Olanzapine Versus Risperidone in the Treatment of Manic or Mixed States in Bipolar I Disorder

Perlis, Roy H.; Baker, Robert W.; Zarate, Carlos A.; Brown, Eileen; Schuh, Leslie M.; Jamal, Hassan H.; Tohen, Mauricio

doi:10.4088/jcp.v67n1112

Cited by 83 publications

(50 citation statements)

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“…However, adverse events were experienced by a greater number of olanzapine patients than lithium patients which may limit olanzapine's clinical utility (Niufan et al 2008). In a direct comparative study with risperidone, no difference in antimanic efficacy was observed (Perlis et al 2006a). With haloperidol as comparator, haloperidol was significantly better at week 6 (primary endpoint), but at week 12 the efficacy of olanzapine and haloperidol were comparable (Tohen et al 2003a).…”

Section: Olanzapinementioning

confidence: 99%

“…Comparison with haloperidol showed no difference in antimanic efficacy (Scherk et al 2007). Additionally, a small head-to head comparison trial against lithium and haloperidol (Segal et al 1998) and a larger comparison against olanzapine (Perlis et al 2006a) support the antimanic efficacy of risperidone monotherapy.…”

Section: Risperidonementioning

confidence: 99%

“…Direct comparative trials between these antimanic substances are still limited, especially between different atypicals, the one exception being olanzapine vs. risperidone (Perlis et al 2006a). Others are either inconclusive (olanzapineÁvalproate (Zajecka et al 2002;Tohen et al 2003b;Tohen et al 2009b), aripiprazoleÁhaloperidol (Vieta et al 2005a)), not powered for comparing investigational drug and comparator, or the relevant statistical comparison has not been made (the various studies using lithium as comparator, or olanzapine as comparator for asenapine ).…”

Section: How Do Antimanics Compare?mentioning

confidence: 99%

See 2 more Smart Citations

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania

Grunze

Vieta

Goodwin

et al. 2009

The World Journal of Biological Psychiatry

316

247

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These updated guidelines are based on a first edition that was published in 2003, and have been edited and updated with the available scientific evidence until end of 2008. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the treatment of acute mania in adults. The data used for these guidelines have been extracted from a MEDLINE and EMBASE search, from the clinical trial database clinicaltrials.gov, from recent proceedings of key conferences, and from various national and international treatment guidelines. Their scientific rigor was categorised into six levels of evidence (AÁF). As these guidelines are intended for clinical use, the scientific evidence was finally asigned different grades of recommendation to ensure practicability.

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Section: Olanzapinementioning

confidence: 99%

Section: Risperidonementioning

confidence: 99%

Section: How Do Antimanics Compare?mentioning

confidence: 99%

See 1 more Smart Citation

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania

Grunze

Vieta

Goodwin

et al. 2009

The World Journal of Biological Psychiatry

316

247

View full text Add to dashboard Cite

show abstract

“…The only randomized, controlled study comparing two atypical agents showed no difference in the primary outcome between olanzapine and risperidone (65). Two outstanding systematic reviews on treatment for acute mania have been recently published (66,67).…”

Section: Comparisons Between Pharmacological Agentsmentioning

confidence: 99%

Antipsychotic agents in the treatment of bipolar mania

Tohen

Vieta

2009

Bipolar Disorders

Self Cite

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Objectives: Antipsychotics have been widely used in the treatment of bipolar mania. The purpose of this manuscript was to briefly review the evidence of typical and atypical antipsychotics for the treatment of bipolar mania.Methods: A detailed literature review was conducted on the use of typical and atypical antipsychotics in the treatment of bipolar mania using standard search engines. A summary of the published literature on each agent is described followed by a discussion on the overall comparison of the different agents.Results: For typical antipsychotics, up until recently, there was a paucity of published evidence on their strengths and limitations in the treatment of bipolar mania. Recent studies have demonstrated clear evidence on the efficacy of haloperidol on the treatment of acute mania. The literature suggests a faster onset of action of haloperidol as compared to either lithium or atypical antipsychotics. A limitation of typical antipsychotics however, is the risk of tardive dyskinesia, extrapyramidal side effects and a possible increased risk of non‐adherence. Evidence on the efficacy for atypical antipsychotics has been demonstrated for aripiprazole, clozapine, olanzapine, quetiapine, risperidone and ziprasidone. Limitations as regards the use of atypical antipsychotics include the risk of weight gain and dyslipidemia. Comparison among different atypical antipsychotics agents are difficult to determine as there are no conclusive head to head studies. There is also a paucity of studies comparing atypical antipsychotics with lithium.Conclusions: Evidence exists on the efficacy of both typical and atypical antipsychotics on the treatment of acute mania such that they are now clearly first‐line along with lithium. An important limitation of the published literature is that most of the studies were designed to obtain regulatory approval for the different agents therefore the generalizability of the findings to clinical practice remains unclear.

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“…Risperidone is significantly better than placebo & Khanna et al 2005 and has equal efficacy to Lithium, Haloperidol (Segal et al 1998) and Olanzapine (Perlis et al 2006). There is significant reduction in symptoms of mania as assessed by Young Mania Rating scale (YMRS).…”

Section: Risperidonementioning

confidence: 99%