title: Use of atypical antipsychotics in a Veterans Affairs hospital.
abstract: In a retrospective chart review, efficacy and drug costs were compared in 91 consecutive outpatients receiving risperidone (n=70) or olanzapine (n=21) at the Veterans Affairs Medical Center in Syracuse, NY. Between-group differences in background characteristics, diagnoses (schizophrenia in more than half of each group) and antipsychotic efficacy [Clinical Global Impressions (CGI) scale scores] were not significant. The mean doses were 3.6+/-2.4 mg/day of risperidone and 10.7+/-7.6 mg/day of olanzapine. The VA costs of these mean doses were S3.32/day for risperidone and $6.67/day for olanzapine. Mean duration of treatment was significantly longer for risperidone (21 months) than for olanzapine (13 months). Incidence of parkinsonian symptoms (14% of both risperidone and olanzapine patients) and tardive dyskinesia (3% of risperidone patients and 5% of olanzapine patients) was similar in the two groups. Akathisia tended to occur more often in patients receiving olanzapine than risperidone (14% versus 3%, P=.08). The results of this retrospective survey indicate that, in comparable VA populations of patients with psychotic and other disorders, risperidone and olanzapine are equally efficacious but olanzapine may be more likely to produce akathisia and is twice as expensive as risperidone.
authors.affiliation: Department of Psychiatry, SUNY Upstate Medical University, New York, USA. thomas_schwartz@yahoo.com
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Schwartz
authors.forename: Mercy
authors.initials: M
authors.lastname: Saba
authors.forename: William
authors.initials: W
authors.lastname: Hardoby
authors.forename: Subhdeep
authors.initials: S
authors.lastname: Virk
authors.forename: Prakash S
authors.initials: PS
authors.lastname: Masand
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D001569:Benzodiazepines; D004363:Drug Utilization; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010045:Outpatients; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D018967:Risperidone / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D018967:Risperidone; D000077152:Olanzapine