Posted by SalArmy4me on August 8, 2001, at 20:44:39
In reply to zyprexa, long-term effects and insomnia, posted by k9lover on August 8, 2001, at 20:17:31
Olanzapine in the long-term treatment of schizophrenia. British Journal of Psychiatry. 174(37S) Supplement:26-29, February 1999:
"...Data on maintenance treatment with olanzapine are becoming available and appear to be encouraging. Recent data have been developed from double-blind extensions of multi-centre studies of olanzapine in acute patients (Tollefson et al, 1997) [29]. To be eligible for the double-blind maintenance treatment phase, patients had to either show a decrease of 40% or more on the BPRS or have a final score of 18 or less after initial treatment. Additionally, they had to have been seen as out-patients at their last acute-phase visit. Relapse in these trials was defined as rehospitalisation.
In North American trials, 2.5-17.5 mg olanzapine was compared with 10-20 mg haloperidol and resulted in no statistically significant difference between the groups. In a larger international study, in which the same two drugs were compared at dosages of 5-20 mg, a significant difference was seen: the haloperidol patients had a 28% relapse rate and the olanazapine group only 19% (P < 0.05) (Tran et al, 1998) [30]. In pooled studies including all patients, the olanzapine group (n=627) had a relapse rate of 20% within one year, while the haloperidol group (n=80) had a relapse rate of 28% (P < 0.05).
It is of considerable importance to consider the olanzapine-treated patients - those who were in the double-blind studies and those in the extension study - in terms of their risk for developing tardive dyskinesia. One per cent of the olanzapine patients developed evidence of tardive dyskinesia after a mean exposure of 237 days. In contrast, 4.6% of haloperidol-treated patients developed tardive dyskinesia after a mean exposure of 203 days. The incidence observed with haloperidol is similar to that reported in other prospective studies of patients receiving conventional neuroleptics (Kane, 1995) [14]. This represents a far lower incidence of tardive dyskinesia than with haloperidol and is extremely encouraging (Tollefson et al, 1997) [29].
CONCLUSION
Maintenance treatment with conventional antipsychotic medication can help prevent relapses in patients with schizophrenia, whether they are experiencing their first episode or have had several episodes. However, long-term therapy has attendant side-effects, in particular an increased risk of tardive dyskinesia. Various strategies have been tried to reduce those risks without sacrificing the efficacy of the medication, but success has been limited. The atypical drug, olanzapine, with a favourable toxicity profile and proven efficacy, offers a promising alternative to previous treatments..."
poster:SalArmy4me
thread:74249
URL: http://www.dr-bob.org/babble/20010804/msgs/74259.html