Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

15 questions · 16 findings · 3 reviews · Common Mental Disorders

No studies found 4 · 25%GRADE not reported 0 · 0%Very low 0 · 0%Low 8 · 50%Moderate 1 · 6.3%High 3 · 18.8%

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with olanzapine (5 mg/d to 20 mg/d) vs augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with placebo

Depressive symptoms · treatment‐resistant depression in adults
2 findings from 1 review

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with olanzapine (5 mg/d to 20 mg/d) vs augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with placebo

Leaving the study early · treatment‐resistant depression in adults

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60… showed no clear difference in dropouts compared with augmentation of current antidepressant (fluoxetine 20 mg/d to 60… (low certainty).

1 finding from 1 review

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with olanzapine (5 mg/d to 20 mg/d) vs augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with placebo

Proportions of participants responding to treatment ≥ 50% reduction in depression score from baseline to end of treatment. A larger RR indicates greater response to treatment in the SAMe group · treatment‐resistant depression in adults

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60… showed no clear difference in response (≥50% reduction in MADRS score) compared with augmentation of current antidepressant (fluoxetine 20 mg/d to 60… (low certainty).

1 finding from 1 review

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with olanzapine (5 mg/d to 20 mg/d) vs augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with placebo

Remission ‐ not measured · treatment‐resistant depression in adults

The review found no eligible studies for this question.

1 finding from 1 review

Augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with olanzapine (5 mg/d to 20 mg/d) vs augmentation of current antidepressant (fluoxetine 20 mg/d to 60 mg/d) with placebo

Quality of life ‐ not measured · treatment‐resistant depression in adults

The review found no eligible studies for this question.

1 finding from 1 review

Lithium vs OLANZAPINE

Efficacy: response (categorical) MSRS/YMRS ≥ 50% decrease in score by end of study · acute mania

Lithium probably leads to lower efficacy: response (categorical) MSRS/YMRS ≥ 50% decrease in score… compared with olanzapine (moderate certainty).

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    OR 0.44 [0.2, 0.94]
    2 studies · 180 participants
    Moderate

Lithium vs OLANZAPINE

Efficacy: response (continuous) CGI severity score at end of study · acute mania
1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    3 studies · 210 participants
    Low

Lithium vs OLANZAPINE

Remission · acute mania

Lithium showed no clear difference in efficacy: remission (categorical) YMRS ≤ 12 at end of study compared with olanzapine (low certainty).

1 finding from 1 review

Lithium vs OLANZAPINE

Acceptability: total withdrawals · acute mania

Lithium may leads to higher acceptability: total withdrawals compared with olanzapine (low certainty).

1 finding from 1 review

Lithium vs OLANZAPINE

Adverse events · acute mania

The review found no eligible studies for this question.

1 finding from 1 review
  • Lithium for acute mania 2019 · Cochrane Headline outcomes only
    no estimate extracted
    Studies not reported
    No studies found

Valproate vs OLANZAPINE

Response rate at 3 weeks (primary efficacy outcome) · Adults (aged 18 and over) with acute mania

Valproate showed no clear difference in response rate at endpoint at 3 weeks (primary efficacy outcome) compared with olanzapine (low certainty).

1 finding from 1 review

Valproate vs OLANZAPINE

Number of participants with any adverse event (primary tolerability outcome) · Adults (aged 18 and over) with acute mania

The review found no eligible studies for this question.

1 finding from 1 review

Valproate vs OLANZAPINE

Adverse effects: 1. Sedation · Adults (aged 18 and over) with acute mania

Valproate leads to lower adverse events ‐ Sedation At 3‐12 weeks (secondary tolerability… compared with olanzapine (high certainty).

1 finding from 1 review

Valproate vs OLANZAPINE

Change in symptom severity at 3 weeks (secondary efficacy outcome) · Adults (aged 18 and over) with acute mania
1 finding from 1 review

Valproate vs OLANZAPINE

Dropout · Adults (aged 18 and over) with acute mania

Valproate showed no clear difference in dropout rate ‐ All‐cause At 3‐12 weeks (secondary acceptability… compared with olanzapine (high certainty).

1 finding from 1 review