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Safety and tolerability of olanzapine compared with other antipsychotics in the treatment of elderly patients with schizophrenia: a naturalistic study

Published online by Cambridge University Press:  16 April 2020

Antonio Ciudad*
Affiliation:
Lilly Research Laboratories, 30 Avenida de la Industria, Alcobendas CP28108, Madrid, Spain
José-Manuel Montes
Affiliation:
Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
José-Manuel Olivares
Affiliation:
Department of Psychiatry, Complejo Hospitalario Xeral, Spain
Juan-Carlos Gómez
Affiliation:
Lilly Research Laboratories, 30 Avenida de la Industria, Alcobendas CP28108, Madrid, Spain
*
*Corresponding author. Email address: [email protected] (A. Ciudad).
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Abstract

Objective

To evaluate the safety and tolerability of olanzapine in the treatment of elderly patients with schizophrenia.

Methods

A total of 135 outpatients with schizophrenia ≥60 years of age were treated with olanzapine (n = 105) or another antipsychotic (n = 30) and followed up for 6 months. Safety measures included the recording of spontaneous adverse events and extrapyramidal symptoms (EPS). Clinical status and effectiveness of the medications were measured using the Clinical Global Impressions-Severity of Illness and the Global Assessment of Function (GAF) scales. Quality of life was assessed by means of the Spanish version of the EuroQol. The Awad scale was applied to evaluate patients’ subjective attitude towards medication.

Results

The incidence of overall adverse events and EPS was non-significantly lower in patients treated with olanzapine than in patients treated with other antipsychotics. The use of anticholinergic drugs was significantly lower (P = 0.04) in patients treated with olanzapine. Both groups of patients experienced similar improvements in Clinical Global Impressions-Severity and GAF scores. Non-significantly greater improvement in the acceptance of medication occurred at endpoint in olanzapine-treated patients than in control patients as measured by the Awad scale. The improvement in the EuroQol quality of life scale achieved at the end of study did not differ between both treatment groups.

Conclusions

Results from this naturalistic study showed that olanzapine was as safe and effective as other antipsychotic drugs in the treatment of elderly patients with schizophrenia.

Type
Original manuscript
Copyright
Copyright © 2004 European Psychiatric Association

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References

Badia, XRoset, MMontserrat, SHerdman, MSegura, A. La versión española del EuroQol: descripción y aplicaciones. Med Clin (Barc 1999;112(Suppl 1):79–85 [The Spanish version of EuroQol: a description and its applications. European Quality of Life scale.].Google Scholar
Barak, YShamir, EZemishlani, H, et al. Olanzapine vs. haloperidol in the treatment of elderly chronic schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2002;26:1199–202.CrossRefGoogle ScholarPubMed
Chouinard, GKopala, LLabelle, A, et al., The RIS-CAN-3 Study Group. Phase-IV multicentre clinical study of risperidone in the treatment of outpatients with schizophrenia. Can J Psychiatry 1998;43:1018–25.CrossRefGoogle Scholar
COSTART. Coding symbols for a thesaurus of adverse reaction terms. Rockville (MD): US Department of Health and Human Services; 1990.Google Scholar
Global Assessment of Function Scale. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington (DC): American Psychiatric Press; 1994.Google Scholar
Gómez, JCSacristan, JAHernández, J, et al. The safety of olanzapine compared with other antipsychotic drugs: results of an observational prospective study in patients with schizophrenia (EFESO study). Pharmacoepidemiologic study of olanzapine in schizophrenia. J Clin Psychiatry 2000;61:335–43.CrossRefGoogle Scholar
Gurland, BJCross, P. Epidemiology of psychopathology in old age: some implications for clinical services. Psychiatr Clin North Am 1982;5:11–26.CrossRefGoogle ScholarPubMed
Gutierrez, MGibert, JBobes, J, et al. Risperidona en el tratamiento de la reagudización de los síntomas de esquizofrenia. [Risperidone in the treatment of acute exacerbation of schizophrenia symptoms.]. Actas Luso-Esp Neurol Psiquiatr Cienc Afines 1998;26:83–9.Google Scholar
Hogan, TPAwad, AGEastwood, R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychol Med 1983;13:177–83.CrossRefGoogle ScholarPubMed
Jeste, DVCaligiuri, MPPaulsen, JS, et al. Risk of tardive dyskinesia in older patients: a prospective longitudinal study of 266 outpatients. Arch Gen Psychiatry 1995;52:756–65.CrossRefGoogle ScholarPubMed
Kampman, OLehtinen, K. Compliance in psychoses. Acta Psychiatr Scand 1999;100:167–75.CrossRefGoogle ScholarPubMed
Kane, JMWoerner, MLieberman, J. Tardive dyskinesia: prevalence, incidence, and risk factors. J Clin Psychopharmacol 1988;8(Suppl 4):52S–6S.Google Scholar
Kasper, S. Risperidone and olanzapine: optimal dosing for efficacy and tolerability in patients with schizophrenia. Int Clin Psychopharmacol 1998;13:253–62.CrossRefGoogle ScholarPubMed
Kennedy, JSJeste, DKaiser, CJ, et al. Olanzapine vs. haloperidol in geriatric schizophrenia: analysis of data from a double-blind controlled trial. Int J Geriatr Psychiatry 2003;18:1013–20.CrossRefGoogle ScholarPubMed
Lingjaerde, OAhlfors, UGBech, P, et al. The UKU Side Effect Rating Scale: a new comprehensive rating scale for psychotropic drugs and a cross-sectional study of the side effects in neuroleptic-treated patients. Acta Psychiatr Scand Suppl 1987;334:1–100.CrossRefGoogle Scholar
Madhusoodanan, SBrenner, RSuresh, P, et al. Efficacy and tolerability of olanzapine in elderly patients with psychotic disorders: a prospective study. Ann Clin Psychiatry 2000;12(1):11–8.CrossRefGoogle ScholarPubMed
Marder, SRMeibach, RC. Risperidone in the treatment of schizophrenia. Am J Psychiatry 1994;151:825–35.Google ScholarPubMed
Meltzer, HYFibiger, HC. Olanzapine: a new atypical antipsychotic drug. Neuropsychopharmacology 1996;14:83–5.CrossRefGoogle Scholar
Montes, JMCiudad, AGascón, JGómez, JC. Safety, effectiveness, and quality of life in first-episode schizophrenia: a naturalistic study. Prog Neuropsychopharmacol Biol Psychiatry 2003;27:667–74.CrossRefGoogle ScholarPubMed
National Institute of Mental Health. Clinical global impressions. In: Guy, E, editor. ECDEU Assessment Manual for Psychopharmacology. Rockville, MD: National Institute of Health; 1976 Rev. ed.Google Scholar
Rosen, JBohon, SGerson, SC. Antipsychotics in the elderly. Acta Psychiatr Scand 1990;358:170–5.CrossRefGoogle ScholarPubMed
Rué, MBadia, X. The Spanish EuroQol tariff: results from the Catalan Health Survey based on self-rating health. In: Badia, XHerdman, MSegura, A, editors. Barcelona: Proceedings of the EuroQol Meeting, 3–6 October 1995; p. 77–98 [Abstract.].Google Scholar
Sacristan, JAGómez, JCMontejo, AL, et al. Doses of olanzapine, risperidone, and haloperidol used in clinical practice: results of a prospective pharmacoepidemiologic study. EFESO Study Group. Estudio Farmacoepidemiologico en la Esquizofrenia con Olanzapina. Clin Ther 2000;22:583–99.CrossRefGoogle Scholar
Sajatovic, MPerez, DBrescan, DRamirez, LF. Olanzapine therapy in elderly patients with schizophrenia. Psychopharmacol Bull 1998;34:819–23.Google ScholarPubMed
Solomons, KGeiger, O. Olanzapine use in the elderly: a retrospective analysis. Can J Psychiatry 2000;45:151–5.CrossRefGoogle ScholarPubMed
Street, JSTollefson, GDTohen, MSanger, TMClark, SGannon, KS, et al. Olanzapine for psychotic conditions in the elderly. Psychiatr Ann 2000;30:191–6.CrossRefGoogle Scholar
Tran, PVDellva, MATollefson, GD, et al. Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses. Br J Psychiatry 1998;172:499–1495.CrossRefGoogle ScholarPubMed
Tran, PVHamilton, SHKuntz, AJPotvin, JHAndersen, SW, Beasley Jr, C, et al. Double-blind comparison of olanzapine versus risperi-done in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol 1997;17:407–18.CrossRefGoogle Scholar
World Health Organization. International classification of diseases. Mental and behavioural disorders. 10th ed. Geneva, Switzerland: World Health Organization; 1994.Google Scholar
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