Olanzapine orally disintegrating tablet vs. risperidone oral solution in the treatment of acutely agitated psychotic patients.
OBJECTIVE
Efficacy and tolerability of risperidone oral solution (RIS-OS) and olanzapine orally disintegrating tablet (OLZ-ODT) were compared for the treatment of acute psychotic agitation.


METHODS
During a 2-month period, patients scoring > or =15 on the Excited Component for Positive and Negative Syndrome Scale (PANSS-EC) were assigned to treatment with OLZ-ODT (n=34) or RIS-OS (n=53) on psychiatric emergency situations, and assessed every 15 min.


RESULTS
Two (OLZ-ODT and RIS-OS) by five (0-, 15-, 30-, 45- and 60-min time points) repeated-measures analysis of variance revealed only a significant main effect of time course on PANSS-EC (F=82.2, P<.0001). No differences in the number of patients receiving additional injection due to worsening were found (OLZ-ODT, 11.8%; RIS-OS, 9.4%). No differences in rate of extrapyramidal symptoms and patient satisfaction with assigned treatment were found. However, patients in the OLZ-ODT group recovered significantly more from tachycardia than those in the RIS-OS group (t=2.17, P=.03).


CONCLUSIONS
OLZ-ODT and RIS-OS treatments yielded similar improvements in acutely agitated patients who accepted oral medication. However, on one physiological parameter (i.e., tachycardia) OLZ-ODT might be superior to RIS-OS. Physiological indicators may also be useful for measuring levels of agitation.
Hatta
Kotaro
K
Department of Psychiatry, Juntendo University School of Medicine, Bunkyo-ku, Tokyo 113-8421, Japan. khatta@med.juntendo.ac.jp
Kawabata
Toshitaka
T
Yoshida
Kenichi
K
Hamakawa
Hiroshi
H
Wakejima
Toru
T
Furuta
Ko
K
Nakamura
Mitsuru
M
Hirata
Toyoaki
T
Usui
Chie
C
Nakamura
Hiroyuki
H
Sawa
Yutaka
Y
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001294:Attitude to Health; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010349:Patient Compliance; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D018967:Risperidone / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012996:Solutions / Q000008:administration & dosage / Q000493:pharmacokinetics; D013607:Tablets / Q000008:administration & dosage / Q000493:pharmacokinetics; D013610:Tachycardia / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D012996:Solutions; D013607:Tablets; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine