Magazine article Clinical Psychiatry News

Studies Support Calming Effect of Olanzapine. (More Than 1,200 Patients)

Magazine article Clinical Psychiatry News

Studies Support Calming Effect of Olanzapine. (More Than 1,200 Patients)

Article excerpt

TUCSON, ARLZ. -- Five randomized, double-blind trials involving more than 1,200 patients have shown that olanzapine calms acute agitation associated with schizophrenia, bipolar disorder, schizoaffective disorder, or dementia, according to two poster presentations at the annual meeting of the Academy of Psychosomatic Medicine.

These findings suggest that olanzapine, administered either in rapidly escalating oral doses or as intramuscular injections, can control agitation at least as well as standard treatments, said investigators at Lilly Research Laboratories in Indianapolis, which sponsored the trials.

One study compared the effects of rapid initial dose escalation (RIDE) of oral olanzapine to usual clinical practice with olanzapine and lorazepam in 148 patients. During the 4-day trial, the 72 patients. in the RIDE group received 20 mg olanzapme plus up to 40 mg more, as needed, on days 1 and 2 and up to 30 mg more on days 3 and 4.

The 76 patients in the usual-practice group received 10 mg olanzapine plus up to 4 mg lorazepam on days 1 and 2 and up to 2 mg on days 3 and 4.

All patients were openly treated with olanzapine in doses of 5-20 mg for another 3 days.

Agitation was defined as a score of 20 or more on the excited component of the Positive and Negative Symptom Scale Excited Component subscale (PANSS-EC), which rates impulse control, tension, hostility, uncooperativeness, and excitement on a scale of 5-35 points.

At baseline, the mean scores were 23.01 for the RIDE group and 22.27 for the usual-care patients. Within 24 hours, the scores had dropped significantly in both groups, but more in the RIDE than in the usual-care group.

The difference continued to widen so that by day 3, scores had fallen by approximately 9 points in the RIDE patients and approximately 6 points in the usual-care patients. There was no significant difference in adverse events, including somnolence, headache, or dizziness, between the groups, said Dr. Robert W Baker, the lead investigator of this trial.

The other four trials compared intra-muscular injections of olanzapine with injections of lorazepam, haloperidol, or a placebo over 24 hours in a total of 1,054 patients. …

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