Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-23T06:44:00.277Z Has data issue: false hasContentIssue false
  • English
  • Français

Olanzapine versus haloperidol in the treatment of schizoaffective disorder

Acute and long-term therapy

Published online by Cambridge University Press:  02 January 2018

Pierre V. Tran ,
Gary D. Tollefson ,
Todd M. Sanger ,
Yili Lu ,
Paul H. Berg  and
Charles M. Beasley Jr
Pierre V. Tran*
Affiliation:
Psychopharmacology Division, Lilly Research Laboratories, Indianapolis, IN, USA
Gary D. Tollefson
Affiliation:
Psychopharmacology Division, Lilly Research Laboratories, Indianapolis, IN, USA
Todd M. Sanger
Affiliation:
Psychopharmacology Division, Lilly Research Laboratories, Indianapolis, IN, USA
Yili Lu
Affiliation:
Psychopharmacology Division, Lilly Research Laboratories, Indianapolis, IN, USA
Paul H. Berg
Affiliation:
Psychopharmacology Division, Lilly Research Laboratories, Indianapolis, IN, USA
Charles M. Beasley Jr
Affiliation:
Psychopharmacology Division, Lilly Research Laboratories, Indianapolis, IN, USA
*
Pierre V. Tran, MD, Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Drop Code 0538, Indianapolis, IN 46285. Tel: (317)27: (317) 276–4491; Fax: (317)277–7893
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The effectiveness of antipsychotic monotherapy in schizoaffective disorder is limited, and further constrained by safety concerns.

Aims

We aimed to compare the efficacy, tolerability and safety profile of the new pharmaceutical, olanzapine, with haloperidol.

Method

Data were assessed from 300 DSM – III – R schizoaffective subjects from a larger double-blind prospective international study. Subjects were randomly allocated to six weeks of olanzapine (5–20 mg) or haloperidol (5–20 mg) treatment; responders were followed for up to one year of double-blind, long-term maintenance therapy.

Results

Olanzapine-treated patients achieved a statistically significant greater improvement than haloperidol-treated patients on overall measures of efficacy, including clinical response. Significantly fewer olanzapine patients left the study early, and fewer adverse events were observed among those receiving olanzapine. During maintenance, olanzapine-treated patients continued to experience additional improvement, with fewer EPS but more weight gain than those on haloperidol.

Conclusions

Olanzapine demonstrated substantial advantages over the conventional antipsychotic haloperidol in the management of schizoaffective disorder.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 1 , January 1999 , pp. 15 - 22
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Declaration of interest

Sponsored by Eli Lilly and Company.

References

American Psychiatric Association (1997) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Arango, V., Emsberger, P., Mariuk, P. M., et al (1990) Autoradiographic demonstration of increased serotonin 5-HT2 and beta-adrenergic receptor binding sites in the brain of suicide victims. Archives of General Psychiatry, 47, 1038–1047.Google Scholar
Barnes, T. R. E. (1989) A rating scale for drug-induced akathisia. British Journal of Psychiatry, 154, 672–676.Google Scholar
Bymaster, F. P., Rasmussen, K., Calligaro, D. C., et al (1997) In vitro and in vivo biochemistry of olanzapine: a novel, atypical antipsychotic drug. Journal of Clinical Psychiatry, 58 (suppl. 10). 28–36.Google Scholar
Glazer, W. M., Morgenstern, H. & Doucette, J. T. (1993) Predicting the long-term risk of tardive dyskinesia in outpatients maintained on neuroleptic medications. Journal of Clinical psychiatry, 54, 133–139.Google ScholarPubMed
Goff, D. & Baldessarini, R. (1993) Drug interactions with antipsychotic agents. Journal of Clinical Psychopharmacology, 13, 57–67.Google Scholar
Goff, D., Amico, E., Dreyfuss, D., et al (1994) A placebo-controlled trial of trihexyphenidyl in unmedicated patients with schizophrenia. American Journal of Psychiatry, 151, 429–131.Google Scholar
Guy, W. (1976) ECDEU Assessment Manual for Psychopharmacology (Revised DHEW Pub. (ADM)). Rockville, MD: National Institute for Mental Health.Google Scholar
Kay, S. R., Opter, L. A. & Fiszbein, A. (1992) Positive and Negative Syndrome Scale (PANSS) Manual. North Tonawanda, NY: Multi-Health Systems. Inc.Google Scholar
Keck, P. E. Jr., McElroy, S. L. & Strakowski, S. M. (1996) New developments in the pharmacologic treatment of schizoaffective disorder. Journal of Clinical Psychiatry. 57 (suppl. 9). 41–48.Google Scholar
Meltzer, H. (1989) Clinical studies on the mechanism of action of clozapine: The dopamine-serotonin hypothesis of schizophrenia. Psychopharmacology 99, S18–S27.Google Scholar
Meltzer, H., Matsubara, S. & Lee, J. (1989) Classification of typical and atypical antipsychotic drugs on the basis of Dopamine D1, D2, and serotonin 2 pKi values. Journal of Pharmacology and Experimental Therapeutics, 251, 283–246.Google ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
Moore, N. A., Tye, N. C., Axton, M. S., et al (1992) The behavioral pharmacology of olanzapine, a novel “atypical” antipsychotic agent. Journal of Pharmacology and Experimental Therapeutics, 262, 545–551.Google ScholarPubMed
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports. 10, 799–812.Google Scholar
Remington, G. J., Addington, D., Colins, E. J., et at (1996) Clozapine: current status and role in the pharmacotherapy of schizophrenia. Canadian Journal of Psychiatry, 41, 161–166.CrossRefGoogle ScholarPubMed
Reyntjens, A., Gelders, Y. G., Hoppenbrouwers, M.-L. J. A., et al (1986) Thymosthenic effects of ritanserin. a centrally acting serotonin-S2 receptor blocker. Drug Development Research, 8, 205–211.CrossRefGoogle Scholar
Schooler, N. R. & Kane, J. M. (1982) Research diagnoses for tardive dyskinesia (letter). Archives of General Psychiatry, 39, 486–487.Google Scholar
Simpson, G. M. & Angus, J. W. S. (1970) A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica, 212 (suppl.). S11–S19.Google Scholar
Stefanksi, R. & Goldberg, S. R. (1997) Serotonin 5-HT2 receptor antagonists: Potential in the treatment of psychiatric disorders. CNS Drugs. 7, 388–409.Google Scholar
Tandon, R., Shipley, J. E., Greden, J. F., et al (1991) Muscarinic cholinergic hyperactivity in schizophrenia: relationship to positive and negative symptoms. Schizophrenia Research. 4, 23–30.Google Scholar
Tollefson, G. D., Beastey, C. M. Jr., Tran, P. V., et al (1997a) Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorders: results of an international collaborative trial. American Journal of Psychiatry, 154. 457–465.Google ScholarPubMed
Tollefson, G. D., Sanger, T. M., Lu, M. K., et al (1997b) Depressive signs and symptoms in schizophrenia – a prospective blinded trial of olanzapine and haloperidol. Archives of General Psychiatry. 55. 250–258.Google Scholar
Tran, P. V., Dellva, M. A., Tollefson, G. D., et al (1997) Extrapyramidal symptoms and tolerability of olanzapine versus haloperidol in the acute treatment of schizophrenia. Journal of Clinical Psychiatry. 58. 205–211.Google Scholar
Tran, P. V., Dellva, M. A., Tollefson, G. D., et al (1998) Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses. British Journal of Psychiatry, 172. 499–505.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.