Bipolar Disorders: Mixed States, Rapid-Cycling, and Atypical Forms

360 R. W. Baker et al.extrapyramidal symptom ratings (Simpson-Angus and Barnes Akathisia scales)did not differ between treatment groups.A6-weektrial(Tohenet al., 2002b), predominantly in outpatients with at leastmoderate symptoms of a manic or mixed episode, compared double-blind additionof olanzapine 5–20 mg/day (n ¼ 229) or placebo (n ¼ 115) to open treatment withvalproate or lithium that had been established for at least 2 weeks. Mean YMRSimprovement at endpoint was superior in the olanzapine group (59% reduction)compared to the placebo group (40%). Response rates were 68% in the olanzapineco-therapy group, versus 45% in patients receiving lithium or divalproex monotherapy(P