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

363 Use of atypical antipsychotic agentsTable 16.2 Improvement from baseline Young Mania Rating Scale in manic versus mixedpatients treated with olanzapine or a comparatorDuration Group Manic Mixed Interaction3 weeks Olanzapine 37% (n ¼ 58) 28% (n ¼ 12) P ¼ 0.998Placebo 16% (n ¼ 54) 25% (n ¼ 12)3 weeks Olanzapine 49% (n ¼ 69) 48% (n ¼ 56) P ¼ 0.950Divalproex 36% (n ¼ 74) 38% (n ¼ 52)4 weeks Olanzapine 53% (n ¼ 31) 50% (n ¼ 23) P ¼ 0.706Placebo 26% (n ¼ 33) 30% (n ¼ 23)6 weeks Olanzapine þ lithium or valproate 60% (n ¼ 99) 58% (n ¼ 121) P ¼ 0.708Placebo þ lithium or valproate 45% (n ¼ 60) 34% (n ¼ 54)Finally, initial results are available of a 1-year comparison of olanzapine 5–20mg/day and lithium (mean level 0.77 mmol/l) for relapse prevention amongbipolar patients stabilized on an open combination of olanzapine and lithiumand a 1-year comparison of olanzapine to placebo for relapse prevention amongmanic patients openly stabilized on olanzapine (Tohen et al., 2004). The lithiumcomparison study however enrolled very few (