{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:14:49Z","timestamp":1777688089797,"version":"3.51.4"},"reference-count":23,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":5024,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2004,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Few controlled studies have examined the use of atypical antipsychotic drugs for prevention of relapse in patients with bipolar I disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate whether olanzapine plus either lithium or valproate reduces the rate of relapse, compared with lithium or valproate alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients achieving syndromic remission after 6 weeks'treatment with olanzapine plus either lithium (0.6\u20131.2 mmol\/l) or valproate (50\u2013125 \u03bcg\/ml) received lithium or valproate plus either olanzapine 5\u201320 mg\/day (combination therapy) or placebo (monotherapy), and were followed in a double-masked trial for 18 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The treatment difference in time to relapse into either mania or depression was not significant for syndromic relapse (median time to relapse: combination therapy 94 days, monotherapy40.5 days; <jats:italic>P<\/jats:italic>=0.742), but was significant for symptomatic relapse (combination therapy 163 days, monotherapy42 days; <jats:italic>P<\/jats:italic>=0.023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients taking olanzapine added to lithium or valproate experienced sustained symptomatic remission, but not syndromic remission, for longer than those receiving lithium or valproate monotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.184.4.337","type":"journal-article","created":{"date-parts":[[2004,3,31]],"date-time":"2004-03-31T18:07:50Z","timestamp":1080756470000},"page":"337-345","source":"Crossref","is-referenced-by-count":258,"title":["Relapse prevention in bipolar I disorder: 18-month comparison of olanzapine plus mood stabiliser <i>v.<\/i> mood stabiliser alone"],"prefix":"10.1192","volume":"184","author":[{"given":"Mauricio","family":"Tohen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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