title: Olanzapine vs. risperidone in patients with first-episode schizophrenia and a lifetime history of cannabis use disorders: 16-week clinical and substance use outcomes.
abstract: The purpose of this study is to compare the efficacy of olanzapine and risperidone for the acute treatment of first-episode schizophrenia patients with cannabis use disorders. This secondary analysis of a previously published study included 49 first-episode patients with a diagnosis of schizophrenia, schizophreniform disorder, or schizoaffective disorder and a co-occurring lifetime diagnosis of cannabis use disorders randomly assigned to treatment with either olanzapine (n=28) or risperidone (n=21) for 16weeks. The olanzapine group did not differ significantly from the risperidone group for initial response rates of positive symptoms, and rates of cannabis use or alcohol use during the study. Positive symptoms and the Scale for Assessment of Negative Symptoms (SANS) global asociality-anhedonia scores improved over time but did not differ between study medications. In both groups, cannabis use during the study was higher in patients who used cannabis within three months of the admission. Thus, our results suggest that olanzapine and risperidone had a similar initial efficacy on psychotic symptoms and substance use in first-episode patients with co-occurring cannabis use disorders. If clinicians are choosing between olanzapine versus risperidone treatment for this population, their decision should be based upon factors other than symptom response and short-term substance misuse.
authors.affiliation: The Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, USA. sevy@lij.edu
authors.forename: Serge
authors.initials: S
authors.lastname: Sevy
authors.forename: Delbert G
authors.initials: DG
authors.lastname: Robinson
authors.forename: Suzanne
authors.initials: S
authors.lastname: Sunday
authors.forename: Barbara
authors.initials: B
authors.lastname: Napolitano
authors.forename: Rachel
authors.initials: R
authors.lastname: Miller
authors.forename: Joanne
authors.initials: J
authors.lastname: McCormack
authors.forename: John
authors.initials: J
authors.lastname: Kane
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D000077152:Olanzapine; D011569:Psychiatric Status Rating Scales; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D019966:Substance-Related Disorders / Q000150:complications / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine