Comparative efficacy of olanzapine and haloperidol for patients with treatment-resistant schizophrenia.

Abstract

BACKGROUND:

There is relatively little information regarding the efficacy of newer atypical antipsychotic drugs for patients with schizophrenia who are treatment-resistant to neuroleptic agents. Several lines of evidence suggest that a clinical trial of olanzapine in this population is warranted.

METHODS:

A subpopulation of patients (n = 526) meeting treatment-resistant criteria selected from a large, prospective, double-blind, 6-week study assessing the efficacy and safety of olanzapine and haloperidol were examined. Both last-observation-carried-forward (LOCF) and completers (observed cases) analyses were conducted.

RESULTS:

Olanzapine demonstrated significantly greater mean improvement from baseline in Positive and Negative Syndrome Scale (PANSS) negative symptoms, comorbid depressive symptoms assessed by the Montgomery-Asberg Depression Rating Scale, akathisia as measured by Barnes Akathisia Scale, and extrapyramidal symptoms as measured by Simpson-Angus Extrapyramidal Rating Scale with both LOCF and completers analyses. In addition, olanzapine was significantly superior to haloperidol for Brief Psychiatric Rating Scale total (p = .006), PANSS total (p = .005), and PANSS positive symptoms (p = .017) in completers of the 6-week study. Significantly greater response rates were observed in olanzapine-treated (47%) than haloperidol-treated (35%) patients in the LOCF analysis (p = .008), but significance was not reached in the completers analysis (p = .093). Mean doses (+/- SD) of olanzapine and haloperidol were 11.1 +/- 3.4 mg/day and 10.0 +/- 3.6 mg/day, respectively.

CONCLUSIONS:

Olanzapine was superior to haloperidol for key symptom domains and parkinsonian side effects. Implications of these data for the therapeutics of this severely ill subgroup are discussed.

• Authors: A Breier, S H Hamilton
• Journal: Biological psychiatry (Biol Psychiatry) Vol. 45 Issue 4 Pg. 403-11 (Feb 15 1999) ISSN: 0006-3223 [Print] United States
• PMID: 10071708 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antipsychotic Agents
• Benzodiazepines
• Pirenzepine
• Haloperidol
• Olanzapine

Topics

• Adult
• Akathisia, Drug-Induced
• Analysis of Variance
• Antipsychotic Agents (therapeutic use)
• Behavioral Symptoms (chemically induced, drug therapy)
• Benzodiazepines
• Chi-Square Distribution
• Double-Blind Method
• Drug Resistance
• Dyskinesia, Drug-Induced
• Female
• Haloperidol (therapeutic use)
• Humans
• Male
• Middle Aged
• Olanzapine
• Pirenzepine (analogs & derivatives, therapeutic use)
• Prospective Studies
• Schizophrenia (drug therapy)
• Treatment Outcome