TY - JOUR
T1 - Olanzapine as Alternative Therapy for Patients With Haloperidol-Induced Extrapyramidal Symptoms: Results of a Multicenter, Collaborative Trial in Latin America
AU - Costa, J.A.
AU - Alvarez, N.
AU - Mazzotti, G.
AU - Gattaz, W.F.
AU - Ospina, J.
AU - Larach, V.
AU - Starkstein, Sergio
AU - Oliva, D.
AU - Cousins, L.
AU - Tohen, M.
AU - Taylor, C.C.
AU - Wang, J.
AU - Tran, P.V.
PY - 2001
Y1 - 2001
N2 - Conventional antipsychotic agents can induce extrapyramidal symptoms (EPS) that may be alleviated by switching patients to novel agents such as olanzapine. Patients with schizophrenia and related disorders (ICD-10) who were taking haloperidol (N = 94; mean dose = 12.7 mg/day) and had EPS (Simpson-Angus Scale [SAS] > 3) were directly switched to 6 weeks of open-label olanzapine treatment (mean dose = 11.4 mg/day). There were significant mean improvements (p <0.001 for all measurements) from baseline to endpoint on the SAS (-9.69 +/- 5.33; percentage change, 87.2%), the Barnes Akathisia Scale (-1.00 +/- 1.19; percentage change, 82.5%), and the Abnormal Involuntary Movement Scale (-1.48 +/- 2.89; percentage change, 81.1%), and anticholinergic use decreased from 47.9% to 12.8% (mean baseline to endpoint change: -1.52 +/- 1.91-mg equivalents of benztropine; p <0.001). Significant mean baseline to endpoint improvements (p 0.001 for all measurements) were observed on the Positive and Negative Syndrome Scale (PANSS; -25.28 +/- 18.67; percentage change, 30.3%), the PANSS-extracted Brief Psychiatric Rating Scale (0-6 scale, -13.41 +/- 10.16; percentage change, 54.4%), and the Clinical Global Impressions Severity scale (-1.16 +/- 1.19; percentage change, 26.4%). Spontaneously reported treatment- emergent adverse events with a greater than 5% incidence were somnolence (16.0%), increased appetite (14.9%), weight gain (11.7%), headache (8.5%), anxiety (7.4%), dizziness (6.4%), and insomnia (5.3%). Criteria for a successful switch were met by 90.5% of patients. Psychotic symptom exacerbation was experienced by 30.9% of patients at any time during the study and by 11.7% of patients at endpoint. Results suggest that a direct switch to olanzapine is a therapeutic option when patients with haloperidol-induced EPS are unable to tolerate a more gradual switch.
AB - Conventional antipsychotic agents can induce extrapyramidal symptoms (EPS) that may be alleviated by switching patients to novel agents such as olanzapine. Patients with schizophrenia and related disorders (ICD-10) who were taking haloperidol (N = 94; mean dose = 12.7 mg/day) and had EPS (Simpson-Angus Scale [SAS] > 3) were directly switched to 6 weeks of open-label olanzapine treatment (mean dose = 11.4 mg/day). There were significant mean improvements (p <0.001 for all measurements) from baseline to endpoint on the SAS (-9.69 +/- 5.33; percentage change, 87.2%), the Barnes Akathisia Scale (-1.00 +/- 1.19; percentage change, 82.5%), and the Abnormal Involuntary Movement Scale (-1.48 +/- 2.89; percentage change, 81.1%), and anticholinergic use decreased from 47.9% to 12.8% (mean baseline to endpoint change: -1.52 +/- 1.91-mg equivalents of benztropine; p <0.001). Significant mean baseline to endpoint improvements (p 0.001 for all measurements) were observed on the Positive and Negative Syndrome Scale (PANSS; -25.28 +/- 18.67; percentage change, 30.3%), the PANSS-extracted Brief Psychiatric Rating Scale (0-6 scale, -13.41 +/- 10.16; percentage change, 54.4%), and the Clinical Global Impressions Severity scale (-1.16 +/- 1.19; percentage change, 26.4%). Spontaneously reported treatment- emergent adverse events with a greater than 5% incidence were somnolence (16.0%), increased appetite (14.9%), weight gain (11.7%), headache (8.5%), anxiety (7.4%), dizziness (6.4%), and insomnia (5.3%). Criteria for a successful switch were met by 90.5% of patients. Psychotic symptom exacerbation was experienced by 30.9% of patients at any time during the study and by 11.7% of patients at endpoint. Results suggest that a direct switch to olanzapine is a therapeutic option when patients with haloperidol-induced EPS are unable to tolerate a more gradual switch.
M3 - Article
VL - 21
SP - 375
EP - 381
JO - Journal of Clinical Psychopharmacology
JF - Journal of Clinical Psychopharmacology
SN - 0271-0749
IS - 4
ER -