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Abstract
Objective
The objectives of this study were to determine the doses of olanzapine (OLZ), rispendone
(RIS), and haloperidol (HAL) used in clinical practice in outpatients with schizophrenia
and the rates of occurrence of extrapyramidal symptoms (EPS) and other adverse events,
clinical response, and use of concomitant medications.
Methods
The present study involved a subset of patients from a 6-month, open-label, prospective
observational study. Data were collected by 293 psychiatrists at mental health centers
and other outpatient treatment facilities in Spain. Medications and doses used, occurrence
of EPS and other adverse events, and scores on the Clinical Global Impression (CGI)
of Severity Scale and Global Assessment of Function (GAF) were recorded. Clinical
response was defined as a decrease of ≥2 points on the CGI, with a final CGI score
≤4.
Results
A total of 2657 patients were included in the analysis. The initial and overall mean
daily doses for the 3 groups were as follows: OLZ, 12.2 and 13.0 mg, respectively;
RIS, 5.2 and 5.4 mg; and HAL, 13.9 and 13.6 mg. Initial and overall median daily doses
were the same in each group: OLZ, 10 mg; RIS, 6 mg; and HAL, 10 mg. A significantly
lower proportion of OLZ-treated patients (36.9%) experienced EPS compared with RIS-treated
(49.6%) and HAL-treated (76.0%) patients (P ≤ 0.001). A significantly lower proportion of patients in the OLZ group (47.8%) experienced
adverse events compared with patients in the RIS (57.2%) and HAL (79.8%) groups (P ≤ 0.001). A significantly greater proportion of OLZ-treated patients (37.3%) were
responders compared with RIS-treated patients (31.5%) (P < 0.05). In all 3 groups, patients who had an initial CGI score ≥5 received significantly
higher overall mean daily doses than did patients with an initial CGI score <5 (P < 0.001). A significantly lower proportion of OLZ-treated patients (10.2%) were receiving
concomitant anticholinergic medication at the end of the study (month 6) compared
with RIS-treated (19.9%) and HAL-treated (44.0%) patients (P < 0.001).
Conclusion
The mean daily doses recorded in this analysis based on data from a naturalistic setting
are consistent with recommendations based on clinical trials. Compared with both RIS-
and HAL-treated patients, OLZ-treated patients were less likely to experience EPS
or other adverse events, and less likely to use concomitant anticholinergic medications.
OLZ-treated patients were also more likely to respond to treatment than were RIS-treated
patients.
Key words
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Article info
Publication history
Accepted:
April 12,
2000
Identification
Copyright
© 2000 Published by Elsevier Inc.
