Olanzapine or chlorpromazine plus lithium in first episode psychotic mania: An 8-week randomised controlled trial.

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State: Public
Version: author
Serval ID
serval:BIB_C99929E80ACE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Olanzapine or chlorpromazine plus lithium in first episode psychotic mania: An 8-week randomised controlled trial.
Journal
European Psychiatry
Author(s)
Conus P., Berk M., Cotton S.M., Kader L., Macneil C., Hasty M.K., Hallam K., Lambert M., Murphy B.P., McGorry P.D.
ISSN
1778-3585 (Electronic)
ISSN-L
0924-9338
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
30
Number
8
Pages
975-982
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Treatment strategies for mental disorders may vary according to illness stage. However no data currently exist to guide treatment in first episode psychotic mania. The aim of this study was to compare the safety and efficacy profile of chlorpromazine and olanzapine, as add-on to lithium, in patients with a first episode of psychotic mania, expecting better safety profile and adherence to olanzapine but similar efficacy for both treatments.
METHODS: Data from 83 patients were collected in an 8-week randomised controlled trial on clinical variables, side effects, vital signs, and weight. Analyses of treatment differences over time were based on intent-to-treat principles. Kaplan-Meier estimated survival curves were used to analyse time-to-event data and mixed effects models repeated measures analysis of variance were used to determine treatment group differences over time on safety and efficacy measures.
RESULTS: Ethics committee approval to delay informed consent procedure until recovery from the acute episode allowed the inclusion of 83 patients highly representative of those treated in the public sector. Contrary to our hypotheses, safety profile of both medications was similar. A signal for higher rate (P=.032) and earlier occurrence (P=.043) of mania remission was observed in the olanzapine group which did not survive correction for multiple comparisons.
CONCLUSIONS: Olanzapine and chlorpromazine have a similar safety profile in a uniquely representative cohort of patients with first episode psychotic mania. The possibility for a greater impact of olanzapine on manic symptoms leading to earlier remission of the episode needs exploration in a large sample.
Keywords
Adult, Antipsychotic Agents/administration & dosage, Antipsychotic Agents/adverse effects, Benzodiazepines/administration & dosage, Benzodiazepines/adverse effects, Bipolar Disorder/diagnosis, Bipolar Disorder/drug therapy, Chlorpromazine/administration & dosage, Chlorpromazine/adverse effects, Diagnostic and Statistical Manual of Mental Disorders, Drug Monitoring, Female, Humans, Lithium/therapeutic use, Male, Psychotic Disorders/drug therapy, Treatment Outcome
Pubmed
Web of science
Create date
29/10/2015 10:56
Last modification date
20/08/2019 16:44
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