Olanzapine compared to lithium in mania: a double-blind randomized controlled trial

Neuroleptics are of established efficacy in mania. Controlled data on the u se of olanzapine in mania is however, absent. In this study 30 patients mee ting DSM-IV criteria for mania were randomly allocated to receive either ol anzapine or lithium in a 4 week double-blind randomized controlled design. There were no significant outcome differences between the two groups on any of the primary outcome measures, the Brief Psychiatric Rating Scale (lithi um 28.2; olanzapine 28.0; P = 0.44); Clinical Global Impression (CGI) impro vement scale (lithium 2.75, olanzapine 2.36; P = 0.163) or the Mania Scale (lithium 13.2, olanzapine 10.2; P = 0.315). Olanzapine was however, signifi cantly superior to lithium on the CGI-severity scale at week 4 (lithium 2.8 3, olanzapine 2.29; P 0.025). Olanzapine did not differ from lithium in ter ms of treatment emergent extrapyramidal side-effects as measured by the Sim pson-Angus Scale. Olanzapine appears to be at least as effective as lithium in the treatment of mania. Int ain Psychopharmacol 14:339-343 (C) 1999 Lip pincott Williams & Wilkins.