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

Conus, P., Berk, M., Cotton, S. M., Kader, L., Macneil, C., Hasty, M. K., Hallam, K., Lambert, M., Murphy, B. P. and McGorry, P. D. 2015, Olanzapine or chlorpromazine plus lithium in first episode psychotic mania: An 8-week randomised controlled trial, European psychiatry, vol. 30, no. 8, pp. 975-982, doi: 10.1016/j.eurpsy.2015.09.009.

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Title Olanzapine or chlorpromazine plus lithium in first episode psychotic mania: An 8-week randomised controlled trial
Author(s) Conus, P.
Berk, M.ORCID iD for Berk, M. orcid.org/0000-0002-5554-6946
Cotton, S. M.
Kader, L.
Macneil, C.
Hasty, M. K.
Hallam, K.
Lambert, M.
Murphy, B. P.
McGorry, P. D.
Journal name European psychiatry
Volume number 30
Issue number 8
Start page 975
End page 982
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2015-11
ISSN 1778-3585
Keyword(s) Antipsychotic treatment
Bipolar disorder
First episode
Mania
Psychosis
Summary 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.
Language eng
DOI 10.1016/j.eurpsy.2015.09.009
Field of Research 11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
111502 Clinical Pharmacology and Therapeutics
Socio Economic Objective 920410 Mental Health
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2015, Elsevier
Persistent URL http://hdl.handle.net/10536/DRO/DU:30079893

Document type: Journal Article
Collection: School of Medicine
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