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Table 5 Outcomes in maintenance trials in bipolar mania – efficacy and discontinuations in trials lasting 26 weeks or longer [vs placebo 46. 48, 49 versus active 45, 47]

From: Atypical antipsychotics in bipolar disorder: systematic review of randomised trials

  

Events/total patients

Event rate (%)

  

Outcome

Trials

Treatment

Active control

Treatment

Active control

Relative Risk (95% CI)

NNTp or NNH (95% CI)

Relapse

       

Any relapse

       

All versus placebo

3

135/332

166/257

41

65

0.6 (0.5 to 0.7)

4.2 (3.1 to 6.2)

Olanzapine versus placebo

2

116/255

130/174

45

75

0.6 (0.5 to 0.7)

3.4 (2.6 to 4.9)

Olanzapine versus active

2

79/250

96/237

32

41

0.8 (0.6 to 0.98)

11 (5.7 to 250)

Depressive relapse

       

All versus placebo

3

84/332

79/257

25

31

0.8 (0.6 to 0.98)

18 (7.8 to 18)

Olanzapine versus placebo

2

75/255

68/174

29

39

0.7 (0.6 to 0.97)

10 (5.3 to 200)

Manic relapse

       

All versus placebo

3

39/332

74/257

12

29

0.4 (0.3 to 0.6)

5.9 (4.2 to 9.5)

Olanzapine versus placebo

2

33/255

55/174

13

32

0.4 (0.3 to 0.6)

5.4 (3.7 to 9.4)

Discontinuation

       

All cause

       

All versus placebo

3

146/354

116/267

41

43

1.1 (0.9 to 1.3)

not calculated

Olanzapine versus placebo

2

107/276

61/184

39

33

1.3 (1.04 to 1.7)

18 (6.9 to 30)

Olanzapine versus active

2

222/342

250/341

65

73

0.9 (0.8 to 0.98)

12 (6.5 to 67)

Lack of efficacy

       

All versus placebo

3

36/354

55/267

10

21

0.6 (0.5 to 0.9)

9.6 (6.2 to 22)

Olanzapine versus placebo

2

17/276

19/184

6

10

0.8 (0.4 to 1.4)

not calculated

Olanzapine versus active

2

55/342

62/340

16

18

0.9 (0.6 to 1.2)

not calculated

Adverse events

       

All versus placebo

3

27/354

9/267

8

4

2.4 (1.1 to 5.0)

24 (13 to 160)

Olanzapine versus placebo

2

22/276

8/184

8

5

2.0 (0.9 to 4.5)

not calculated

Olanzapine versus active

2

72/342

80/340

21

24

0.9 (0.7 to 1.2)

not calculated

  1. For discontinuations NNTp is shown in bold, indicating fewer events with treatment than placebo. More events with treatment than placebo, NNH, is in plain text. Active comparators were haloperidol, lithium, or divalproex