Literature DB >> 17845277

Onset of antidepressant effect of olanzapine and olanzapine/fluoxetine combination in bipolar depression.

Sanjay Dubé1, Gary D Tollefson, Michael E Thase, Susan D Briggs, Luann E Van Campen, Michael Case, Mauricio Tohen.   

Abstract

OBJECTIVES: The current analysis investigated the onset of antidepressant effect of olanzapine/fluoxetine combination.
METHODS: Data for these post hoc analyses were obtained from a clinical trial comparing olanzapine, placebo, and olanzapine/fluoxetine combination in bipolar depression (BD). Subjects were 833 patients with a DSM-IV diagnosis of bipolar I disorder, depressed. The Montgomery-Asberg Depression Rating Scale measured depressive symptoms. Multiple analytic methods were applied, including traditional (mean differences) analysis, pattern analysis, survival analysis of sustained response, mixed-effects regression, and area-under-the-curve analysis.
RESULTS: Traditional analysis showed significantly greater improvement in depression scores at week 1 for olanzapine/fluoxetine combination versus placebo (-9.55 versus -5.08, p < 0.001) and for olanzapine versus placebo (-8.31 versus -5.08, p < 0.001). Pattern analysis revealed olanzapine/fluoxetine combination had a significantly greater percentage of early persistent responders than placebo or olanzapine (32.4% versus 12.7%, p < 0.001; and 18.3%, p < 0.05, respectively). Survival analysis showed a significantly shorter time to sustained response for the combination versus placebo (p < 0.001), for olanzapine versus placebo (p = 0.04), and for the combination versus olanzapine (p = 0.03). Mixed-effects regression analysis revealed a significant therapy-by-time interaction (p < 0.001). Early area-under-the-curve analysis revealed a significantly greater percentage of improvement for the combination versus placebo (26.7% versus 13.9%, p < 0.001) and for olanzapine versus placebo (22.0% versus 13.9%, p < 0.001).
CONCLUSIONS: Based on consistent results from related methods of measuring onset, olanzapine/fluoxetine combination demonstrated rapid onset of antidepressant effect (within 7 days) compared to placebo that was sustained over 8 weeks of treatment in a sample of BD patients. Using multiple statistical techniques may help profile a drug's onset of effect.

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Year:  2007        PMID: 17845277     DOI: 10.1111/j.1399-5618.2007.00491.x

Source DB:  PubMed          Journal:  Bipolar Disord        ISSN: 1398-5647            Impact factor:   6.744


  10 in total

Review 1.  The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm.

Authors:  Konstantinos N Fountoulakis; Lakshmi Yatham; Heinz Grunze; Eduard Vieta; Allan Young; Pierre Blier; Siegfried Kasper; Hans Jurgen Moeller
Journal:  Int J Neuropsychopharmacol       Date:  2017-02-01       Impact factor: 5.176

Review 2.  Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry.

Authors:  Konstantinos N Fountoulakis; Siegfried Kasper; Ole Andreassen; Pierre Blier; Ahmed Okasha; Emanuel Severus; Marcio Versiani; Rajiv Tandon; Hans-Jürgen Möller; Eduard Vieta
Journal:  Eur Arch Psychiatry Clin Neurosci       Date:  2012-06       Impact factor: 5.270

3.  General and comparative efficacy and effectiveness of antidepressants in the acute treatment of depressive disorders: a report by the WPA section of pharmacopsychiatry.

Authors:  Thomas C Baghai; Pierre Blier; David S Baldwin; Michael Bauer; Guy M Goodwin; Kostas N Fountoulakis; Siegfried Kasper; Brian E Leonard; Ulrik F Malt; Dan Stein; Marcio Versiani; Hans-Jürgen Möller
Journal:  Eur Arch Psychiatry Clin Neurosci       Date:  2011-11       Impact factor: 5.270

4.  Pharmacological Augmentation in Unipolar Depression: A Guide to the Guidelines.

Authors:  Rachael W Taylor; Lindsey Marwood; Emanuella Oprea; Valeria DeAngel; Sarah Mather; Beatrice Valentini; Roland Zahn; Allan H Young; Anthony J Cleare
Journal:  Int J Neuropsychopharmacol       Date:  2020-12-03       Impact factor: 5.176

5.  Class effect of pharmacotherapy in bipolar disorder: fact or misbelief?

Authors:  Konstantinos N Fountoulakis; Xenia Gonda; Eduard Vieta; Zoltan Rihmer
Journal:  Ann Gen Psychiatry       Date:  2011-03-24       Impact factor: 3.455

Review 6.  Molecular mechanisms underlying synergistic effects of SSRI-antipsychotic augmentation in treatment of negative symptoms in schizophrenia.

Authors:  Yael Chertkow; Orly Weinreb; Moussa B H Youdim; Henry Silver
Journal:  J Neural Transm (Vienna)       Date:  2009-07-04       Impact factor: 3.575

Review 7.  Olanzapine/fluoxetine: a review of its use in the treatment of acute bipolar depression.

Authors:  Emma D Deeks; Gillian M Keating
Journal:  Drugs       Date:  2008       Impact factor: 9.546

8.  Antidepressant Prescription Patterns in Bipolar Disorder: a Nationwide, Register-based Study in Korea.

Authors:  Woon Yoon; Seung-Hyun Shon; Youjin Hong; Yeon Ho Joo; Jung Sun Lee
Journal:  J Korean Med Sci       Date:  2018-10-19       Impact factor: 2.153

9.  Clinical research of Olanzapine for prevention of chemotherapy-induced nausea and vomiting.

Authors:  Lijun Tan; Jiangtao Liu; Xiuli Liu; Jie Chen; Zhijun Yan; Huifen Yang; Daxin Zhang
Journal:  J Exp Clin Cancer Res       Date:  2009-09-23

10.  Sleep architecture and cognitive changes in olanzapine-treated patients with depression: a double blind randomized placebo controlled trial.

Authors:  Lauren K Lazowski; Ben Townsend; Emily R Hawken; Ruzica Jokic; Regina du Toit; Roumen Milev
Journal:  BMC Psychiatry       Date:  2014-07-17       Impact factor: 3.630

  10 in total

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