title: Efficacy of accelerated dose titration of olanzapine with adjunctive lorazepam to treat acute agitation in schizophrenia.
abstract: We conducted a prospective double-blind study of accelerated dose titration of olanzapine in the treatment of newly admitted acutely agitated patients with schizophrenia. Patients were randomized to either oral olanzapine (10 mg per day) or oral haloperidol (10 mg per day), plus lorazepam as needed (up to 12 mg per day). Antipsychotic dosage was increased to 20 mg per day as early as day 3. Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) Agitation subscale during the first 24 hours of treatment, daily for the first week, then weekly until study completion. Significant within-group improvement was demonstrated in PANSS Agitation scores for both groups as early as 1 hour after initiating therapy (-5.79 +/- 6.30 for olanzapine and -4.89 +/- 6.05 for haloperidol, P <.001). This study demonstrated that accelerated dose titration of oral olanzapine is as efficacious as oral haloperidol in reducing acute agitation in patients with schizophrenia.
authors.affiliation: Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana 46285, USA.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Kinon
authors.forename: Jonna
authors.initials: J
authors.lastname: Ahl
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Rotelli
authors.forename: Edmund
authors.initials: E
authors.lastname: McMullen
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D014151:Anti-Anxiety Agents / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004637:Emergency Services, Psychiatric / Q000379:methods / Q000592:standards; D004638:Emergency Treatment / Q000379:methods / Q000592:standards; D005260:Female; D006220:Haloperidol / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008140:Lorazepam / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D000077152:Olanzapine; D011446:Prospective Studies; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000209:etiology; D012559:Schizophrenia / Q000150:complications*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D006220:Haloperidol; D000077152:Olanzapine; D008140:Lorazepam