Quality of life during treatment with haloperidol or olanzapine in the year following a first psychotic episode.
OBJECTIVE
Schizophrenia causes significant impairments of quality of life. As treatment approaches have advanced, more attention has been given to re-integrating patients into their psychosocial environments, rather than simply monitoring psychotic symptoms. The development of the second-generation antipsychotics raised hope that these medications would provide better quality of life improvement than conventional antipsychotics. This improvement is particularly relevant early in the course of schizophrenia.


METHODS
To address these considerations, improvements in measures of general health and social function (determined using the SF-36) were assessed in 195 patients with first-episode schizophrenia for up to one year following randomization to either olanzapine or haloperidol in a double blind clinical trial. We hypothesized that olanzapine would demonstrate better improvement on these measures than haloperidol. In order to test this hypothesis, we used a repeated measure model with SF-36 scores as the outcome, and treatment group, time, time2, time-by-treatment group interaction, and time2-by-treatment group interaction as fixed effects.


RESULTS
Both treatments demonstrated similar changes on the SF-36. Independent of treatment, patients demonstrated significant improvements in most of the SF-36 subscales, which approached normative scores by the end of one year of treatment. Forty-six of 100 olanzapine-treated patients and 37 of 95 haloperidol-treated patients completed the one year of this study (p<.4).


CONCLUSIONS
These results suggest an important initial treatment goal for patients with new onset schizophrenic disorders, namely that they can expect to recover significant quality of life and social function at least initially in treatment.
Strakowski
Stephen M
SM
Center for Imaging Research and Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, 231 Albert Sabin Way (ML0583), Cincinnati, OH 45267-0583, USA. Stephen.Strakowski@uc.edu
Johnson
Jacqueline L
JL
Delbello
Melissa P
MP
Hamer
Robert M
RM
Green
Alan I
AI
Tohen
Mauricio
M
Lieberman
Jeffrey A
JA
Glick
Ira
I
Patel
Jayendra K
JK
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006220:Haloperidol / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011618:Psychotic Disorders / Q000175:diagnosis*; D011788:Quality of Life / Q000523:psychology*; D013997:Time Factors
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D006220:Haloperidol; D000077152:Olanzapine