Risperidone and Olanzapine versus Another First Generation Antipsychotic in Patients with Schizophrenia Inadequately Responsive to First Generation Antipsychotics

J.-J. Chen; H.-Y. Chan; C.-H. Chen; S. S.-F. Gau; H.-G. Hwu

doi:10.1055/s-0031-1291293

Pharmacopsychiatry, Table of Contents

Pharmacopsychiatry 2012; 45(02): 64-71
DOI: 10.1055/s-0031-1291293

Original Paper

Risperidone and Olanzapine versus Another First Generation Antipsychotic in Patients with Schizophrenia Inadequately Responsive to First Generation Antipsychotics

J.-J. Chen

¹Department of General Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan

,

H.-Y. Chan

¹Department of General Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan

²Department of Psychology, Chung Yuan Christian University, Chung-Li, Taiwan

³Department of Psychiatry, National Taiwan University Hospital and School of Medicine, National Taiwan University, Taipei, Taiwan

,

C.-H. Chen

¹Department of General Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan

,

S. S.-F. Gau

³Department of Psychiatry, National Taiwan University Hospital and School of Medicine, National Taiwan University, Taipei, Taiwan

,

H.-G. Hwu

³Department of Psychiatry, National Taiwan University Hospital and School of Medicine, National Taiwan University, Taipei, Taiwan

› Author Affiliations

Abstract

Objective:

This study compares the efficacy of risperidone and olanzapine to that of first-generation antipsychotics (FGAs) in patients with schizophrenia, who failed to show a response to initial trials of FGAs.

Method:

This study was an 8-week treatment, randomized, rater-blind, active-control study with 3 treatment arms. 48 patients, who showed inadequate response to 1 FGA, were enrolled and randomized into risperidone, olanzapine, or FGA (haloperidol or trifluoperazine) groups. They were blindly assessed with the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression Scale-Severity, and the Extrapyramidal Symptom Rating Scale (ESRS) at baseline and biweekly.

Results:

All 3 groups demonstrated a significant decrease in the PANSS total, positive, and general scores from baseline to endpoint (p-values range from 0.003 to 0.021). There were no significant differences among the 3 groups in score changes. The olanzapine group had significant score reductions than the risperidone and FGAs groups in terms of the ESRS subjective total score and did not experience a significant increase in the dose of anticholinergics. The FGA group demonstrated that extrapyramidal syndrome (EPS) worsened under an increased dosage of anti-EPS drugs. Olanzapine was associated with significant body weight gain (2.69±4.0 kg, p=0.026), but there were no significant group differences on weight gain.

Conclusions:

Haloperidol or trifluoperazine demonstrated similar efficacy as risperidone or olanzapine for patients with schizophrenia who had failed their first trial with a FGA. Related double-blind, fixed dose studies with a larger sample size are needed to confirm the results of our study.

Key words

schizophrenia - risperidone - olanzapine - inadequate response

Full Text

References

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