Journal Title:  Annals of Clinical Psychiatry | Vol:  16 | Issue:  2 | Year:     
Print ISSN:  1040-1237 | Online ISSN:  1547-3325   

Long–Term Observational Comparison of Risperidone and Olanzapine in Bipolar Disorder

S. NASSIR GHAEMI M.D.
DOUGLAS J. HSU B.S.
KLARA J. ROSENQUIST B.S.
JACOB J. KATZOW M.D.
REDERICK K. GOODWIN M.D.

pages: 69 - 73
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Abstract:

To compare long-term effectiveness and safety of risperidone versus olanzapine as adjunctive maintenance treatments of bipolar disorder. Retrospective observational chart review of 29 outpatients with bipolar or schizoaffective disorder (type I =15, type II =3, NOS =5, schizoaffective =6) who received risperidone or olanzapine added to lithium or valproate>3 months. Acute indications were depression (n =8), manic/hypomanic/mixed states (n =8), rapid cycling (n =6), other indications (n =6), and prophylaxis (n =1). Logistic regression models adjusted for potential confounding factors (i.e., severity of illness, comorbid substance abuse, diagnostic subtype). Overall duration of follow-up was 65.9 ±70.1 weeks. Mild to moderate response was similar in the risperidone and olanzapine groups after adjusting for potential confounders (OR =0.91, 95% CI [0.05, 16.17]). Somewhat greater adjusted moderate to marked response (OR>3.60, 95% CI [0.31,>42.00]) and longer duration of treatment (HR =0.52, 95% CI [0.22, 1.22]) occurred in the risperidone group, but were still compatible with the null hypothesis. Weight gain occurred more frequently with olanzapine (57%) than risperidone (13%). EPS was similar, and tardive dyskinesia did not occur. Risperidone and olanzapine appeared to have similar real-world maintenance effectiveness for bipolar disorder, but differed somewhat in side effects.