{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:13:50Z","timestamp":1777536830195,"version":"3.51.4"},"reference-count":32,"publisher":"Royal College of Psychiatrists","issue":"2","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"unspecified","delay-in-days":3623,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2008,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Combinations of olanzapine and carbamazepine are often used in clinical practice in the management of mania.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To assess the efficacy and safety of olanzapine plus carbamazepine in mixed and manic bipolar episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Randomised, double-blind, 6-week trial of olanzapine (10\u201330 mg\/day) plus carbamazepine (400\u20131200 mg\/day;<jats:italic>n<\/jats:italic>=58)<jats:italic>v.<\/jats:italic>placebo plus carbamazepine (<jats:italic>n<\/jats:italic>=60) followed by open-label, 20-week olanzapine (10\u201330 mg\/day) plus carbamazepine (400\u20131200 mg\/day,<jats:italic>n<\/jats:italic>=86), with change in manic symptoms as main outcome measure. Safety and pharmacokinetics were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences (baseline to endpoint) in efficacy measures between treatment groups, but at 6 weeks triglyceride levels were significantly higher (<jats:italic>P<\/jats:italic>=0.008) and potentially clinically significant weight gain (\u2a7e7%) occurred more frequently (24.6%<jats:italic>v.<\/jats:italic>3.4%,<jats:italic>P<\/jats:italic>=0.002) in the combined olanzapine and carbamazepine group. Carbamazepine reduced olanzapine concentrations but olanzapine had no effect on carbamazepine concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of olanzapine and carbamazepine did not have superior efficacy to carbamazepine alone. 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