Olanzapine risperidone

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. 

Spannheimer A, Clouth J, Gregor KJ (1999). Pharmacoeconomic evaluation of the rrearmenr of schizophrenia in Germany a comparison of olanzapine, risperidone and haloperidol using a clinical decision model. Poster presented at the ISPOR Second Annual European Meeting, Edinburgh, November 1999. 

Lee, C. et al. (2006). Treatment with olanzapine, risperidone or typical antipsychotic drugs in Asian patients with schizophrenia. Aust. N. Z. J. Psychiatry, 40, 437-45. 

Atypical antipsychotics The second generation or so-called atypical antipsychotics have chemical, pharmacological, and clinical properties that are different from those of the classical antipsychotics/ neuroleptics. The most commonly used atypicals include clozapine, olanzapine, risperidone, and quetiapine. 

Tardive dyskinesia refers to uncontrollable facial movements. It is more likely to occur in the elderly. Tardive dyskinesia is commonly associated with the use of antipsychotic drugs, such as haloperidol. The atypical antipsychotics, such as clozapine, olanzapine, risperidone and quetiapine are less likely to cause tardive dyskinesia. 

Bilder, R.M., Goldman, R.S., Volavka, J., et al Neurocognitive effects of clozapine, olanzapine, risperidone, and haloperidol in patients with chronic schizophrenia or schizoaffective disorder.. 4m. J. Psychiatry 159, 1018-1028, 2002. 

Novel antipsychotics (NAPs) [e.g., clozapine, olanzapine, risperidone, quetiapine, ziprasidone, aripiprazole]... 

To review the unique pharmacological properties of several atypical antipsychotics, including olanzapine, risperidone, quetiapine, clozapine, ziprasidone and others. 

In 48 patients with schizophrenia taking clozapine, olanzapine, risperidone, or typical neuroleptic drugs, and 31 untreated healthy control subjects newer neuroleptic drugs, such as clozapine and olanzapine, compared with typical agents, were associated with adverse effects on blood glucose regulation (774). 

David SR, Taylor CC, Kinon BJ, Breier A. The effects of olanzapine, risperidone, and haloperidol on plasma prolactin levels in patients with schizophrenia. Clin Ther 2000 22(9) 1085-96. 

In the development of new antipsychotics, cQT intervals are routinely evaluated but it is currently unclear how predictive these are of clinically significant cardiotoxicity or sudden death. For this reason, the heart rate variability (HRV) index has been developed. It has been shown that the HRV decreases after TCAs and clozapine. In a comparison of the acute effects of olanzapine, risperidone and thioridazine in healthy male volunteers, olanzapine was shown to increase, thioridazine to decrease while risperidone was without effect on the HRV. A decrease in the HRV is an established predictor of poor cardiac outcome. The cardiac changes were unrelated to the degree of sedation caused by the drugs. 

Barbee JG, Comad EJ, Jamhour NJ. The effectiveness of olanzapine, risperidone, quetiapine, and ziprasidone as augmentation agents in treatment-resistant major depressive disorder. J Clin Psychiatry 2004 65(7) 975-981. 

Volavka J, Czobor P, Sheitman B, Lindenmayer JP, Citrome L, McEvoy JP, Cooper TB, Chakos M, Lieberman JA. Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder. Am J Psychiatry 2002 159(2) 255-62. 

Sacristan JA, Gomez JC, Montejo AL, Vieta E, Gregor KJ. Doses of olanzapine, risperidone, and haloperidol used in clinical practice results of a prospective phar-macoepidemiologic study. EFESO Study Group. Estudio Farmacoepidemiologico en la Esquizofrenia con Olanzapina. Clin Ther 2000 22(5) 583-99. 

Dissolvable tablets Olanzapine, risperidone Quicker absorption, provides alternative to injection... 

Second-generation antipsychotics (SGAs) (also known as atypical antipsy-chotics), except clozapine, are the agents of first choice in treatment of schizophrenia. Growing, but stiU controversial, evidence supports that the SGAs (e.g., clozapine, olanzapine, risperidone, quetiapine, ziprasidone, and aripiprazole) have superior efficacy for treatment of negative symptoms, cognition, and mood. 

Representative Chemicals Chlorpromazine Tri-flupromazine Promazine Promethazine Ace-promazine Ethopropazine Thioridazine Mesoridazine Piperacetazine Fluphenazine Perphenazine Prochlorperazine Trifluoperazine Acetophenazine Molindone Pimozide Haloper-idol Droperidol Thiothixene Chlorprothixene Clozapine Olanzapine Risperidone Quetiapine Loxapine... 

Quantifying blood levels of those compounds for which assays are available is an easy and reliable method to ensure compliance and assess metabolic status. Reliable assays are currently available for compounds such as nortriptyline, clozapine, olanzapine, risperidone, and all the mood stabilizers. 

Lithium and valproate are the mainstays of treatment for both acute mania and prophylaxis for recurrent manic and depressive episodes. Anticonvulsants such as lamotrigine, carbamazepine, and oxcarbazepine and atypical antipsy-chotics such as aripizrazole, olanzapine, risperidone, queti-... 

I Liquid preparations (e.g. risperidone, fluoxetine) and oral dispersible tablets (e.g. olanzapine, risperidone, mirtazapine) are aimed at ensuring administration/improving compliance. They generally have minimal effects on absorption. 

Flence, various factors may lead the clinician to choose a particular medication, among them the type of mania (i.e. euphoric, dysphoric, mixed, or rapid cycling). As mentioned before, some evidence suggests a greater efficacy of carbamazepine, olanzapine, risperidone, olanzapine, or valproate compared with lithium in the treatment of mixed states. ... 

Augmentation is called for when there is partial or non-response to the above approaches. Combinations of SSRIs with buspirone, clonazepam, clonidine, inositol, lithium, pindolol, olanzapine, risperidone, trazodone, tryptophan, and venlafaxine have been reported, with limited benefit. To date, only two augmenting agents have been found to be effective in double-blind studies risperidone and pindolol. Augmentation of SSRIs with clomipramine (or vice versa) is a common practice in non-responders however, this combination may lead to a substantial increase in the level of tricyclics in the blood and/or increase the risk of serotonin syndrome. Phenelzine may be helpful in symmetry-related or other atypical obsessions. Electroconvulsive therapy (ECT) should be reserved for severely depressed and suicidal OCD patients. Neurosurgery is the last resort current operations include anterior cingulotomy, anterior capsulotomy, subcaudate tractotomy, and limbic leucotomy. The outcome of such operations is questionable. 

At any tim consider adding an antipsychotic agent (preferably an SGA olanzapine, risperidone, ziprasidone)... 

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