Olanzapine versus lithium in the acute treatment of bipolar mania: a double-blind, randomized, controlled trial.

BACKGROUND: This multicenter, double-blind, randomized, controlled study conducted in China examined the efficacy and safety of olanzapine versus lithium in the treatment of patients with bipolar manic/mixed episodes. METHODS: Patients with bipolar manic or mixed episode (DSM-IV criteria) and Young Mania Rating Scale (YMRS) score> or =20 at screening received olanzapine (5-20 mg/day, n=69) or lithium carbonate (600-1800 mg/day, n=71) for 4 weeks. The primary outcome was mean change from baseline in Clinical Global Impressions-Bipolar Version Overall Severity of Illness (CGI-BP) score. Secondary efficacy measures included YMRS, Brief Psychiatric Rating Scale (BPRS), and Montgomery-Asberg Depression Rating Scale (MADRS) scores. Safety was also assessed. RESULTS: A significantly greater mean change was observed in olanzapine versus lithium patients in CGI-BP (Overall Severity) (P=0.009), YMRS (P=0.013), BPRS (P=0.032), and CGI-BP (Severity of Mania) (P=0.012) scores. More olanzapine than lithium patients experienced at least one adverse event possibly related to study drug (P=0.038). More olanzapine patients had a clinically significant weight increase (> or =7% of baseline weight) compared to lithium patients (P=0.009). More olanzapine patients completed the study than lithium patients, although this difference was not statistically significant (olz, 91.3%; lith, 78.9%; P=0.057). LIMITATIONS: No placebo arm was included; however both treatments have previously been reported to be more effective than placebo. CONCLUSIONS: These results suggest that olanzapine has superior efficacy to lithium in the acute treatment of patients with bipolar mania over a 4-week period. However, adverse events were experienced by a greater number of olanzapine patients than lithium patients.

The regional cerebral blood flow of naive schizophrenia before and after drug treatment by 99mTc-ECD brain SPECT imaging / 中国神经精神疾病杂志

Objective 　To investigate the effect of risperidone on regional cerebral blood flow (rCBF) and the relationship between efficacy and rCBF ratio. Methods　Twenty four naive schizophrenic patients (diagnosed according to the ICD 10) completed 8 weeks treatment with risperidone. Ten patients were male and 14 were female. Twenty six healthy controls were enrolled as control group. The treatment dose of risperidone was 3～6 mg/d. After 8 weeks treatment, brain imaging was conducted again. Results　Before treatment with risperidone, compared to the control group, the baseline rCBF ratios of left and right inferior posterior temporal of patients were higher and the cognitive activated rCBF ratios of left mid-lateral frontal was lower. After treatment, the baseline state rCBF ratios of right lateral temporal, left and right superior posterior temporal were significantly decreased. The cognitive activated rCBF ratios of left and right inferior medial frontal, left inferior lateral frontal, left superior fronto temporal and left superior lateral fronal significantly increased. The efficacy was correlated with changes of the baseline rCBF ratio in some RIOs. Conclusions　Risperidone could change the blood perfusion in some ROIs. It suggested that the perfusion in these ROIs could be useful for predicting treatment efficacy.