مقایسه اثربخشی اولانزاپین و لیتیوم کربنات در درمان حمله حاد مانیا، یک مطالعه دوسوکور

    Background & Aims : Bipolar Mood Disorder in acute manic episode is one of the psychiatric emergencies and usually needs to be admitted and intensive management. Treatment of these episodes ordinarily need mood stabilizer together with antipsychotic drugs. Although lithium carbonate is effective in acute mania alone, it needs more time to control episode. Only a few studies have been done about the efficacy of olanzapine (a new generation antipsychotic) alone in the treatment of acute mania, and the findings cannot be generalized. No similar study was conducted in Iran. So our main purpose was to compare the efficacy of olanzapine with lithium carbonate in the treatment of acute mania.   Materials & Methods : A clinical trial study was designed and patients with acute mania according to DSM-IV-TR were selected and the severity of manic episode were measured by Young Mania Rating Scale (YMRS) that is exclusive to patients under 18 years old and those with ultra acute episode who need other rapid interventions. Patients were randomly treated with olanzapine or lithium carbonate in a period of 4 weeks. Each group consisted of 30 patients and according to clinical responsiveness the efficacy and safety of two drugs were compared.   Results : There was no statistical significant gender difference in two groups. Olanzapine group contained 18 males and 12 females versus lithium carbonate group that were 20 males and 10 females (p=0.287). The mean clinical responsiveness rate in olanzapine group was 72%, whereas this rate in lithium group was 66 % (significant differences and p=0.005). The mean increasement of blood glucose in Olanzapine group was 12.2 mg/dl (16 % increasement of baseline). This rate in lithium carbonate group was 0.3mg/dl (0.1 % increasement of baseline). The difference was significant (p<0.0001). The mean weight increase in olanzapine group was 3.1kg (4.4 % increasement of baseline), whereas this rate in lithium carbonate group was 1.2kg (1.6 % increasement of baseline). The difference was significant (p<0.001). There were no significant differences related to extra pyramidal side effects (EPS) between two groups (p=0.231).   Conclusion : Findings of this study reveal that although the responsiveness of acute mania to olanzapine is more than lithium carbonate but regarding the side effects, lithium carbonate seems safer than Olanzapine.    SOURCE: URMIA MED J 2015: 25(11): 987 ISSN: 1027-3727