Effectiveness of short-term olanzapine in patients with bipolar i disorder, with or without comorbidity with substance use disorder

Gabriele Sani, Georgios D. Kotzalidis, Paul Vöhringer, Daniela Pucci, Alessio Simonetti, Giovanni Manfredi, Valeria Savoja, Stefano Maria Tamorri, Lorenzo Mazzarini, Isabella Pacchiarotti, Carla Ludovica Telesforo, Stefano Ferracuti, Roberto Brugnoli, Elisa Ambrosi, Matteo Caloro, Antonio Del Casale, Alexia E. Koukopoulos, Derick E. Vergne, Paolo Girardi, S. Nassir Ghaemi

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Prognosis of comorbid bipolar disorder (BD) and drug abuse is poor. We assessed the efficacy of olanzapine in manic or mixed BD patients, with (SUD) or without (N-SUD) comorbidity with substance use disorder (SUD) and its effect on drug abuse, days of abuse, and craving. Methods: Eighty patients with BD-I (40 SUD) were hospitalized for a manic or mixed episode and received add-on olanzapine. Assessments were conducted at admission, discharge, and 4 and 8 weeks after discharge. Primary outcome was the proportion of responders and remitters in each group. We used a logistic regression model to adjust for possible confounders. We assessed craving and drug-abuse days with a visual analog scale and the Timeline Follow-Back. Results: SUD and N-SUD were similar on response and remission, adjusted for sex, age, years ill, age at first episode, first episode depressive, number of hospitalizations, and duration of hospitalization (odds ratio, 1.09; 95% confidence interval, 1.02-2.29). Mood rating scores dropped significantly from baseline to end point in both groups. Timeline follow-back decreased in SUD from 22.5 to 7.3 at 8 weeks postdischarge, whereas craving dropped from 8.3 to 5.1 (P <0.03). Conclusions: The effectiveness of short-term olanzapine in BD-I mania or mixed mania did not differ according to SUD comorbidity. Treatment was followed by less substance use/abuse and craving in comorbid bipolar-SUD patients.

Original languageEnglish
Pages (from-to)231-235
Number of pages5
JournalJournal of Clinical Psychopharmacology
Volume33
Issue number2
DOIs
Publication statusPublished - Apr 2013

Keywords

  • bipolar disorder type I
  • comorbidity
  • craving
  • olanzapine
  • substance use disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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