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I read with interest the article by Tohen et al,¹ which has clearly demonstrated the efficacy of olanzapine in the treatment of acute bipolar mania; however, this study¹ has certain methodological limitations. First, the authors mentioned that a minimum baseline total Young–Mania Rating Scale (Y-MRS)² score of at least 20 was a prerequisite on the day of randomization; however, they included a single patient whose baseline total Y-MRS score was 14. No reason has been given for this inclusion in their methodology. Second, although the authors used both the Y-MRS and the 21-item Hamilton Psychiatric Rating scale for Depression (HAMD-21) to evaluate psychopathology, both the definition of improvement and the final analysis (ie, improvement from baseline to end point) were restricted only to Y-MRS scores. Since 42.6% of the study subjects had mixed affective episodes, and the Y-MRS does not evaluate depressive symptoms, both the outcome definition and the final . . . [Full Text of this Article]