OLANZAPINE IN TREATMENT-RESISTANT BIPOLAR DISORDER

Background: We evaluated the response to olanzapine in 14 consecutive patients with bipolar I disorder who were inadequately responsive to s tandard psychotropic agents. Methods: Fourteen patients with bipolar I disorder by DSM-IV criteria experiencing persistent affective symptom s inadequately responsive to at least one standard mood stabilizer wer e treated with open-label olanzapine by one of the authors. Response w as assessed with the Clinical Global Impression Scale modified for use in bipolar disorder (CGI-BP). Results: The 14 patients received olanz apine at a mean (SD dosage of 14.1+/-7.2 (range 5-30) mg/day for a mea n+/-SD of 101.4 + 56.3 (range 30-217) days of treatment. Of the 14 pat ients; 8 (57%) displayed much or very much overall improvement in thei r illness. In general, olanzapine was well tolerated. The most common side effects were sedation, tremor, dry mouth, and appetite stimulatio n with weight gain. Limitations: Data were obtained nonblindly and wit hout a randomized control group, and olanzapine was added to ongoing p sychotropic regimens. Conclusion: Olanzapine may have antimanic and mo od-stabilizing effects in some patients with bipolar disorder, and is generally well tolerated. Controlled studies of olanzapine in bipolar disorder appear warranted. (C) 1998 Elsevier Science B.V.