title: Intramuscular olanzapine versus short-acting typical intramuscular antipsychotics: comparison of real-life effectiveness in the treatment of agitation.
abstract: OBJECTIVE
  To compare the effectiveness of intramuscular (IM) olanzapine and typical IM antipsychotics in naturalistically treated acutely agitated patients with schizophrenia or acute mania.
  
  
  METHODS
  During the acute phase, 2011 inpatients (including emergency settings) were assessed at 2, 24 and 72 h, and 7 days following initial injection and on oral antipsychotic transition. Mean change in agitation was assessed via Positive and Negative Symptom Scale-Excited Component (PANSS-EC) and Clinical Global Impressions-Severity (CGI-S) scores. Response (> or = 40% reduction in baseline PANSS-EC score) was analysed using logistic regression.
  
  
  RESULTS
  Significantly greater decreases in PANSS-EC and CGI-S scores were observed in patients receiving IM olanzapine (n = 1294) as their first injection compared with patients receiving other IM antipsychotics (n = 717) (P<0.05; 2 h: effect size 0.1); IM haloperidol treatment (all assessments, P<0.05); and IM zuclopenthixol treatment (2 h, P<0.001). Higher response rates were observed with IM olanzapine compared with other IM antipsychotics at 24 and 72 h, and 7 days (P<0.05). IM olanzapine was associated with fewer extrapyramidal side effects compared with other assessed IM antipsychotics.
  
  
  CONCLUSIONS
  IM olanzapine provided somewhat more effective control of acute agitation than other assessed IM antipsychotics.
authors.affiliation: St. Vincent's Hospital, The University of Melbourne, Fitzroy, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Castle
authors.forename: Tudor
authors.initials: T
authors.lastname: Udristoiu
authors.forename: Chang Yoon
authors.initials: CY
authors.lastname: Kim
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarosi
authors.forename: Vladimir
authors.initials: V
authors.lastname: Pidrman
authors.forename: A Nasser
authors.initials: AN
authors.lastname: Omar
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Rosales
authors.forename: Yuval
authors.initials: Y
authors.lastname: Melamed
authors.forename: Turgut
authors.initials: T
authors.lastname: Isik
authors.forename: Jamie
authors.initials: J
authors.lastname: Karagianis
authors.forename: Tamas
authors.initials: T
authors.lastname: Treuer
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001480:Basal Ganglia Diseases / Q000139:chemically induced; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D003006:Clopenthixol / Q000008:administration & dosage / Q000627:therapeutic use; D003431:Cross-Cultural Comparison; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D000077152:Olanzapine; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D003006:Clopenthixol; D006220:Haloperidol; D000077152:Olanzapine