Dr. Bob's Psychopharmacology Tips

Olanzapine + typical antipsychotics

From: MKomrad@aol.com
Date: Tue, 18 Mar 1997 22:37:35 -0500 (EST)
Subject: Olanzapine + haloperidol

I have seen a few patients now who had partial responses to olanzapine 20-25 mg after a few weeks and suddenly had a robust improvement when haloperidol was added to the olanzapine. Maybe it's sometimes important to block the D2 receptor more completely.

Date: Tue, 18 Mar 1997 20:47:01 -0800 (PST)
From: Tina <tinam@tidepool.com>
Subject: Olanzapine + haloperidol

I have seen this same positive response in our clinic, with a chronic paranoid schizophrenic man. This man was on haloperidol 60 mg po per day plus decanoate 100 mg q3wks. He was switched to olanzapine 10 mg qHS and later increased to 20 mg qHS. He had remarkable improvement in his negative symptoms, but as his haloperidol was taken away he started having terrible auditory hallucinations. The decanoate was added back, with good response. He has since decided that he wants only pills and is now taking olanzapine 20 mg qHS plus haloperidol 5 mg BID prn. He has now been without the decanoate for one month, so we shall see if the haloperidol po will hold him. So far, the combination seems to be working well.

Date: Thu, 20 Mar 1997 13:21:55 -0800 (PST)
From: "M. Underwood" <undrwood@u.washington.edu>
Subject: Olanzapine + haloperidol

We have used this combination in 5 patients who are treatment resistant. The use of olanzapine alone at 30-35 mg/day provided moderate relief of negative symptoms but the patients continued to be very delusional and to complain of voices. Adding 5-10 mg/d haloperidol has seemed to be effective in reducing the residual positive symptoms. These patients have been on this combination for 4-5 wks.

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