Olanzapine amisulpride

A search of Medline, EMBASE and PsycLIT was conducted in August 2000, using the following terms Amisulpride, clozapine, olanzapine, risperidone, sertindole, zotepine, ziprasidone, economics, healthcare, costs. All manufacturers of atypical antipsychotic drugs were contacted in April 2000 and asked to supply primary reference data on their product, and all companies had complied with this request by August 2000. A further manual search was conducted of files and journals kept in the National Centre for Information on Psychotropics at the Maudsley Hospital. Reference sections from all retrieved papers were scrutinized for further relevant references. 

Table 41.5 summarizes existing studies on the use of atypical antipsychotics in EOS. As the table demonstrates, most studies have been carried out with clozapine, only three with olanzapine and two with risperidone each, and only one study has assessed use of amisulpride and one quetiapine. 

Antipsychotic drugs with strong sedative clinical effects (e.g. chlorpromazine. clozapine, olanzapine) produce subjective and objective sedation and impair most areas of performance in healthy volunteers, usually at doses far below those typically used in patients. Antipsychotic drugs with little sedative clinical action (e.g. pimozide, sulpiride, amisulpride) produce few subjective and objective effects in healthy... 

The atypical antipsychotics are divided into two major pharamacological groups, namely the multiple receptor antagonists, such as clozapine, olanzapine and quetiapine, and the more selective 5-HT2/D2 antagonists as exemplified by risperidone, sertindole, ziprasidone and zotepine. The benzamide antipsychotic amisulpride is the most selective antagonist for the D2/D3 receptors which presumably gives it the mesocortical selectivity of action with a minimal effect on the dopamine receptors in the basal ganglia. 

In a randomized comparison of amisulpride with olanzapine in 377 patients with schizophrenia with predominantly positive symptoms, who were treated for 6 months with either amisulpride 200-800 mg or olanzapine 5-20 mg, positive and negative scores were similar for amisulpride and olanzapine new weight gain was less in amisulpride-treated patients by day 56, amisulpride recipients had gained 0.4 kg whereas olanzapine recipients had gained 2.7 kg (Mortimer S21). 

There were moderate but significant improvements in neurocognition (including executive function, working memory, and declarative memory) in a randomized, double -blind, 8-week study in 52 patients with schizophrenia assigned either to olanzapine (10-20 mg/day n = 18) or amisulpride (400-800 mg/day n = 18) (11). Of 16 dropouts, six were due to adverse events olanzapine—sedation (n = 2) and increased transaminases (n = 1) amisulpride—rash, extrapyramidal symptoms, and galactorrhea (n — 1 each). 

Wagner M, Quednow BB, Westheide J, Schlaepfer TE, Maier W, Kuhn KU. Cognitive improvement in schizophrenic patients does not require a serotonergic mechanism randomized controlled trial of olanzapine vs amisulpride. Neuropsychopharmacology 2005 30 381-90. 

Mortimer A, Martin S, Loo H, Peuskens J, for the SOLIANOL Study Group. A double-blind, randomized comparative trial of amisulpride versus olanzapine for 6... 

Atypical agents-, amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, zotepine. 

Try one of fhe ofher afypical anfipsychofics (risperidone, olanzapine, quefiapine, ziprasidone, amisulpride)... 

The newer atypical psychotropics vary widely in their receptor binding profiles. Olanzapine and quetiapine bear resemblance to the profile of clozapine in that their therapeutic effects appear to derive from action on different receptors and transmitter systems. All atypicals (except amisulpride) exhibit greater antagonism of SHT -receptors than Baroceptors compared with the classical agents. Atypical drugs that do antagonise dopamine D -receptors appear to have affinity for those in the... 

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