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Table 2 Outcomes for placeo controlled trials in bipolar depression [18, 20, 22] – efficacy and discontinuations in trials lasting 8 weeks

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

  

Events/total patients

Event rate (%)

  

Outcome

Trials

Treatment

Placebo

Treatment

Placebo

Relative Risk (95% CI)

NNT (95% CI)

Efficacy

       

Response

       

olanzapine 2–20 mg/day

1

137/351

108/355

39

30

1.3 (1.04 to 1.6)

11.6 (6.4 to 62)

quetiapine 300–600 mg/day

2

379/648

313/330

58

40

1.5 (1.3 to 1.7)

5.4 (4.2 to 7.7)

Combined atypical

3

516/999

240/685

52

35

1.4 (1.2 to 1.6)

6.0 (4.8 to 7.7)

Symptomatic remission

       

olanzapine 2–20 mg/day

1

115/351

87/355

33

25

1.3 (1.06 to 1.7)

12.1 (6.7 to 62)

quetiapine 300–600 mg/day

2

640/648

96/330

52

29

1.8 (1.5 to 2.2)

4.3 (3.5 to 5.9)

Combined atypical

3

455/999

183/685

46

27

1.6 (1.3 to 1.9)

5.3 (4.3 to 7.0)

Emergence of mania

       

olanzapine 2–20 mg/day

1

19/345

23/345

6

7

0.8 (0.5 to 1.5)

not calculated

quetiapine 300–600 mg/day

2

23/697

18/347

5

3

0.6 (0.4 to 1.2)

not calculated

Combined atypical

3

42/1042

41/692

4

6

0.7 (0.5 to 1.1)

not calculated

Discontinuations

       

All cause

       

olanzapine 2–20 mg/day

1

191/351

232/355

54

65

0.8 (0.7 to 0.9)

9.1 (5.5 to 27)

quetiapine 300–600 mg/day

2

292/702

132/349

38

42

1.1 (0.8 to 1.3)

not calculated

Combined atypical

3

483/1053

364/704

46

52

0.9 (0.8 to 1.05)

17 (10 to 50)

Lack of efficacy

       

olanzapine 2–20 mg/day

1

73/351

121/355

21

34

0.6 (0.5 to 0.8)

7.5 (5.1 to 15)

quetiapine 300–600 mg/day

2

13/702

37/349

2

11

0.2 (0.1 to 0.3)

11 (7.7 to 20)

Combined atypical

3

86/1053

158/704

8

22

0.5 (0.4 to 0.6)

7.0 (5.6 to 10)

Adverse events

       

olanzapine 2–20 mg/day

1

34/351

19/355

10

5

1.8 (1.1 to 3.1)

23 (12 to 220)

quetiapine 300–600 mg/day

2

109/702

17/349

16

5

3.2 (2.0 to 5.2)

9.4 (6.7 to 14)

Combined atypical

3

143/1053

36/704

14

5

2.6 (1.8 to 3.7)

12 (10 to 14)

  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. The trial with olanzapine included only the monotherapy treatment arm