Olanzapine May Have Mild Anticholinergic Profile in Elderly

Article excerpt

NEW ORLEANS -- Olanzapine appears to have a relatively safe side effect profile in the elderly, Dr. Bruce J. Kinon reported in two poster presentations at the annual meeting of the American Psychiatric Association.

In an 8-week, open-label study of 82 elderly patients with dementia, psychosis, and agitation, anticholinergic adverse events were infrequent, suggesting that olanzapine may have a relatively mild anticholinergic profile in elderly patients, said Dr. Kinon, senior clinical research physician at Eli Lilly & Co. in Indianapolis.

Patients were subjected to a washout period of 3-7 days prior to receiving olanzapine 2.5 mg daily for 3 days.

If needed, patients received olanzapine titrated up to 10 mg daily in 2.5-mg increments. If patients did not respond after 2 weeks, the dose was increased to as high as 20 mg daily. The mean daily dose was 5 mg.

None of the patients received concomitant antiparkinsonian agents.

There was no significant difference from baseline in scores on the Mini-Mental State Examination and in overall and individual symptom scores on the Udvalg for Kliniske Undersogelser autonomic symptom subscale, which measures peripheral anticholinergic adverse events. Serum olanzapine anticholinergic levels, measured by a radioreceptor assay, did not increase significantly from baseline.

In a separate poster presentation, Dr. Kinon reported that olanzapine appears to have a prolactin-sparing profile in elderly patients that is similar to that seen in younger patients. He analyzed a subgroup of 68 demented elderly patients from the olanzapine study who had psychosis and agitation. The analysis, which considered the varying effects olanzapine had on patients, based on whether they had previously taken another antipsychotic, found the following:

* Risperidone. …