Safety, effectiveness, and patterns of use of olanzapine in acute schizophrenia: a multivariate analysis of a large naturalistic study in the hospital setting.
OBJECTIVE
This study assessed the safety and effectiveness of the atypical antipsychotic olanzapine for the treatment of inpatients with acute schizophrenia. Furthermore, we evaluated patterns of use of olanzapine and their relationship to safety and effectiveness.


METHODS
This was a prospective, comparative, nonrandomized, open-label, observational study of 848 patients with schizophrenia (International Classification of Diseases, 10th edition) hospitalized due to an acute psychotic episode. Data were collected during patients' entire hospital stay. Safety of antipsychotic therapy was assessed with an extrapyramidal symptoms questionnaire (based on the Udvalg for Kliniske Undersøgelser scale) and the report of spontaneous adverse events. Clinical status was assessed with the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impressions-Severity of Illness (CGI-S). A multivariate statistical approach was employed.


RESULTS
Patients treated with olanzapine in monotherapy had the lowest risk of developing extrapyramidal symptoms (11.2%), whereas patients treated with conventional antipsychotics had a higher risk (39.0%; p < 0.001). Patients treated with olanzapine in monotherapy (even patients with prominent positive symptoms) displayed a higher rate of response compared with conventional antipsychotics-treated patients (p = .007).


CONCLUSIONS
Olanzapine is a safe and effective treatment for patients with acute schizophrenia in the hospital setting, even for patients with prominent positive or agitation symptoms.
Cañas
Fernando
F
Psychiatry Unit, Hospital Psiquiátrico de Madrid, Madrid, Spain.
Ciudad
Antonio
A
Gutiérrez
Miguel
M
Gibert
Juan
J
Gascón
Josep
J
Carrasco
José Luis
JL
Bobes
Julio
J
Gómez
Juan Carlos
JC
Alvarez
Enrique
E
D000208:Acute Disease; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D010054:Brief Psychiatric Rating Scale; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D019370:Observation; D000077152:Olanzapine; D011446:Prospective Studies; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy* / Q000534:rehabilitation*; D012720:Severity of Illness Index; D012931:Social Environment
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine