Academic journal article East Asian Archives of Psychiatry

Serum Prolactin Levels and the Acute-Phase Efficacy in Drug-Naïve Schizophrenia Treated with Ziprasidone and Olanzapine (Translated Version)

Academic journal article East Asian Archives of Psychiatry

Serum Prolactin Levels and the Acute-Phase Efficacy in Drug-Naïve Schizophrenia Treated with Ziprasidone and Olanzapine (Translated Version)

Article excerpt

Abstract

Objectives: To study the efficacy and associated serum prolactin levels of ziprasidone and olanzapine treatment in drug-naïve schizophrenia patients.

Methods: All 78 inpatients with drug-naïve schizophrenia were recruited from the Department of Psychology, The Third Affiliated Hospital of Sun Yat-sen University. They were divided into either olanzapine group (n = 49 [24 men, 25 women]; mean [standard deviation] age, 24 [6] years) or ziprasidone group (n = 29 [14 men, 15 women]; mean [standard deviation] age, 23 [7] years), all of whom were treated for 4 weeks. The serum prolactin level, the Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), and Clinical Global Impression-Improvement scores were measured before and at the end of treatment.

Results: In the olanzapine group, the respective mean (standard deviation) PANSS and CGI-S scores after the treatment (62 ± 15 and 3 ± 1) were significantly lower than those before the treatment (104 ± 14 and 6 ± 1) [p < 0.01]. In the ziprasidone group, the corresponding scores after the treatment (75 ± 20 and 4 ± 1) were also significantly lower than those before the treatment (104 ± 17 and 6 ± 1) [p < 0.01]. The decreases in mean (standard deviation) PANSS total (42 ± 17) and PANSS positive scores (12 ± 6) in the olanzapine group were significantly higher than those in the ziprasidone group (29 ± 12 and 6 ± 4, respectively) [p < 0.01]. The increase of serum prolactin in the ziprasidone female group (47 ± 51 µg/L) was significantly higher than that in the ziprasidone male group (17 ± 11 µg/L), the olanzapine male group (5 ± 16 µg/L), and the olanzapine female group (21 ± 34 µg/L) [p < 0.05].

Conclusions: Both ziprasidone and olanzapine are effective for treating drug-naïve acute schizophrenia, but olanzapine was superior to ziprasidone in terms of positive and general psychopathological symptoms. In women, ziprasidone was associated with greater changes in prolactin level than olanzapine.

Key words: Antipsychotic agents; Prolactin; Schizophrenia

Introduction

Ziprasidone is a new atypical antipsychotic drug approved for use in the United States in 2001 and in Mainland China in 2007. Olanzapine was approved for use in the United States in 1996 and in Mainland China in 1999. Worldwide, both drugs are currently first-line drugs for the treatment of schizophrenia, as they are efficacious in terms of treating the positive, negative and general psychopathological symptoms.1-4 Ziprasidone has minimal effect on body mass and glycolipid metabolism which is not the case for olanzapine, but the effects of the 2 drugs on prolactin levels were smaller than those of traditional antipsychotics and the atypical antipsychotic risperidone. To date, domestic clinical studies directly comparing the effects of ziprasidone and olanzapine on prolactin levels have been rare, but case reports of clinical associations were not uncommon. This study was therefore initiated to compare the efficacy of ziprasidone and olanzapine on drug-naïve acute schizophrenia and their effects on serum prolactin levels.

Subjects and Methods

Study Subjects

The subjects of this study were inpatients at the Department of Psychology of the Third Affiliated Hospital, Sun Yat-sen University during the period March 2010 to February 2011. The study was approved by the local ethics committee, and was conducted in accordance with the World Medical Association's Declaration of Helsinki. The inclusion criteria were: (1) fulfilment of the diagnostic criteria for schizophrenia stated in the third version of the Chinese Classification and Diagnostic Criteria of Mental Disorders; (2) being antipsychotic drug-naïve; (3) giving written informed consent; (4) aged being 18 to 35 years; and (5) having a Positive and Negative Syndrome Scale (PANSS) score of ≥ 60. Exclusion criteria were: (1) presence of any severe physical illness (particularly gynaecological and endocrine diseases); (2) a history of drug and alcohol dependence; and (3) being pregnant or breast-feeding within the last 2 years. …

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