Bridle, C., Palmer, Stephen, MSc, Bagnall, A.-M., Darba, J., Duffy, Steven, 1969-, Sculpher, Mark J. and Riemsma, R. P.. (2004) A rapid and systematic review and economic evaluation of the clinical effectiveness and cost-effectiveness of newer drugs for treatment of mania associated with bipolar affective disorder. Health Technology Assessment, Vol.8 (No.19). pp. 1-200. ISSN 1366-5278

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Abstract

Objectives: To evaluate the clinical and cost-effectiveness of quetiapine, olanzapine and valproate semisodium in the treatment of mania associated with bipolar disorder. Data sources: Electronic databases; industry submissions made to the National Institute for Clinical Excellence. Review methods: Randomised trials and economic evaluations that evaluated the effectiveness of quetiapine, olanzapine or valproate semisodium in the treatment of mania associated with bipolar disorder were selected for inclusion. Data were extracted by one reviewer into a Microsoft Access database and checked for quality and accuracy by a second. The quality of the cost-effectiveness studies was assessed using a checklist updated from that developed by Drummond and colleagues. Relative risk and mean difference data were presented as Forest plots but only pooled where this made sense clinically and statistically. Studies were grouped by drug and, within each drug, by comparator used. χ2 tests of heterogeneity were performed for the outcomes if pooling was indicated. A probabilistic model was developed to estimate costs from the perspective of the NHS, and health outcomes in terms of response rate, based on an improvement of at least 50% in a patient’s baseline manic symptoms derived from an interview-based mania assessment scale. The model evaluated the cost-effectiveness of the alternative drugs when used as part of treatment for the acute manic episode only. Results: Eighteen randomised trials met the inclusion criteria. Aspects of three of the quetiapine studies were commercial-in-confidence. The quality of the included trials was limited and overall, key methodological criteria were not met in most trials. Quetiapine, olanzapine and valproate semisodium appear superior to placebo in reducing manic symptoms, but may cause side-effects. There appears to be little difference between these treatments and lithium in terms of effectiveness, but quetiapine is associated with somnolence and weight gain, whereas lithium is associated with tremor. Olanzapine as adjunct therapy to mood stabilisers may be more effective than placebo in reducing mania and improving global health, but it is associated with more dry mouth, somnolence, weight gain, increased appetite, tremor and speech disorder. There was little difference between these treatments and haloperidol in reducing mania, but haloperidol was associated with more extrapyramidal side-effects and negative implications for health-related quality of life. Intramuscular olanzapine and lorazepam were equally effective and safe in one very short (24 hour) trial. Valproate semisodium and carbamazepine were equally effective and safe in one small trial in children. Olanzapine may be more effective than valproate semisodium in reducing mania, but was associated with more dry mouth, increased appetite, oedema, somnolence, speech disorder, Parkinson-like symptoms and weight gain. Valproate semisodium was associated with more nausea than olanzapine. The results from the base-case analysis demonstrate that choice of optimal strategy is dependent on the maximum that the health service is prepared to pay per additional responder. For a figure of less than £7179 per additional responder, haloperidol is the optimal decision; for a spend in excess of this, it would be olanzapine. Under the most favourable scenario in relation to the costs of responders and non-responders beyond the 3-week period considered in the base-case analysis, the incremental cost-effectiveness ratio of olanzapine is reduced to £1236. Conclusions: In comparison with placebo, quetiapine, olanzapine and valproate semisodium appear superior in reducing manic symptoms, but all drugs are associated with adverse events. In comparison with lithium, no significant differences were found between the three drugs in terms of effectiveness, and all were associated with adverse events. Several limitations of the cost-effectiveness analysis exist, which inevitably means that the results should be treated with some caution. There remains a need for well-conducted, randomised, double-blind head-to-head comparisons of drugs used in the treatment of mania associated with bipolar disorder and their cost-effectiveness. Participant demographic, diagnostic characteristics, the treatment of mania in children, the use of adjunctive therapy and long-term safety issues in the elderly population, and acute and long-term treatment are also subjects for further study.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Manic-depressive illness -- Treatment -- Cost effectiveness, Mania -- Treatment -- Cost effectiveness, Olanzapine -- Cost effectiveness
Journal or Publication Title:	Health Technology Assessment
Publisher:	NIHR Health Technology Assessment programme
ISSN:	1366-5278
Date:	May 2004
Volume:	Vol.8
Number:	No.19
Page Range:	pp. 1-200
Identification Number:	10.3310/hta8190
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	NIHR Health Technology Assessment Programme (Great Britain)
References:	1. Angst J, Bowden CL, Calabrese JR, Chengappa R, Goodwin G, Lecrubier Y, et al. ECNP consensus meeting March 2000: NICE guidelines for investigating efficacy in bipolar disorder. Eur Neuropsychopharmacol 2001;11:79–88. 2. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997; 349:1436–42. 3. Dinan TG. Lithium in bipolar mood disorder. BMJ 2002;324:989–90. 4. Muller Oerlinghausen B, Berghofer A, Bauer M. Bipolar disorder. Lancet 2002;359:241–7. 5. Daly I. Mania. Lancet 1997;349:1157–60. 6. Miller-Oerlinghausen B, Muser-Causemann B, Volk J. Suicides and parasuicides in a high risk patient group on and off lithium long-term medication. J Affect Disord 1992;25:261–9. 7. Carlson GA, Strober M. Manic depressive-illness in early adolescence: a study of clinical and diagnostic characteristics in six cases. J Am Acad Child Adolesc Psychiatry 1978;17:138–53. 8. Woznniak J, Biederman J, Mundy E, Mennin D, Faraone SV. A pilot family study of childhoodonset mania. J Am Acad Child Adolesc Psychiatry 1995;34:1577–83. 9. DeLong GR, Aldershof AL. Long-term experience with lithium treatment in childhood: correlation with clinical diagnosis. J Am Acad Child Adolesc Psychiatry 1987;26:389–94. 10. Koegal P, Burman MA, Farr RK. The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles. Arch Gen Psychiatry 1988;45:1085–92. 11. Angst J. The emerging epidemiology of hypomania and bipolar II disorder. J Affect Disord 1998;50:143–51. 12. McGuffin P, Katz R. Nature, nurture and affective disorder. In Deakin JWF, editor. The biology of depression. London: Gaskell; 1986. pp. 26–51. 13. Nurnberger JI, Gershon E. Genetics. In Paykel ES, editor. Handbook of affective disorders. 2nd ed. New York: Churchill Livingstone; 1992. pp. 131–48. 14. Goodwin FK, Jamison KR. Manic-depressive illness. New York: Oxford University Press; 1990. 15. Coryell W, Scheftner W, Keller M, Endicott J, Maser J, Klerman GL. The enduring psychosocial consequences of mania and depression. Am J Psychiatry 1993;150:720–7. 16. Das Gupta R, Guest JF. Annual cost of bipolar disorder to UK society. Br J Psychiatry 2002; 180:227–33. 17. British Medical Association, Royal Pharmaceutical Society of Great Britain. British National Formulary. London: BMA and Royal Pharmaceutical Society of Great Britain; 2002. p. 43. 18. Moore NA, Tye NC, Axton MS, Risius FC. The behavioral pharmacology of olanzapine, a novel ‘atypical’ antipsychotic agent. J Pharmacol Exp Ther 1992;262:545–51. 19. Keck PE, Jr, McElroy SL. Pharmacological treatments for bipolar disorder. In Nathan PE, Gorman JM, editors. A guide to treatments that work. 2nd ed. Oxford: Oxford University Press; 2002. pp. 277–99. 20. Saller CF, Salama AI. Sequel: biochemical profile of a potential atypical antipsychotic. Psychopharmacology 1993;112:285–92. 21. Fariello R, Smith MC. Valproate: mechanisms of action. In Schatzberg AF, editor. Antiepileptic drugs. New York: Raven Press; 1989. pp. 567–75. 22. Chen G, Huang LD, Zeng WZ, Manji HK. Mood stabilizers regulate cytoprotective and mRNAbinding proteins in the brain: long-term effects on cell survival and transcript stability. Int J Neuropsychopharmacol 2001;4:47–64. 23. NHSCRD. Undertaking systematic reviews of research on effectiveness: CRD’s guidance for carrying out or commissioning reviews: CRD report 4. 2nd ed. York: NHS Centre for Reviews and Dissemination; 2001. 24. Drummond MF, O’ Brien B, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. 2nd ed. Oxford: Oxford Medical Publications; 1997. 25. National Institute for Clinical Excellence. Technical guidance for manufacturers and sponsors on making a submission to a technology appraisal. London: National Institute for Clinical Excellence; 2001. 26. AstraZeneca UK Ltd. The clinical and cost effectiveness of newer drugs for the treatment of mania associated with bipolar affective disorder: submission of evidence from AstraZeneca UK Ltd regarding the atypical antipsychotic quetiapine. Alderley Park, Macclesfield: AstraZeneca UK Ltd; October 2002. 27. AstraZeneca UK Ltd. The clinical and cost effectiveness of newer drugs for the treatment of mania associated with bipolar affective disorder: submission of evidence from AstraZeneca UK Ltd regarding the atypical antipsychotic quetiapine. Alderley Park, Macclesfield: AstraZeneca UK Ltd; November 2002. 28. Sachs G, Mullen JA, Devine NA, Sweitzer DE. Quetiapine vs placebo as adjunct to mood stabilizer in the treatment of acute mania [meeting abstract]. Eur Neuropsychopharmacol 2002; 12 (Suppl 3):S235. 29. Mullen J, Paulsson B. Quetiapine in combination with lithium or divalproex for the treatment of mania associated with bipolar disorder. In Fifth International Conference on Bipolar Disorder; 12–14 June 2003, Piitsburgh, PA. 30. Brecher M, Huizar K. Quetiapine monotherapy for acute mania associated with bipolar disorder. In Fifth International Conference on Bipolar Disorder, 12–14 June 2003, Pittsburgh, PA. 31. Jones M, Huizar K. Quetiapine monotherapy for mania associated with bipolar disorder. In Fifth International Conference on Bipolar Disorder, 12–14 June 2003, Pittsburgh, PA. 32. Jones M, Huizar K. Quetiapine monotherapy for mania associated with bipolar disorder. In 166th Annual Meeting of the American Psychiatric Association, 17–22 May 2003, San Francisco, CA. 33. DelBello MP, Schwiers ML, Rosenberg HL, Strakowski SM. A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. J Am Acad Child Adolesc Psychiatry 2002;41:1216–23. 34. Paulsson B, Huizar K. Quetiapine monotherapy for the treatment of bipolar mania. In Fifth Annual International Conference on Bipolar Disorder, 12–14 June 2003, Pittsburgh, PA. 35. Tohen M, Sanger TM, McElroy SL, Tollefson GD, Chengappa KN, Daniel DG, et al. Olanzapine versus placebo in the treatment of acute mania. Olanzapine HGEH Study Group. Am J Psychiatry 1999;156:702–9. 36. Tohen M, Jacobs TG, Grundy SL, McElroy SL, Banov MC, Janicak PG, et al. Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. The Olanzipine HGGW Study Group. Arch Gen Psychiatry 2000; 57:841–9. 37. Tohen M, Zhang F, Feldman PD, Evans AR, Breier AF. Olanzapine versus haloperidol in the treatment of acute mania [meeting abstract]. 2001 Annual Meeting of the American Psychiatric Association, 5–10 May 2001, New Orleans, LA. 38. Shi L, Namjoshi MA, Zhang F, Ghandi G, Edgell ET, Tohen M, et al. Olanzapine versus haloperidol in the treatment of acute mania: clinical outcomes, health-related quality of life and work status. Int Clin Psychopharmacol 2002;17:227–37. 39. Shi L, Namjoshi M, Tohen MF, Zhang F, Breier AF, Edgell ET. Olanzapine versus haloperidol: a prospective comparison of clinical and humanistic outcomes in bipolar disorder [meeting abstract]. In 2001 Annual Meeting of the American Psychiatric Association, 5–10 May 2001, New Orleans, LA. 40. Berk M, Ichim L, Brook S. Olanzapine compared to lithium in mania: a double-blind randomized controlled trial. Int Clin Psychopharmacol 1999; 14:339–43. 41. Tohen M, Chengappa KNR, Suppes T, Zarate CA, Jr, Calabrese JR, Bowden CL, et al. Efficacy of olanzapine in combination with valproate or lithium in the treatment of mania in patients partially nonresponsive to valproate or lithium monotherapy. Arch Gen Psychiatry 2002; 59:62–9. 42. Meehan K, Zhang F, David S, Tohen M, Janicak P, Small J, et al. A double-blind, randomized comparison of the efficacy and safety of intramuscular injections of olanzapine, lorazepam, or placebo in treating acutely agitated patients diagnosed with bipolar mania. J Clin Psychopharmacol 2001;21:389–97. 43. Meehan K, Breier A, David SR, Koch KE, Rizk R, Tohen M, et al. Efficacy and safety of intramuscular (im) olanzapine versus im lorazepam and im placebo in acutely agitated patients diagnosed with mania associated with bipolar disorder. Schizophr Res 2001;49:239. 44. Namjoshi M, Shi L, Zhang F, Edgell ET, Tohen MF, Breier AF. Olanzapine versus haloperidol: improvements in quality of life and compliance with treatment in patients with bipolar disorder. In 2001 Annual Meeting of the American Psychiatric Association, 5–10 May 2001, New Orleans, LA. 45. Tohen KF, Tohen M, Timpe TM, Risser R, Chengappa KR, Suppes TR, et al. Efficacy of olanzapine combined with mood stabilizers in the treatment of bipolar disorder. Schizophr Res 2001; 49:248. 46. Tohen M, Jacobs TG, Meyers TM, Risser RC, Keeter EL, Feldman PD, et al. Efficacy of olanzapine combined with mood stabilizers in the treatment of bipolar disorder. Int J Neuropsychopharmacol 2000;3 (Suppl 1):S335. 47. Tohen M, Jacobs TG, Timpe TM, Risser RC, Keeter EL, Chengappa KNR, et al. Efficacy of olanzapine combined with valproate or lithium in the treatment of bipolar disorder. Biol Psychiatry 2001;49:385. 48. Pope HG, Jr., McElroy SL, Keck PE, Jr, Hudson JI. Valproate in the treatment of acute mania: a placebo-controlled study. Arch Gen Psychiatry 1991; 48:62–8. 49. Bowden CL, Brugger AM, Swann AC, Calabrese JR, Janicak PG, Petty F, et al. Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group. JAMA 1994; 271:918–24. 50. Swann AC, Bowden CL, Morris D, Calabrese JR, Petty F, Small J, et al. Depression during mania: treatment response to lithium or divalproex. Arch Gen Psychiatry 1997;54:37–42. 51. Swann AC, Bowden CL, Calabrese JR, Dilsaver SC, Morris DD. Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry 1999;156:1264–6. 52. Bowden CL, Davis J, Morris D, Swann A, Calabrese J, Lambert M, et al. Effect size of efficacy measures comparing divalproex, lithium and placebo in acute mania. Depress Anxiety 1997;6:26–30. 53. Hirschfeld RM, Allen MH, McEvoy JP, Keck PE, Jr, Russell JM. Safety and tolerability of oral loading divalproex sodium in acutely manic bipolar patients. J Clin Psychiatry 1999;60:815–18. 54. Kowatch RA, Suppes T, Carmody TJ, Bucci JP, Hume JH, Kromelis M, et al. Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 2000;39:713–20. 55. McElroy SL, Keck PE, Stanton SP, Tugrul KC, Bennett JA, Strakowski SM. A randomized comparison of divalproex oral loading versus haloperidol in the initial treatment of acute psychotic mania. J Clin Psychiatry 1996;57:142–6. 56. Tohen M, Baker RW, Altshuler LL, Zarate CA, Suppes T, Ketter TA, et al. Olanzapine versus divalproex in the treatment of acute mania. Am J Psychiatry 2002;159:1011–17. 57. Zajecka J, Weisler R, Sommerville KW, Tracy K, Swann AC, Sachs G, et al. Divalproex sodium vs olanzapine for the treatment of mania in bipolar disorder. In 39th Annual Meeting of the American College of Neuropsychopharmacology, 10–14 December 2000, San Juan, Puerto Rico. Nashville, TN: Vanderbilt University Medical Center, American College of Neuropsychopharmacology; 2000. p. 257. 58. Keck PE, Jr, Nabulsi AA, Taylor JL, Henke CJ, Chmiel JJ, Stanton SP, et al. A pharmacoeconomic model of divalproex semisodium vs. lithium in the acute and prophylactic treatment of bipolar I disorder. J Clin Psychiatry 1996;57:213–22. 59. Keck PE, Jr., McElroy SL, Strakowski SM, West SA, Hawkins JM, Huber TJ, et al. Outcome and comorbidity in first- compared with multipleepisode mania. J Nerv Ment Dis 1995;183:320–4. 60. McElroy SL, Strakowski SM, Keck PE, Jr, Tugrul KL, West SA, Lonczak HS. Differences and similarities in mixed and pure mania. Compr Psychiatry 1995; 36:187–94. 61. Department of Health. Hospital episode statistics (HES) 2000/01 [monograph online]. 2002. Available at http://www.doh.gov.uk/hes/ [accessed 2002]. 62. Briggs A, Goeree R, Blackhouse G, O’Brien B. Probabilistic analysis of cost-effectiveness models: choosing between treatment strategies for gastroesophageal reflux disease. Med Decis Making 2002;22:290–308. 63. McAlistair F, Laupacis A, Wells G, Sackett D. Users’ guide to the medical literature. XIX Applying clinical trial results. B. Guidelines for determining whether a drug is exerting (more than) a class effect. JAMA 1999;282:1371–77. 64. Hasselblad V. Meta-analysis of multi-treatment studies. Med Decis Making 1998;18:37–43. 65. Higgins J, Whitehead J. Borrowing strength from external clinical trials in a meta-analysis. Stat Med 1996;15:2733–49. 66. Lumley T. Network meta-analysis for indirect treatment comparisons. Stat Med 2002;21:2313–24. 67. Ades A. A chain of evidence with mixed comparisons: models for multi-parameter evidence synthesis and consistency of evidence. Paper presented to DEEM workshop, 11–12 April, Oxford. Available at http://www.ihs.ox.ac.uk/herc/DEEM/Ades.pdf [accessed 2002]. 68. Johannesson M, Weinstein M. On the decision rules of cost-effectiveness analysis. J Health Econ 1993;12:459–67. 69. Van Hout B, Gordon G, Rutten F. Costs, effects and C/E ratios alongside a clinical trial. Health Econ 1994;3:309–19. 70. Fenwick E, Claxton K, Sculpher M. Representing uncertainty: the role of cost-effectiveness acceptability curves. Health Econ 2001;10:779–89. 71. Maj M, Priozzi R, Kemali D. Long term outcome of lithium prolaxis in patients initially classified as complete responders. Neuropharmacology 1988; 98:535–8. 72. Allen D. Olanzapine in the treatment of acute mania in the community. Psychiatr Bull R Coll Psychiatr 1998;22:189–190. Available at http://pb.rcpsych.org/. 73. Anon. Zyprexa: short-term treatment of acute manic episodes of bipolar disorder. Formulary 2000;35:388–90. 74. Anon. Multicenter study confirms value of divalproex for mania. Am J Hosp Pharm 1994; 51:388–90. 75. Anon. Disodium valproate: new preparation: an alternative for acute mania after lithium failure or intolerance. Prescrire Int 2001;10:113–15. 76. Anon. Combination therapy is most appropriate for acute mania. Drugs Ther Perspect 1995;6:12–14. 77. Baetz M, Bowen RC. Efficacy of divalproex sodium in patients with panic disorder and mood instability who have not responded to conventional therapy. Can J Psychiatry 1998;43:73–7. 78. Baker RW, Kinon BJ, Liu H, Richey A, Hill AL, Bergstrom RF, et al. Effectiveness of rapid initial dose escalation of oral olanzapine for acute agitation [meeting abstract]. In Meeting of American Psychiatric Association, 18–23 May 2002, Philadelphia, PA, USA. 79. Baker RW, Tohen M, Risser RC, Stauffer VL, Breier A, Tollefson GD. Depression during mania: treatment response to olanzapine or placebo [meeting abstract]. Eur Neuropsychopharmacol 2000;10:S246. 80. Baker RW, Milton DR, Tohen M, Stauffer VL, Breier A. Olanzapine is not associated with exacerbation of bipolar mania [meeting abstract]. Biol Psychiatry 2001;49 (Suppl 8):43S. 81. Baker RW, Milton DR, Tohen MF, Stauffer VL, Breier AF. Olanzapine is not associated with exacerbation of bipolar mania [meeting abstract]. In 52nd Meeting of Institute on Psychiatric Services, 25–29 October 2000, Philadelphia, PA. 82. Baker CB, Woods SW, Sernyak MJ. Costeffectiveness of divalproex versus lithium. J Clin Psychiatry 1997;58:363–4. 83. Bares M, Hrdlicka M, Propper L. Atypical neuroleptic drug, olanzapine, in the treatment of impaired mood. Prakt Lek 2000;80:329–32. 84. Berney A, Bryois C. Treatment of acute mania using valproate: open study. Schweiz Arch Neurol Psychiatr 1999;150:233–7. 85. Beyzarov EP. Antipsychotic drug receives indication for bipolar disorder. Drug Topics 2000; 144:29. 86. Bhana N, Perry CM. Olanzapine: a review of its use in the treatment of bipolar I disorder. CNS Drugs 2001;15:871–904. 87. Bowden CL, Swann AC, Calabrese JR, McElroy SL, Morris D, Petty F, et al. Maintenance clinical trials in bipolar disorder: design implications of the divalproex–lithium–placebo study. Psychopharmacol Bull 1997;33:693–9. 88. Bowden CL. Dosing strategies and time course of response to antimanic drugs. J Clin Psychiatry 1996;57 (Suppl 13):4–9; discussion, 10–12. 89. Bowden CL, Calabrese JR, McElroy SL, Gyulai L, Wassef A, Petty F, et al. A randomized, placebocontrolled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Divalproex Maintenance Study Group. Arch Gen Psychiatry 2000;57:481–9. 90. Bowden CL. Efficacy of divalproex vs lithium and placebo in mania: in reply. JAMA 1994;272:1006. Available at http://jama ama-assn org/ 91. Brasfield KH. Pilot study of divalproex sodium versus valproic acid: drug acquisition costs versus all related costs. Curr Ther Res Clin Exp 1999; 60:138–44. 92. Brown WA. A correction: efficacy of olanzapine in acute bipolar mania: a double-blind, placebocontrolled study. The Olanzipine HGGW Study Group. Arch Gen Psychiatry 2002;59:91. 93. Brown S, Nejtek VA, Perantie DC, Bobadilla L. Quetiapine in patients with bipolar disorder and cocaine dependence. Biol Psychiatry 2001;49:178. 94. Calabrese JR, Shelton MD, Rapport DJ, Kujawa M, Kimmel SE, Caban S. Current research on rapid cycling bipolar disorder and its treatment. J Affect Disord 2001;67:241–55. 95. Calabrese JR, Markovitz PJ, Kimmel SE, Wagner SC. Spectrum of efficacy of valproate in 78 rapidcycling bipolar patients. J Clin Psychopharmacol 1992;12(Suppl.):53–6. 96. Carroll BT, Thalassinos A, Fawver JD. Loading strategies in acute mania. CNS Spectr 2001; 6:919–22, 930. 97. Cavazzoni P, Berg PH, Baker RW, Evans AR, Tohen M. Extrapyramidal symptoms of olanzapine versus placebo or haloperidol in the treatment of acute mania and contrasts to schizophrenia. Schizophr Res 2002;53:169–70. 98. Chou JY. Drug treatment of acute mania. Drugs Today 1992;28:119–30. 99. Conney J, Kaston B. Pharmacoeconomic and health outcome comparison of lithium and divalproex in a VA geriatric nursing home population: influence of drug-related morbidity on total cost of treatment. Am J Manag Care 1999; 5:197–204. 100. Cookson J. Use of antipsychotic drugs and lithium in mania. Br J Psychiatry 2001;178 (Suppl 41):s148–56. 101. Dalkilic A, Diaz E, Baker CB, Pearsall HR, Woods SW. Effects of divalproex versus lithium on length of hospital stay among patients with bipolar disorder. Psychiatr Serv 2000;51:1184–6. 102. Dardennes RM, Even C. Is divalproex a costeffective alternative in the acute and prophylactic treatment of bipolar I disorder? J Clin Psychiatry 1997;58:495–6. 103. David SR, Battaglia J, Alaka K, Meehan K, Wright P. Calming versus sedative effects of IM olanzapine in agitated patients [meeting abstract]. Biol Pyschiatry 2002;51:197S. 104. Davis JM, Wang Z, Janicak PG. A quantitative analysis of clinical drug trials for the treatment of affective disorders. Psychopharmacol Bull 1993; 29:175–81. 105. Dose M, Emrich HM. Acute mania: practical therapeutic guidelines. CNS Drugs 1995;3:427–35. 106. Dunayevich E. Quetiapine in the treatment of mania. Schizophr Res 2001;49:226. 107. Dunayevich E, Strakowski SM. Quetiapine for treatment-resistant mania. Am J Psychiatry 2000; 157:1341. 108. Dunayevich E, McElroy SL. Atypical antipsychotics in the treatment of bipolar disorder: pharmacological and clinical effects. CNS Drugs 2000;13:433–41. 109. Ellenor G, Lohr JB, Ito M, Dishman B, Gammariello A. The comparative efficacy of divalproex low and high serum level in bipolar disorder and schizophrenia. New Clinical Drug Evaluation Unit Meeting 1995;563. 110. Emrich HM, Gunther R, Dose M. Current perspectives in the pharmacopsychiatry of depression and mania. Neuropharmacology 1983; 22:385–8. 111. Falsetti AE. Olanzapine: psychopharmacology, clinical efficacy, and adverse effects. Hosp Pharm 1999;34:423–35. 112. Feldstein JH, Curtis JL. Update on the costs of Depakote and Depakene. Ment Retard 1995;33:62. 113. Fellows L, Jones M, Mehnert A. Inpatient treatment of bipolar disorder: a comparison of outcomes with risperidone and olanzapine [meeting abstract]. Eur Neuropsychopharmacol 2001; 11 (Suppl 3):S249. 114. Frankenburg FR, Zanarini MC. Divalproex sodium treatment of women with borderline personality disorder and bipolar II disorder: a double-blind placebo-controlled pilot study. J Clin Psychiatry 2002;63:442–6. 115. Frazier JA, Biederman J, Jacobs TG, Tohen MF, Toma V, Feldman PD, et al. Olanzapine in the treatment of bipolar-disorder in juveniles. Schizophr Res 2000;41:B49. 116. Frazier JA, Tohen M, Biederman J, Jacobs T, Toma V, Feldman P. Olanzapine in the treatment of juvenile bipolar disorder. Int J Neuropsychopharmacol 2000;3 (Suppl 1):S330. 117. Frye MA, Altshuler LL, Szuba MP, Finch NN, Mintz J. The relationship between antimanic agent for treatment of classic or dysphoric mania and length of hospital stay. J Clin Psychiatry 1996; 57:17–21. 118. Freeman TW, Clothier JL, Pazzaglia P, Lesem MD, Swann AC. A double-blind comparison of valproate and lithium in the treatment of acute mania. Am J Psychiatry 1992;149:108–11. 119. Garza-Trevino ES. Alternatives to lithium therapy in the treatment of acute mania. Drugs Today 1998; 34:295–305. 120. Geddes J, Goodwin G. Bipolar disorder: clinical uncertainty, evidence-based medicine and largescale randomised trials. Br J Psychiatry 2001; 178 (Suppl 41):s191–4. 121. Gerner RH, Stanton A. Algorithm for patient management of acute manic states: lithium, valproate, or carbamazepine? J Clin Psychopharmacol 1992;12:57s–63s. 122. Ghaemi SN. New treatments for bipolar disorder: the role of atypical neuroleptic agents. J Clin Psychiatry 2000;61 (Suppl 14):33–42. 123. Ghaemi SN, Sachs GS, Goodwin FK. Divalproex vs. lithium in the treatment of bipolar disorder. Biol Psychiatry 1999;45:204. 124. Ghaemi N. Erratum: the use of quetiapine for treatment-resistant bipolar disorder (Annals of Clinical Psychiatry (1999) 11 (137–140)). Ann Clin Psychiatry 2000;12:63. 125. Ghaemi SN, Katzow JJ. The use of quetiapine for treatment-resistant bipolar disorder: a case series. Ann Clin Psychiatry 1999;11:137–40. 126. Goldberg JF, Altshuler LL, Frye M, Keck PE, Jr. Pharmacoeconomics of lithium and divalproex sodium in the treatment of bipolar disorder. In Powell SM, editor. The Hatherleigh guide to psychopharmacology. New York: Hatherleigh Press; 1999. pp. 141–67. 127. Goodwin G. Drug treatment in mania. Prescr J 1994;34:19–26. 128. Haddad P, Chaudhry I, Soni S. Adjunctive use of olanzapine in the treatment of mania. Int J Psychiatry Clin Pract 1999;3:213–15. Available at www.tandf.co.uk/journals/md/13651501.html 129. Hamilton D. Medical minute. Zyprexa offers hope in the treatment of manic depression. Los Angeles Times 4 December 2000;Sect. S3. 130. Hellewell JSE. A continuing role for antipsychotics in the treatment of bipolar disorders: the story so far. Continuing Professional Development Bull Psychiatry 2000;2:107–14. 131. Hilger E, Barnas C. Atypical antipsychotics in the treatment of bipolar affective disorders. Fortschr Neurol Psychiatr 2002;70:234–42. 132. Hilty DM, Brady KT, Hales RE. A review of bipolar disorder among adults. Psychiatr Serv 1999; 50:201–13. 133. Hirschfeld RM, Weisler RH, Keck PE, Ahern E, Revicki D. Cost-effectiveness evaluation of divalproex sodium versus lithium in the treatment of bipolar disorder [meeting abstract]. In 152nd Annual Meeting of the American Psychiatric Association, 15–20 May 1999, Washington, DC; 1999. pp. 262–3. 134. Icovino J, Haddad H, Detoledo J. Carbamazepine and sodium divalproex in the treatment of bipolar and schizoaffective disorders in the mentally retarded: a prospective study. Neurology 1994; 44 (Suppl 2):A401. 135. Jacobsen FM, Comas-Diaz L. Dose-severity responses to divalproex in bipolar illness [meeting abstract]. Clin Pharmacol Ther 1995;57:207. 136. Jagadheesan K. Olanzapine in acute bipolar mania. Arch Gen Psychiatry 2002;59:188. 137. James ACD, Javaloyes AM. Practitioner review: the treatment of bipolar disorder in children and adolescents. J Child Psychol Psychiatry 2001; 42:439–49. 138. Janicak PG, Newman RH, Davis JM. Advances in the treatment of mania and related disorders: a reappraisal. Psychiatr Ann 1992;22:92–103. 139. Jann MW, Garrelts JC, Ereshefsky L, Saklad SR. Alternative drug therapies for mania: a literature review. Drug Intell Clin Pharm 1984;18:577–89. 140. Janowsky DS. New treatments of bipolar disorder. Curr Psychiatry Rep 1999;1:111–13. 141. Jonnalagada JR, Norton JW. Acute dystonia with quetiapine. Clin Neuropharmacol 2000;23:229–30. 142. Kafantaris V. Treatment of bipolar disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry 1995;34:732–41. 143. Kafantaris V, Coletti DJ, Dicker R, Padula G, Kane JM. Adjunctive antipsychotic treatment of adolescents with bipolar psychosis. J Am Acad Child Adolesc Psychiatry 2001;40:1448–56. 144. Kaiser CJ, Beyer JL, Siegel A, Kennedy JS, Tohen K, Berg P, et al. Olanzapine, divalproex, and placebo treatment comparison of older adult acute mania. Am J Geriatr Psychiatry 2002;10:99. 145. Keck PE Jr, McElroy SL. Clinical pharmacodynamics and pharmacokinetics of antimanic and mood-stabilizing medications. J Clin Psychiatry 2002;63:3–11. 146. Keck PE, Jr, McElroy SL, Stanton SP, Bennett JA. Pharmacoeconomic aspects of the treatment of bipolar disorder. Psychiatr Ann 1996; 26 (7 Suppl):S449–53. 147. Keck PE, Jr, McElroy SL, Bennett JA. Healtheconomic implications of the onset of action of antimanic agents. J Clin Psychiatry 1996; 57 (Suppl 13):13–18; discussion, 19–22. 148. Keck PE, Martin J, Thomas JH, Allen MH, Hirschfeld RM, Sommerville K. Safety and efficacy of oral loading divalproex sodium in acutely manic bipolar patients [meeting abstract]. In 152nd Annual Meeting of the American Psychiatric Association, 15–20 May 1999, Washington, DC p. 192. 149. Keck PE, Jr, Welge JA, McElroy SL, Arnold LM, Strakowski SM. Placebo effect in randomized, controlled studies of acute bipolar mania and depression. Biol Psychiatry 2000;47:748–55. 150. Keck PE, Jr, McElroy SL, Strakowski SM, Soutullo CA. Antipsychotics in the treatment of mood disorders and risk of tardive dyskinesia. J Clin Psychiatry 2000;61 (Suppl 4):33–8. 151. Keck PE, Jr, Mendlwicz J, Calabrese JR, Fawcett J, Suppes T, Vestergaard PA, et al. A review of randomized, controlled clinical trials in acute mania. J Affect Disord 2000;59 (Suppl 1):S31–7. 152. Kennedy JS, Bymaster FP, Schuh L, Calligaro DO, Nomikos G, Felder CC, et al. A current review of olanzapine’s safety in the geriatric patient: from pre-clinical pharmacology to clinical data. Int J Geriatr Psychiatry 2001;16 (Suppl 1):S33–61. 153. Kerwin R. Olanzapine was more effective than lorazepam at 2 hours but not at 24 hours in bipolar mania with acute agitation. Evid Based Ment Health 2002;5:18. 154. Ketter TA, Wang PW, Winsberg ME, Sachs N, Tate DL, Strong CM, et al. Baseline hypofrontality and divalproex response in bipolar disorders. Biol Psychiatry 2000;47:412. 155. Kravitz HM, Fawcett J. Efficacy of divalproex vs lithium and placebo in mania. JAMA 1994; 272:1005–6. 156. Kupka RW, Nolen WA, Altshuler LL, Denicoff KD, Frye MA, Leverich GS, et al. The Stanley Foundation Bipolar Network. 2. Preliminary summary of demographics, course of illness and response to novel treatments. Br J Psychiatry 2001; 178 (Suppl 41):s177–83. 157. Lacerda ALT, Soares JC, Tohen M. The role of atypical antipsychotic agents in the treatment of bipolar disorder: a literature review. Rev Bras Psiquiatr 2002;24:34–43. 158. Lemoine P, Fondarai J, Faivre T. Valpromide increases amplitude of heart rate circadian rhythm in remitted bipolar and unipolar disorders: a placebo-controlled study. Eur Psychiatry 2000; 15:424–32. 159. Levine J, Chengappa KNR, Parepally H. Side effect profile of enteric-coated divalproex sodium versus valproic acid. J Clin Psychiatry 2000; 61:680–1. 160. Licht RW. Drug treatment of mania: a critical review. Acta Psychiatr Scand 1998;97:387–97. 161. Licht RW. Typical and atypical antipsychotics in bipolar disorder. Acta Neuropsychiatr 2000; 12:115–19. 162. Licht RW. Limitations in randomised controlled trials evaluating drug effects in mania. Eur Arch Psychiatry Clin Neurosci 2001;251:66–71. 163. Madhusoodanan S, Sinha S, Brenner R, Gupta S, Bogunovic O. Use of olanzapine for elderly patients with psychotic disorders: a review. Ann Clin Psychiatry 2001;13:201–13. 164. Masand PS, Wang X, Manjooran J, Schwartz T, Saba M, Hardoby W, et al. Comparison of risperidone and olanzapine in bipolar and schizoaffective disorders [meeting abstract]. Biol Psychiatry 2000;47 (Suppl 8):90S. 165. Maggi JD, Halman MH. The effect of divalproex sodium on viral load: a retrospective review of HIV-positive patients with manic syndromes. Can J Psychiatry 2001;46:359–62. 166. Martinez JM, Russell JM, Hirschfeld RM. Tolerability of oral loading of divalproex sodium in the treatment of acute mania. Depress Anxiety 1998;7:83–6. 167. McClellan J, Werry J. Practice parameters for the assessment and treatment of children and adolescents with bipolar disorder. American Academy of Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry 1997;36:157s–76s. 168. McElroy SL, Keck PE, Jr. Pharmacologic agents for the treatment of acute bipolar mania. Biol Psychiatry 2000;48:539–57. 169. Mehnert A, Jones M. Risperidone and olanzapine in inpatient treatment of bipolar disorder [meeting abstract]. Eur Psychiatry 2001; 17 (Suppl 1):105s. 170. Miller DS, Yatham LN, Lam RW. Comparative efficacy of typical and atypical antipsychotics as add-on therapy to mood stabilizers in the treatment of acute mania. J Clin Psychiatry 2001; 62:975–80. 171. Milton DR, Baker RW, Stauffer VL, Tohen M, Breier A. Olanzapine is not associated with exacerbation of bipolar mania [meeting abstract]. In Annual Meeting of the American Psychiatric Association, 5–10 May 2001, New Orleans, LA. 172. Müller-Oerlinghausen B, Retzow A. Treatment of acute manic episodes with valproate as an adjunct to neuroleptic medication [meeting abstract]. In 9th Congress of the Association of European Psychiatrists, 20–24 September 1998, Copenhagen. p. 204s. 173. Müller Oerlinghausen B, Retzow A, Henn FA, Giedke H, Walden J. Valproate as an adjunct to neuroleptic medication for the treatment of acute episodes of mania: a prospective, randomized, double-blind, placebo-controlled, multicenter study. European Valproate Mania Study Group. J Clin Psychopharmacol 2000;20:195–203. 174. Namjoshi MA, Rajamannar G, Jacobs T, Sanger TM, Risser R, Tohen MF, et al. Economic, clinical, and quality-of-life outcomes associated with olanzapine treatment in mania: results from a randomized controlled trial. J Affect Disord 2002; 69:109–18. 175. Namjoshi M, Rajamannar G, Risser R, Tohen M, Breier A. Impact of olanzapine added to lithium or valproate on the quality of life of patients with bipolar disorder. Int J Neuropsychopharmacol 2000; 3 (Suppl 1):S235. 176. Namjoshi M, Rajamannar G, Jacobs T, Feldman P, Sanger T, Tohen M, et al. Clinical, humanistic, and economic outcomes associated with long-term treatment of mania with olanzapine [meeting abstract]. Int J Neuropsychopharmacol 2000; 3 (Suppl 1):S332. 177. Namjoshi M, Rajamannar G, Jacobs TG, Feldman PD, Sanger TM, Tohen MF, et al. Clinical, humanistic and economic outcomes associated with long-term olanzapine treatment of mania [meeting abstract]. In 153rd Annual Meeting of the American Psychiatric Association, 13–18 May 2000, Chicago, IL. 178. Namjoshi M, Jacobs T, Sanger TM, Gannon KS, Tohen M, Breier A. Changes in health-related quality of life of patients with bipolar disorder treated with olanzapine. Eur Neuropsychopharmacol 1999;9 (Suppl 5):S245–6. 179. Namjoshi M, Risser RC, Shi L, Edgell ET, Tohen MF, Breier AF. Impact of olanzapine added to lithium or valproate on the quality of life of patients with bipolar disorder. In 2001 Annual Meeting of the American Psychiatric Association, 5–10 May 2001, New Orleans, LA. 180. Noaghiul S, Narayan M, Nelson JC. Divalproex treatment of mania in elderly patients. Am J Geriatr Psychiatry 1998;6:257–62. 181. Ozcan Y, Ozcan ME, Boztepe AV, Karlidag R. Akut manide lityum, karbamazepin ve sodyum valproatyn klinik etkinliginin karsylastyrylmasy: bir oen calysma [Comparison of the clinical efficacy of lithium, carbamazepine and sodium valproate in acute mania: preliminary results]. Klin Psikofarmakol Buelt 1999;9:203–7. 182. Ozcan ME, Boztepe AV. Lithium, carbamazepine and valproate in acute mania. Klin Psikofarmakol Buelt 2001;11:90–5. 183. Papatheodorou G, Kutcher SP. Divalproex sodium treatment in late adolescent and young adult acute mania. Psychopharmacol Bull 1993;29:213–19. 184. Papatheodorou G, Kutcher SP, Katic M, Szalai JP. The efficacy and safety of divalproex sodium in the treatment of acute mania in adolescents and young adults: an open clinical trial. J Clin Psychopharmacol 1995;15:110–16. 185. Piepho RW. Cardiovascular effects of antipsychotics used in bipolar illness. J Clin Psychiatry 2002;63 (Suppl 4):20–3. 186. Poolsup N, Li Wan Po A, de Oliveira IR. Systematic overview of lithium treatment in acute mania. J Clin Pharmacol Ther 2000;25: 139–56. 187. Post RM, Denicoff KD, Frye MA, Leverich GS. Algorithms for bipolar mania. Mod Probl Pharmacopsychiatry 1997;25:114–45. 188. Price PL. Olanzapine to treat the acute mania of bipolar disorder. S D J Med 2000;53:523. 189. Procyshyn RM, Zerjav S. Drug utilization patterns and outcomes associated with in-hospital treatment with risperidone or olanzapine. Clin Ther 1998;20:1203–17. 190. Reddy YCJ, Srinath S. Juvenile bipolar disorder. Acta Psychiatr Scand 2000;102:162–70. 191. Rossler W. Cui bono or who needs health economics? Psychiatr Prax 2001:S29–31. 192. Sachs GS, Printz DJ, Kahn DA, Carpenter D, Docherty JP. Medication treatment of bipolar disorder 2000. Minneapolis: Healthcare Information Programs, McGraw-Hill Healthcare Information Group; 2000. 193. Sachs GS, Grossman F, Ghaemi SN, Okamoto A, Bowden CL. Combination of a mood stabilizer with risperidone or haloperidol for treatment of acute mania: a double-blind, placebo-controlled comparison of efficacy and safety. Am J Psychiatry 2002;159:1146–54. 194. Sajatovic M, Gerhart C, Semple W. Association between mood-stabilizing medication and mental health resource use in the management of acute mania. Psychiatr Serv 1997;48:1037–41. 195. Sanger TM, Tohen M, Tollefson GD, McElroy SL, Greaney MG, Toma V. Olanzapine vs placebo in the treatment of acute Mania [meeting abstract]. Schizophr Res 1998;29:152. 196. Sanger T, Tohen MF, Jacobs T, Gannon KS, Greaney M, Tollefson GD. Long-term olanzapine treatment of mania [meeting abstract]. In 152nd Annual Meeting of the American Psychiatric Association, 15–20 May 1999, Washington, DC. p. 190. 197. Sanger TM, Grundy SL, Gibson PJ, Namjoshi MA, Greaney MG, Tohen MF. Long-term olanzapine therapy in the treatment of bipolar I disorder: an open-label continuation phase study. J Clin Psychiatry 2001;62:273–81. 198. Sanger T, Tohen M, Tollefson G, David S, Greaney M. Olanzapine versus placebo in rapid-cycling bipolar disorder [meeting abstract]. Eur Neuropsychopharmacol 1998;8 (Suppl 2):S227. 199. Schneider RK. Divalproex did not differ from placebo or lithium in preventing recurrence of new mood episodes in bipolar I disorder, remission phase. Evid Based Ment Health 2001;4:9. 200. Schwartz TL, Boylan D, Kuhles ID, Gupta S, Chengappa KNR, Parepally H, et al. Clinical effectiveness of divalproex sodium in lithium carbonate refractory Bipolar spectrum patients. Pharmacy and Therapeutics 2000;25:410–17. 201. Segal J, Walton S, Clark H, Berk M. Pharmacotherapy of mania: a review. Int J Psychiatry Clin Pract 2000;4:171–93. 202. Shi L, Zhu B, Namjoshi M, Tunis S, Baker R, Tohen M, et al. Improvement in health-related quality of life was associated with antidepressant property: evidence from an acute mania clinical trial of olanzapine versus divalproex [meeting abstract]. In Annual Meeting of American Psychiatric Association; 18–23 May 2002, Philadelphia, PA. 203. Solomon DA, Keitner GI, Miller IW, Shea MT, Keller MB. Course of illness and maintenance treatments for patients with bipolar disorder. J Clin Psychiatry 1995;56:5–13. 204. Solomon DA, Ryan CE, Keitner GI, Miller IW, Shea MT, Kazim A, et al. A pilot study of lithium carbonate plus divalproex sodium for the continuation and maintenance treatment of patients with bipolar I disorder. J Clin Psychiatry 1997;58:95–9. 205. Steffens DC, Krishnan KR. Decision model for the acute treatment of mania. Depress Anxiety 1996; 4:289–93. 206. Strakowski SM, DelBello MP, Adler CM. Comparative efficacy and tolerability of drug treatments for bipolar disorder. CNS Drugs 2001;15:701–18. 207. Swann AC. Prediction of treatment response in acute mania: controlled clinical trials with divalproex. Encephale 2001;27:277–9. 208. Tohen M, Chengappa KNR, Suppes T, Baker RW, Risser RC, Evans AR, et al. Olanzapine combined with mood stabilizers in prevention of recurrence in bipolar disorder: an 18 month study [meeting abstract]. In 23rd CINP Congress; 23–27 June 2002, Montreal Collegium Internationale Neuro- Psychopharmacologium. 209. Tohen M, Zhang F, Taylor CC, Burns P, Zarate C, Sanger T, et al. A meta-analysis of the use of typical antipsychotic agents in bipolar disorder. J Affect Disord 2001;65:85–93. 210. Tohen M, Zhang F, Keck PE, Feldman PD, Risser RC, Tran PV, et al. Olanzapine versus haloperidol in schizoaffective disorder, bipolar type. J Affect Disord 2001;67:133–40. 211. Tohen M, Chengappa KNR, Suppes T, Baker RW, Risser RC, Evans AR, et al. Olanzapine versus haloperidol in the treatment of acute mania. Biol Psychiatry 2002;51:541. 212. Tohen M, Zarate CA, Jr. Antipsychotic agents and bipolar disorder. J Clin Psychiatry 1998; 59 (Suppl 1):38–48; discussion, 49. 213. Tohen M, Jacobs TG, Feldman PD. Onset of action of antipsychotics in the treatment of mania. Bipolar Disord 2000;2:261–8. 214. Tohen M, Grundy S. Management of acute mania. J Clin Psychiatry 1999;60 (Suppl 5):31–4; discussion, 35–6. 215. Tohen M, Jacobs TG, Grundy SL, McElroy SL, Banov MC, Janicak PG, et al. Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. Rev Psiquiatr Clin 2001; 28:218. 216. Tohen M, Risser R, Grundy SL. Olanzapine in acute bipolar mania: in reply. Arch Gen Psychiatry 2002;59:188. 217. Toren P, Laor N, Weizman A. Use of atypical neuroleptics in child and adolescent psychiatry. J Clin Psychiatry 1998;59:644–56. 218. Townes P, Swartz CM. Comparison of valproic acid and lithium in mania. J Clin Psychiatry 1997; 58:273–4. 219. Vasudev K, Goswami U, Kohli K. Carbamazepine and valproate monotherapy: feasibility, relative safety and efficacy, and therapeutic drug monitoring in manic disorder. Psychopharmacology 2000;150:15–23. 220. Woods SW. The economic burden of bipolar disorder. J Clin Psychiatry 2000; 61 (Suppl 13):38–41. 221. Woods SW. Classic mania: treatment response to divalproex or lithium. Arch Gen Psychiatry 1998; 55:1050. 222. Yatham LN, Kusumakar V, Parikh SV, Haslam DRS, Matte R, Sharma V, et al. Bipolar depression: treatment options. Can J Psychiatry 1997; 42 (Suppl 2):87s–91s. 223. Young LT, Joffe RT, Robb JC, MacQueen GM, Marriott M, Patelis Siotis I. Double-blind comparison of addition of a second mood stabilizer versus an antidepressant to an initial mood stabilizer for treatment of patients with bipolar depression. Am J Psychiatry 2000;157:124–6. 224. Zarate CA, Jr, Tohen M, Narendran R, Tomassini EC, McDonald J, Sederer M, et al. The adverse effect profile and efficacy of divalproex sodium compared with valproic acid: a pharmacoepidemiology study. J Clin Psychiatry 1999;60:232–6. 225. Zhu B, Lage MJ, Shi L, Tunis S, Tohen M. Longterm quality-of-life and economic outcomes associated with the use of olanzapine versus divalproex for acute mania [meeting abstract]. Eur Neuropsychopharmacol 2001;11 (Suppl 3):S260. 226. Tohen M, Sanger T, Tollefson GD, McElroy SL, Greaney MG, Toma V. Experience using olanzapine in the treatment of acute bipolar mania [meeting abstract]. In 151st Annual Meeting of the American Psychiatric Association, 30 May–4 June 1998, Toronto. p. 306. 227. Tohen M, Sanger TM, McElroy SL, Tollefson GD, Grundy SL, Greaney M, et al. Olanzapine versus placebo in the treatment of acute mania [meeting abstract]. Eur Neuropsychopharmacol 1998; 8 (Suppl 2):S178. 228. Sanger TM, Tohen M, Tollefson GD, Jacobs T, David S. Olanzapine vs. placebo in rapid-cycling bipolar disorder [meeting abstract]. Schizophr Res 1998;29:152. 229. Toben M, Zarate C, Jr, Sanger IM. A placebocontrolled trial of olanzapine in psychotic or nonpsychotic acute mania [meeting abstract]. Schizophr Res 1998;29:204. 230. Tohen M, Jacobs T, Sanger TM, Grundy S, Greaney M, Toma V, et al. Safety of the novel antipsychotic olanzapine in the acute treatment of bipolar I disorder. Schizophr Res 1999;1:358. 231. Tohen M, Jacobs T, Gannon KS, Sanger TM, Greaney M, Toma V, et al. Long-term olanzapine treatment: cognitive and mood improvement in psychotic and nonpsychotic manic patients. Schizophr Res 1999;36:299. 232. Tohen M, Baker RW, Altshuler L, Zarate CA, Suppes T, Ketter TA, et al. Olanzapine versus divalproex sodium for the treatment of acute mania and maintenance of remission: a 47-week study. Biol Psychiatry 2002;51:208. 233. Merideth C, Sommerville KW, Zajecka J, Tracy K, Swann AC, Sachs G, et al. Divalproex sodium vs. Olanzapine for the treatment of mania in bipolar disorder: effects on body weight change and related outcomes. In 39th Annual Meeting of the American College of Neuropsychopharmacology, 10–14 December 2000, San Juan, Puerto Rico. Vanderbilt university Medical Center, American College of Neuropsychopharmacology; 2000. p. 258.
URI:	http://wrap.warwick.ac.uk/id/eprint/46333

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