, [14][15][16][17][18] interpersonal and social rhythm therapy (IPSRT), 19 and group psychoeducation 20,21 in preventing depressive and manic recurrences, stabilizing symptoms, or enhancing functioning in 1-to 2-year periods.…”

mentioning

confidence: 99%

Psychosocial Treatments for Bipolar Depression

Miklowitz

Otto

Frank

et al. 2007

Arch Gen Psychiatry

460

161

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Context: Psychosocial interventions have been shown to enhance pharmacotherapy outcomes in bipolar disorder.Objective: To examine the benefits of 4 disorderspecific psychotherapies in conjunction with pharmacotherapy on time to recovery and the likelihood of remaining well after an episode of bipolar depression.Design: Randomized controlled trial.Setting: Fifteen clinics affiliated with the Systematic Treatment Enhancement Program for Bipolar Disorder.Patients: A total of 293 referred outpatients with bipolar I or II disorder and depression treated with protocol pharmacotherapy were randomly assigned to intensive psychotherapy (n = 163) or collaborative care (n=130), a brief psychoeducational intervention.Interventions: Intensive psychotherapy was given weekly and biweekly for up to 30 sessions in 9 months according to protocols for family-focused therapy, interpersonal and social rhythm therapy, and cognitive behavior therapy. Collaborative care consisted of 3 sessions in 6 weeks. Main Outcome Measures:Outcome assessments were performed by psychiatrists at each pharmacotherapy visit.Primary outcomes included time to recovery and the proportion of patients classified as well during each of 12 study months.Results: All analyses were by intention to treat. Rates of attrition did not differ across the intensive psychotherapy (35.6%) and collaborative care (30.8%) conditions. Patients receiving intensive psychotherapy had significantly higher year-end recovery rates (64.4% vs 51.5%) and shorter times to recovery than patients in collaborative care (hazard ratio, 1.47; 95% confidence interval, 1.08-2.00; P=.01). Patients in intensive psychotherapy were 1.58 times (95% confidence interval, 1.17-2.13) more likely to be clinically well during any study month than those in collaborative care (P=.003). No statistically significant differences were observed in the outcomes of the 3 intensive psychotherapies.Conclusions: Intensive psychosocial treatment as an adjunct to pharmacotherapy was more beneficial than brief treatment in enhancing stabilization from bipolar depression. Future studies should compare the costeffectiveness of models of psychotherapy for bipolar disorder.

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confidence: 99%

Psychosocial Treatments for Bipolar Depression

Miklowitz

Otto

Frank

et al. 2007

Arch Gen Psychiatry

460

161

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“…A number of unpublished reports of the efficacy of olanzapine in bipolar disorder have been presented in trials comparing olanzapine against lithium, divalproex and placebo. These suggest that olanzapine may have efficacy in the maintenance phase of bipolar disorder 101–106 . Aripiprazole treatment has also demonstrated efficacy in maintenance in a 26‐week placebo‐controlled trial of 161 patients with Bipolar I Disorder 107…”

Section: Treatment Options In Bipolar Disordermentioning

confidence: 99%

“…These suggest that olanzapine may have efficacy in the maintenance phase of bipolar disorder. [101][102][103][104][105][106] Aripiprazole treatment has also demonstrated efficacy in maintenance in a 26week placebo-controlled trial of 161 patients with Bipolar I Disorder. 107 Additionally, there is evidence from double-blind, placebo controlled studies to support the use of olanzapine, aripiprazole, quetiapine, risperidone and ziprasidone in the treatment of acute mania.…”

Section: Role Of the Atypical Antipsychoticsmentioning

confidence: 99%

The management of bipolar disorder in primary care: A review of existing and emerging therapies

Berk

Dodd

Berk

2005

Psychiatry Clin Neurosci

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Recent evidence suggests that the prevalence of bipolar disorder is as much as fivefold higher than previously believed, and may amount to nearly 5% of the population, making it almost as common as unipolar major depression. It is, therefore, not unrealistic to assume that primary care or family physicians will frequently encounter bipolar patients in their practice. Such patients may present with a depressive episode, for a variety of medical reasons, for longer-term maintenance after stabilization, and even with an acute manic episode. Whatever the reason, a working knowledge of current trends in the acute and longer-term management of bipolar disorder would be helpful to the primary care physician. In addition, an understanding of important side-effects and drug interactions that occur with drugs used to treat bipolar disorder, which may be encountered in the medical setting, are paramount. This paper will attempt to review existing and emerging therapies in bipolar disorder, as well as their common drug interactions and side-effects.

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“…Such effects could be additive or synergistic and raise the possibility that treatment with more than one agent, each exerting effects at different points along a pathophysiological process, might be more beneficial in acute and long-term treatment than treatment with one agent alone. This possibility has only recently been supported by preliminary acute treatment 61,89 and maintenance studies. 50,90 …”

Section: Primary Mood Stabilizers and Mechanisms Of Actionmentioning

confidence: 99%

What makes a drug a primary mood stabilizer?

et al. 2002

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The term 'mood stabilizer' has been applied to a number of medications for the treatment of patients with bipolar disorder. The operational definition of the properties of a mood-stabilizing medication has varied according to the properties of specific medications and the clinical characteristics of the illness. Randomized controlled trials of agents accepted or proposed as mood stabilizers are reviewed to marshall the available evidence in support of this claim. In addition, potential pharmacological mechanisms underlying mood-stabilizing effects of established compounds are reviewed. Molecular Psychiatry (2002) 7, S8-S14.

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Olanzapine combined with mood stabilizers in prevention of recurrence in bipolar disorder: An 18-month study

Cited by 13 publications

References 0 publications

Psychosocial Treatments for Bipolar Depression

Psychosocial Treatments for Bipolar Depression

The management of bipolar disorder in primary care: A review of existing and emerging therapies

What makes a drug a primary mood stabilizer?

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