title: A comparison between augmentation with olanzapine and increased risperidone dose in acute schizophrenia patients showing early non-response to risperidone.
abstract: We examined whether augmentation with olanzapine would be superior to increased risperidone dose among acute schizophrenia patients showing early non-response to risperidone. We performed a rater-blinded, randomized controlled trial at psychiatric emergency sites. Eligible patients were newly admitted patients with acute schizophrenia. Early response was defined as Clinical Global Impressions-Improvement Scale score ≤3 following 2 weeks of treatment. Early non-responders were allocated to receive either augmentation with olanzapine (RIS+OLZ group) or increased risperidone dose (RIS+RIS group). The 78 patients who completed 2 weeks of treatment were divided into 52 early responders to risperidone and 26 early non-responders to risperidone (RIS+OLZ group, n=13; RIS+RIS group, n=13). No difference in the achievement of ≥50% improvement in Positive and Negative Syndrome Scale total score was observed between RIS+OLZ and RIS+RIS groups. Although time to treatment discontinuation for any cause was significantly shorter in the RIS+RIS group (6.8 weeks [95% confidence interval, 5.2-8.4]) than in early responders to risperidone (8.6 weeks [7.9-9.3]; P=0.018), there was no significant difference between the RIS+OLZ group (7.9 weeks [6.3-9.5]) and early responders to risperidone. Secondary outcomes justify the inclusion of augmentation arms in additional, larger studies comparing strategies for early non-responders.
authors.affiliation: Department of Psychiatry, Juntendo University Nerima Hospital, Tokyo, Japan. khatta@juntendo.ac.jp
authors.forename: Kotaro
authors.initials: K
authors.lastname: Hatta
authors.forename: Taro
authors.initials: T
authors.lastname: Otachi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sudo
authors.forename: Hironori
authors.initials: H
authors.lastname: Kuga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takebayashi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ishii
authors.forename: Masataka
authors.initials: M
authors.lastname: Kasuya
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Morikawa
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hata
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Nakamura
authors.forename: Chie
authors.initials: C
authors.lastname: Usui
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Hirata
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sawa
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000627:therapeutic use; D004351:Drug Resistance / Q000187:drug effects*; D004359:Drug Therapy, Combination / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D000077152:Olanzapine; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*; D016037:Single-Blind Method
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine