NICE endorses mania treatments as data suggest prevention role
Patients in England and Wales who have acute mania associated with bipolar I disorder should be offered the option of treatment with olanzapine (Zyprexa) or valproate semisodium (Depakote), says the National Institute for Clinical Excellence in guidance issued this week.
NICE stresses the importance of discussing all treatment options with
patients before deciding on which drug to prescribe in acute mania. The
full guidance is available on the NICE website.
Meanwhile, data presented at the annual congress of the European College
of Neuropsychopharmacology in Prague this week indicate that olanzapine
is at least as effective as lithium in the long-term maintenance treatment
of manic depression.
In a randomised double blind trial, patients diagnosed with bipolar I
disorder and who had experienced at least two manic episodes within the
past six years were randomised to take either olanzapine (5–20mg
daily, n=217) or lithium (titrated to a serum level of 0.6–1.2mEq/L,
n=214).
Patients taking olanzapine had a lower incidence of relapse into episodes
of mania compared with those taking lithium (14.3 per cent versus 28.0
per cent) and both groups had similar incidence of relapse into depressive
episodes (16.1 per cent vs 15.4 per cent). The incidence of admission
to hospital was also lower in patients treated with olanzapine.
A licence application for olanzapine as a preventive agent is currently
being reviewed. |
