Olanzapine treatment

Edgell ET, Hamilton SH, Revicki DA, et al (1998). Costs of olanzapine treatment compared with haloperidol for schizophrenia results from a randomized clinical trial. Poster presented at the 21st CINP Congress, Glasgow, July 1998. 

Potenza, M.N., Holmes, J.R Kanes, S.J., and McDougle, C.J. (1999) Olanzapine treatment of children, adolescents and adults with pervasive developmental disorders an open-lahel pilot study. / Clin Psychopharmacol 19 37-44. 

There is every reason to expect that this property would exist with olanzapine. Three fixed-dose ranges of olanzapine (5.0 2.5 mg, 10.0 2.5 mg, 15.0 2.5 mg) and one fixed-dose range of haloperidol (15.0 5 mg) were compared with placebo for up to 52 weeks of therapy (218). Survival analysis of time to rehospitalization for psychotic symptoms indicated that olanzapine was comparable to haloperidol and significantly better than placebo (p = 0.007). Kaplan-Meier estimation showed that 71.5% of olanzapine-treated patients did not relapse, compared with 32.8% for those on placebo. Further, another survival analysis demonstrated that significantly fewer patients in the olanzapine treatment group experienced relapse at any given time than those in the haloperidol group (i.e., p = 0.048 80.9% for olanzapine compared with 72.2% for haloperidol). 

In this context, Lilly (474) reported a meta-analysis of three controlled studies of patients with TD who were treated with olanzapine. These authors found an 11-fold decrease in TD on olanzapine versus haloperidol based on the AIMS scale. There were a few patients who developed TD in the first 6 weeks of olanzapine, but this could have been from previous drug exposure, now not suppressed by the neuroleptic. Interestingly, there were no new cases (0/375) of TD developing in patients on long-term olanzapine treatment, whereas there were three of 83 cases on haloperidol. It is very difficult to arrive at definitive evidence about TD because most patients have received previous neuroleptic therapy and because TD-like symptoms occur spontaneously, providing an alternative explanation. It is clear that it is difficult to prove that olanzapine causes TD but equally difficult to prove that it does not. The 11-fold decreased incidence, however, is strong evidence that at least it produces much less TD. 

La Via MC, Gray N, Kaye WH. Case reports of olanzapine treatment of anorexia nervosa. Int J Eat Disord 2000 27 363-366. 

Gatta B, Rigalleau V, Gin H. Diabetic ketoacidosis with olanzapine treatment. Diabetes Care 1999 22(6) 1002-3. 

A 23-year-old man, who had had repeated episodes of weight gain during olanzapine treatment, had good control and subsequent weight reduction after 4—5 weeks of therapy with nizatidine. 

Floris M, Lejeune J, Deberdt W. Effect of amantadine on weight gain during olanzapine treatment. Eur Neuropsychopharmacol 2001 ll(2) 181-2. 

Littrell KH, Petty RG, Hilligoss NM, Peabody CD, Johnson CG. Weight loss associated with olanzapine treatment. J Clin Psychopharmacol 2002 22(4) 436-7. 

Ercan ES, Kutlu A, Varan A, (, ikoglu S, Co kunol H, Bayraktar E. Olanzapine treatment of eight adolescent patients with psychosis. Hum Psychopharmacol Chn Exp 2004 19 53-6. 

There was a highly significant reduction in rating scale scores for the syndrome with olanzapine 10 mg versus baseline and versus pimozide 2 mg, and a significant reduction with olanzapine 5 mg versus pimozide 4 mg only moderate sedation was reported by one patient during olanzapine treatment while three complained of minor motor adverse effects and sedation during pimozide treatment. 

Jauss M, Schroder J, Pantel J, Bachmann S, Gerdsen I, Mundt C. Severe akathisia during olanzapine treatment of acute schizophrenia. Pharmacopsychiatry 1998 31(4) 146-8. 

Cohen H, Loewenthal U, Matar MA, Kotler M. Reversal of pathologic cardiac parameters after transition from clozapine to olanzapine treatment a case report. Clin Neuropharmacol 2001 24(2) 106-8. 

Olanzapine-induced de novo obsessive-compulsive disorder has been reported in two cases (147). One of the patients developed de novo obsessive-compulsive symptoms with the introduction of olanzapine, whereas in the other case the patient had undisturbing obsessive symptoms before olanzapine treatment. 

A 65-year-old man who had had primary insomnia for 20 years, was given olanzapine 2.5 mg/day at nighttime because of lack of response to various anxiolytics he developed fecal incontinence during the 20 days of olanzapine treatment in combination with two anxiolytic drugs. The frequency of incontinence varied from 1 to 3 times a day, and withdrawal of olanzapine resulted in complete recovery. 

Various therapies have been used to avoid or to control weight gain during olanzapine treatment, including nizatidine (SEDA-25, 65), famotidine (SEDA-29,74), and behavioral therapy (SEDA-26, 58). Topiramate has also been used to treat weight gain in 43 women who had taken olanzapine for at least 3 months in a 10-week, doubleblind, placebo-controlled study (283). Those who took topiramate lost on average 5.6 kg (95% Cl— 3.0,8.5). 

Krishnamoorthy J, King BH. Open-label olanzapine treatment in five preadolescent children. J Child Adolesc Psychopharmacol 1998 8(2) 107-13. 

Stratta P, Donda P, Rossi A, Rossi A. Executive function assessment of patients with schizophrenic disorder residual type in olanzapine treatment an open study. Hum Psychopharmacol 2005 20 401-8. 

Buchanan RW, Ball MP, Weiner E, Kirkpatrick B, Gold JM, McMahon RP, Carpenter WT Jr. Olanzapine treatment of residual positive and negative symptoms. Am J Psychiatry 2005 162 124-9. 

Gheorghiu S, Knobler HY, Drumer D. Recurrence of neuroleptic malignant syndrome with olanzapine treatment. Am J Psychiatry 1999 156(11) 1836. 

Nemets B, Geller V, Grisaru N, Belmaker RH. Olanzapine treatment of clozapine-induced NMS. Hum Psychopharmacol 2000 15(2) 77-8. 

Pozo P, Alcantara AG. Mania-like syndrome in a patient with chronic schizophrenia during olanzapine treatment. J Psychiatry Neurosci 1998 23(5) 309-10. 

Swartz JR, Ananth J, Smith MW, Burgoyne KS, Gadasally R, Arai Y. Olanzapine treatment after clozapine-induced granulocytopenia in 3 patients. J Clin Psychiatry 1999 60(2) 119-21. 

Finkel B, Lerner A, Oyffe I, Rudinski D, Sigal M, Weizman A. Olanzapine treatment in patients with typical and atypical neuroleptic-associated agranulocytosis. Int Clin Psychopharmacol 1998 13(3) 133-5. 

Misra LK, Kofoed L, Oesterheld JR, Richards GA. Olanzapine treatment of methamphetamine psychosis. J Clin Psychopharmacol 2()0() 20(3) 393—4. 

---