Effectiveness of short-term olanzapine in patients with bipolar I disorder, with or without comorbidity with substance use disorder

J Clin Psychopharmacol. 2013 Apr;33(2):231-5. doi: 10.1097/JCP.0b013e318287019c.


Objectives: Prognosis of comorbid bipolar disorder (BD) and drug abuse is poor. We assessed the efficacy of olanzapine in manic or mixed BD patients, with (SUD) or without (N-SUD) comorbidity with substance use disorder (SUD) and its effect on drug abuse, days of abuse, and craving.

Methods: Eighty patients with BD-I (40 SUD) were hospitalized for a manic or mixed episode and received add-on olanzapine. Assessments were conducted at admission, discharge, and 4 and 8 weeks after discharge. Primary outcome was the proportion of responders and remitters in each group. We used a logistic regression model to adjust for possible confounders. We assessed craving and drug-abuse days with a visual analog scale and the Timeline Follow-Back.

Results: SUD and N-SUD were similar on response and remission, adjusted for sex, age, years ill, age at first episode, first episode depressive, number of hospitalizations, and duration of hospitalization (odds ratio, 1.09; 95% confidence interval, 1.02-2.29). Mood rating scores dropped significantly from baseline to end point in both groups. Timeline follow-back decreased in SUD from 22.5 to 7.3 at 8 weeks postdischarge, whereas craving dropped from 8.3 to 5.1 (P < 0.03).

Conclusions: The effectiveness of short-term olanzapine in BD-I mania or mixed mania did not differ according to SUD comorbidity. Treatment was followed by less substance use/abuse and craving in comorbid bipolar-SUD patients.

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines / therapeutic use*
  • Bipolar Disorder / complications
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / physiopathology
  • Case-Control Studies
  • Diagnosis, Dual (Psychiatry)
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Olanzapine
  • Prospective Studies
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / drug therapy*
  • Time Factors
  • Treatment Outcome
  • Young Adult


  • Antipsychotic Agents
  • Benzodiazepines
  • Olanzapine