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The addition of olanzapine to valproate or lithium for acute manic or mixed bipolar episodes reduced manic symptoms
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QUESTION: In patients with acute manic or mixed bipolar episodes, is a combination of olanzapine with valproate or lithium more effective than valproate or lithium alone?

Design

6 week randomised {allocation concealed*}, blinded {patients, clinicians, data collectors, and outcome assessors},*, placebo controlled trial.

Setting

33 centres in the US and 5 in Canada.

Patients

344 patients (mean age 41 y, 52% women) who had bipolar disorder, manic (48%) or mixed (52%) episodes with or without psychotic episodes; had a score ≥16 (mean score 22) on the Young Mania Rating Scale (YMRS) at baseline; and had received treatment …

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