Lizheng Shi

Olanzapine versus haloperidol in the treatment of acute mania: clinical outcomes, health-related quality of life and work status

We aimed to compare clinical outcomes, health-related quality of life (HRQOL) and work status associated with olanzapine and haloperidol treatment in patients with bipolar disorder. This double-blind, randomized controlled trial, comparing flexible dosing of olanzapine (5–20 mg/day, n =234) to haloperidol (3–15 mg/day, n =219), consisted of a 6-week acute phase, followed by a 6-week continuation phase. Symptomatic remission rates were similar for olanzapine- and haloperidol-treated patients at weeks 6 and 12. At week 6, significant changes in five dimensions of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) [general health (P =0.010), physical functioning (P <0.001), role limitations due to physical problems (P <0.001), social functioning (P <0.05) and vitality (P <0.01)] and the SF-36 physical components summary score were found in favour of olanzapine compared to haloperidol. At week 12, olanzapine treatment maintained the significantly favourable HRQOL changes. At the end of week 12, patients on olanzapine showed significantly greater improvement than haloperidol in work activities impairment and household activities impairment scores on the Streamlined Longitudinal Interview Clinical Evaluation from the Longitudinal Interval Follow-up Evaluation (SLICE/LIFE) activities impairment scores. Subgroup analyses revealed that olanzapine treatment significantly increased a proportion of employed patients and their weekly paid working hours. In conclusion, compared to haloperidol, olanzapine treatment was comparably effective in the remission of bipolar mania and significantly improved HRQOL and work status in patients with bipolar I disorder.

Service utilization and costs of olanzapine versus divalproex treatment for acute mania: results from a randomized, 47-week clinical trial

ABSTRACT Objective: This study examined direct treatment costs based on medication and service use data collected in a 47-week multi-center, double-blind, randomized clinical trial of olanzapine versus divalproex for patients with bipolar disorder and experiencing acute mania. Research design and methods: Patients who completed the 3-week acute phase and entered into the 44-week maintenance phase (n = 147) of the trial were included. Service use data were collected at weeks 3, 7, 15, 23, 31, 39 and 47 of the maintenance phase. Analyses were conducted to address potential biases from discontinuation patterns and use of this patient sub-sample. Results: Overall, per patient yearly costs were similar for olanzapine- and divalproex-treated patients (

Open-label olanzapine treatment in bipolar I disorder: clinical and work functional outcomes

14 967 vs.

Improvement of Positive and Negative Syndrome Scale cognitive score associated with olanzapine treatment of acute mania.

15 801). Psychiatric-related costs accounted for 95.4% and 93.6% of the total costs for olanzapine- and divalproex-treated patients, respectively. Study medication costs were significantly higher for olanzapine than for divalproex (

Effects of olanzapine alone and olanzapine/fluoxetine combination on health-related quality of life in patients with bipolar depression: secondary analyses of a double-blind, placebo-controlled, randomized clinical trial.

4662 vs.

Quality of life assessment in patients with bipolar disorder treated with olanzapine added to lithium or valproic acid

1755, p < 0.01). However, this was offset by the combined effects of numerically lower costs for several other services with olanzapine treatment. Some of the savings associated with olanzapine treatment compared with divalproex treatment resulted from differences in costs associated with emergency room services (

Olanzapine vs divalproex: Prospective comparison on self-reported cognitive function in patients with bipolar disorder

432 vs.

Olanzapine versus haloperidol as initial treatment in acute mania: Prospective comparison of work functional outcomes

1346, p < 0.05). Conclusions: Overall per-patient treatment costs were similar for olanzapine and divalproex. Recognizing challenges in analyzing and generalizing cost outcomes from a clinical trial setting, results provide some much-needed comparative economic information regarding these two medication options for treating mania in bipolar disorder.

Long-term quality-of-life and economic outcomes associated with the use of olanzapine versus divalproex for acute mania

ABSTRACT Objectives: The objective of this study was to describe clinical and work functional outcomes associated with 6‐month open‐label olanzapine treatment for bipolar I disorder. Methods: The study consisted of 249 patients entering a 6‐month open label phase after 12 weeks of acute double-blind haloperidol or olanzapine treatment. Baseline for analysis was defined as the beginning of open-label treatment. The clinical outcomes were symptomatic remission defined by a Y‐MRS total score ≤ 12 and a HAM‐D total score ≤ 8 at the end of 6 months of treatment. The work functional outcomes included work functional scores, the proportion of patients who reported to ‘work’ as employee, volunteers, students, or house workers and the proportion of patients who specifically reported to ‘work for pay’. Results: A total of 240 patients reported work functional outcomes post open-label baseline. Among them, 15.4% patients moved into a ‘work group’ from a ‘no-work group’ at baseline, while 7.1% did the opposite ( p = 0.0065) and 13.3% reported an improvement to ‘work for pay’ status from a ‘not working for pay’ status at baseline, while there was 4.2% of worsening in employment status ( p = 0.0007). Overall, improvement in the work functional score was found at all post-baseline time points, beginning at month two ( p = 0.003). Limitations: Results of this study need to be confirmed by double-blind randomized controlled studies. There was a lack of detailed information on work functioning from the questionnaire. Conclusions: Open‐label olanzapine treatment for 6 months was associated with improvements in work functional outcomes in patients with bipolar disorder.

Clinical and health-related quality of life outcomes associated with olanzapine in patients with bipolar disorder as compared with haloperidol

SUMMARY Objective: This study analyzed the effect of olanzapine on a psychopathology-based scale assessing abnormal thought processes and examined the relationship between improvement on this scale and mania and depression improvement in acutely manic patients. Methods: The study sample (N = 254) was pooled from two double-blind, randomized, placebo-controlled clinical trials. Disturbance in thought processes was measured by the Positive and Negative Symptom Scale cognitive component (PANSS-Cognitive) score. Mood severity was measured by the Young-Mania Rating Scale (Y-MRS) and Hamilton Depression Inventory (HAM-D). Last-observation-carried-forward (LOCF) changes from baseline to endpoint (Week 3) were presented for patients who had at least one post-baseline assessment. Results: Olanzapine-treated patients experienced modest but significant improvement in PANSS-Cognitive score (olanzapine: –4.25 n = 124; placebo: –1.69 n = 120, p < 01), regardless of age, gender, mania subtype (pure, mixed), course (rapid or non-rapid cycling), or the presence or absence of psychotic features. PANSS-Cognitive improvement was more highly correlated with mania than depression improvement. Conclusion: Olanzapine improved abnormal thought processes measured by the PANSS-Cognitive score in patients with acute mania. This improvement in thought processes was significantly associated with improvement in acute mania. More sensitive and specific neuropsychological testing could help clarify whether improvement in thought processes on olanzapine was independent of mania reduction.