双相障碍诊断及治疗进展精要.ppt

单药AAP包括olanzapineb, risperidone, quetiapine, quetiapine XR, aripiprazole, ziprasidone, asenapine, paliperidone 联合AAP包括risperidone, quetiapine, olanzapine, aripiprazole, asenapine * * * Key Point: Olanzapine showed a statistically significant improvement in treating acute manic symptoms in three of these four double-blind randomized clinical trials, with olanzapine showing numerical improvement that was not statistically significant in the fourth study. Background: All studies had a similar, parallel two-group flexible-dose design. Mean modal daily doses were as follows: olanzapine vs. placebo (3 wks): 14.9 mg olanzapine1; olanzapine vs. placebo (4 wks): 16.4 mg olanzapine2; olanzapine vs. divalproex (3 wks- Tohen): 17.4 mg olanzapine and 1401 mg divalproex3; olanzapine vs. divalproex (3 wks- Zajecka): 14.7 mg olanzapine and 2115 mg divalproex4. Adverse events experienced by patients were similar across studies. In the 3-week placebo-controlled study, somnolence, dizziness, dry mouth, and weight gain occurred significantly more often with olanzapine. In the 4-week placebo-controlled study, weight gain and somnolence occurred significantly more often with olanzapine. In the Tohen olanzapine vs. divalproex 3-week study, weight gain, dry mouth, increased appetite, and somnolence occurred significantly more often with olanzapine, while significantly more nausea occurred with divalproex. In the Zajecka olanzapine vs. divalproex 3-week study, somnolence, weight gain, rhinitis, edema, and slurred speech occurred significantly more often with olanzapine, while no adverse events were reported to have occurred with divalproex in a statistically greater proportion to that of olanzapine. References: 1. Tohen M, Sanger TM, McElroy SL, et al. Olanzapine versus Placebo in the Treatment of Acute Mania. Am J Psychiatry 1999; 156(5):702-709. 2. Tohen M, Jacobs TG, Grundy SL, et al. Efficacy of Olanzapine in Acute Bipolar Mania. Arch Gen Psychiatry 2000; 57(9):841-849. 3.