Olanzapine vs. lithium in management of acute mania

Abstract

Objective Among the available mood stabilizers, it appears that lithium may share an important role for treatment of acute mania. In a study from Sep. 2007 to Apr. 2008 at Razi Psychiatric Hospital we evaluated the efficiency of olanzapine vs. lithium. Methods Forty (40) female inpatients meeting DSM-IV-TR criteria for acute mania were entered into a 3-week parallel group, double-blind study for random assignment to olanzapine or lithium carbonate in a 1:1 ratio. Primary outcome measurements were the changes in Manic State Rating Scale (MSRS) at baseline and weekly intervals up to the third week. Similarly, overall illness severity was rated using the Clinical Global Impression-Severity of illness scale (CGI-S) at baseline and at the end of the third week. Analysis of the data was accomplished by means of split-plot (mixed) and repeated measures analysis of variance (ANOVA) and t test. Results While both olanzapine and lithium were found to be significantly helpful in the improvement of manic symptoms ( p < 0.05), lithium was considerably more successful by the end of the third week ( p < 0.0002 and p < 0.003, for frequency and intensity of the symptoms). CGI-S also showed important improvements with both olanzapine and lithium ( p < 0.043 and p < 0.015 for olanzapine and lithium). Conclusion Though both olanzapine and lithium were effective in the improvement of manic symptoms, lithium was more beneficial.