Switching depot antipsychotic drug responders to oral olanzapine.
In an open-label study, 13 patients taking depot antipsychotic medication for greater than 3 years were switched to oral olanzapine. The first 3-month experience has been previously reported. We now describe a second 3-month experience and integrate our observations into a cumulative 6-month report. Monthly, we assessed patients using clinical ratings [Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Mini-Mental State Exam (MMSE), and Clinical Global Improvement Scale (CGI)] and side effect parameters [Abnormal Involuntary Movement Scale (AIMS), Association for Methodology and Documentation in Psychiatry psychotropic side effect rating scale (AMDP-5), and weights]. Olanzapine patients showed statistically significant improvement (baseline to endpoint sixth month) in GAF (p=0.015), MMSE (p=0.022), CGI improvement, and AIMS (p=0.038). There was no statistically significant change in PANSS, CGI severity, or AMDP-5 overall side effects. Weight gain over 6 months averaged 8.9 lb. All patients completed the study. Compliance was estimated at 90%, and 81% of patients chose to continue on the oral olanzapine. One patient was hospitalized at the conclusion of the study. Our findings suggest that clinicians may consider oral olanzapine as a viable alternative to depot antipsychotic medications, balancing clinical improvement in some clinical measures with lack of improvement in other clinical measures; and balancing improvement in abnormal involuntary movements with weight gain and its sequelae.
Godleski
Linda S
LS
Department of Veterans Affairs Medical Center, Louisville, KY, USA.
Goldsmith
L Jane
LJ
Vieweg
W Victor R
WV
Zettwoch
Nancy
N
Stikovac
Dejzi
D
Lewis
Susan
S
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D001569:Benzodiazepines; D000077152:Olanzapine