WorldWideScience

Sample records for olanzapine inwhole bloodusing

  1. Olanzapine

    Science.gov (United States)

    ... bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods) in ... Olanzapine may cause side effects. Tell your doctor if any of these ... difficulty walking constipation weight gain dry mouth pain in arms, legs, ...

  2. Pharmacogenetics of olanzapine metabolism.

    Science.gov (United States)

    Söderberg, Mao Mao; Dahl, Marja-Liisa

    2013-08-01

    The pharmacokinetics of the atypical antipsychotic, olanzapine, display large interindividual variation leading to multiple-fold differences in drug exposure between patients at a given dose. This variation in turn gives rise to the need for individualized dosing in order to avoid concentration-dependent adverse effects or therapeutic failure. Genetically determined differences in olanzapine metabolism represent a less studied source of variability in comparison to environmental and physiological factors. In this review, we summarize available in vitro and in vivo data addressing the influence of polymorphisms in drug-metabolizing enzymes on olanzapine serum exposure. The polymorphic CYP2D6 enzyme appears to have no significant influence on olanzapine steady-state serum concentrations. The formation of the various olanzapine metabolites is influenced by polymorphisms in the genes coding for CYP1A2, CYP1A expression regulator AHR, UGT1A4 and UGT2B10, as well as FMO3. An impact on steady-state olanzapine serum concentrations has been suggested for variants of CYP1A2 and UGT1A4, with somewhat conflicting findings. The potential involvement of FMO1 and CYP3A43 in olanzapine disposition has also been suggested but needs future validation.

  3. Focus on olanzapine.

    Science.gov (United States)

    Green, B

    1999-01-01

    Olanzapine (2-methyl-4-(4-methyl-1-piperazinyl)-10H-thieno[2,3-b][1,5] benzodiazepine) is a novel antipsychotic agent of the theinobenzodiazepine class developed by Eli Lilly & Co. It has a pleotrophic pharmacology and affects the dopaminergic, serotonergic, muscarinic and adrenergic systems. The therapeutic advantage of recent antipsychotics (so-called atypical antipsychotics) has been attributed to additional serotonergic effects. Clinical studies and trials suggest that olanzapine is comparable or superior to haloperidol and may be superior to risperidone in terms of efficacy and side-effect profiles. The starting dose of olanzapine is a single dose of 10 mg. The drug reaches peak plasma levels in 5-8 h, and has a half-life of about 35 h, depending on metabolism. The recommended maximum dose is 20 mg daily, but higher doses have been employed. Abnormalities of the QTc interval on ECG are unlikely to occur and so there is no need for a baseline ECG as with sertindole, which has recently been withdrawn. The most common side-effects are somnolence and weight gain. About 40% of patients in clinical trials gain weight--especially if they are on a high starting dose and if they were underweight pre-treatment. Reported evidence to date suggests that olanzapine is relatively less likely to produce sexual dysfunction. In general, weight gain and sexual dysfunction are of great concern to people taking antipsychotics and the side-effect profile of any antipsychotic may affect compliance. Olanzapine's general efficacy and side-effect profile suggest that, unforeseen post-marketing complications notwithstanding, olanzapine deserves a major place in the first-line management of psychotic disorders.

  4. A Case of Olanzapine-Induced Fever

    Science.gov (United States)

    Yang, Cho-Hsiang; Chen, Ying-Yeh

    2017-01-01

    Olanzapine, a frequently used second-generation antipsychotic, has rarely been implicated as a cause of drug-induced fever in the absence of neuroleptic malignant syndrome. We describe a patient who developed isolated fever following olanzapine monotherapy, which subsided after discontinuation of olanzapine. Blockade of dopaminergic receptors and elevated cytokines concentration are possible mechanisms of fever development during treatment with olanzapine. This case calls for attention to olanzapine-induced fever in clinical practice. PMID:28138204

  5. Olanzapine-induced eosinophilic pleuritis

    Directory of Open Access Journals (Sweden)

    Matthew Evison

    2015-01-01

    Eosinophilic pleural fluid is not a marker of non-malignant aetiology and eosinophilic pleural effusions require a careful and systematic diagnostic work-up. This is the second case report to identify olanzapine as a causative agent in eosinophilic pleural effusion.

  6. Postmortem redistribution of olanzapine following intramuscular administration of olanzapine pamoate in dogs.

    Science.gov (United States)

    Johnson, Jason T; Everly, Amy G; Kpakima, Felicia E Frazier; Detke, Holland C

    2015-12-01

    The potential for postmortem redistribution of olanzapine was investigated in beagle dogs. Olanzapine pamoate monohydrate was administered once every 14 days by intramuscular injection for 3 months to fed male dogs (n=15) at a dose of 20 mg/kg olanzapine (equivalent to 46 mg/kg olanzapine pamoate monohydrate). Blood samples were collected after the fifth (Day 57) and sixth (Day 71) doses to determine olanzapine and N-oxide olanzapine concentrations. On Day 71 at 72 h postdose, dogs were euthanized and placed on their backs without additional manipulation and held for postmortem blood, urine, and tissue collection at room temperature for up to 168 h postdose (96 h after euthanasia). Concentrations of olanzapine and N-oxide olanzapine were determined by liquid chromatography-mass spectroscopy/mass spectroscopy (LC-MS/MS). Postmortem olanzapine concentrations in blood increased up to seven-fold compared to the last quantified antemortem blood concentration. Olanzapine concentrations in vein tissue samples (surrogates for peripheral blood) also increased, whereas other tissue concentrations, such as myocardium, lung, liver, and kidney decreased over the postmortem period. An increase in blood concentration of olanzapine after death was observed in all but one animal, suggesting that postmortem redistribution may occur in dogs following biweekly intramuscular administration of olanzapine pamoate monohydrate. The rise in olanzapine concentrations in blood after death in this study may potentially be attributed to diffusion from multiple tissues to blood and, to a lesser extent, reduction of the N-oxide olanzapine metabolite back to olanzapine. However, the generalizability of these results to humans cannot be confirmed by the present study.

  7. Olanzapine induced neuroleptic malignant syndrome.

    Science.gov (United States)

    Patra, Bichitra Nanda; Khandelwal, Sudhir K; Sood, Mamta

    2013-01-01

    An 18 year old male diagnosed as a case of bipolar affective disorder (BPAD), developed neuroleptic malignant syndrome (NMS) following treatment with olanzapine (20 mg per day), an atypical antipsychotic drug. NMS is usually seen with typical antipsychotic drugs. The patient was diagnosed as a case of NMS, offending agent was immediately withdrawn and prompt treatment with bromocriptine and levodopa produced a good recovery. The various features of the case are discussed in view of the potential mortality of the syndrome.

  8. A suspected case of olanzapine induced hyponatremia

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Bakhla

    2014-01-01

    Full Text Available Here we report a case of a 63-year-old male diagnosed with recurrent depressive disorder and current episode of severe depression with psychotic symptoms, developed hyponatremia soon after addition of olanzapine and increasing the dose of escitalopram. A possible causality association was established with olanzapine, and the possible etiological reasons of this clinically significant risk were discussed.

  9. Olanzapine induced neuroleptic malignant syndrome

    Directory of Open Access Journals (Sweden)

    Bichitra Nanda Patra

    2013-01-01

    Full Text Available An 18 year old male diagnosed as a case of bipolar affective disorder (BPAD, developed neuroleptic malignant syndrome (NMS following treatment with olanzapine (20 mg per day, an atypical antipsychotic drug. NMS is usually seen with typical antipsychotic drugs. The patient was diagnosed as a case of NMS, offending agent was immediately withdrawn and prompt treatment with bromocriptine and levodopa produced a good recovery. The various features of the case are discussed in view of the potential mortality of the syndrome.

  10. Olanzapine-induced ischemic colitis

    Directory of Open Access Journals (Sweden)

    Esteban Sáez-González

    Full Text Available Background: Ischemic colitis (IC is an uncommon adverse event associated with antipsychotic agents, more commonly found with phenothiazine drugs and atypical neuroleptics such as clozapine. The risk of developing ischemic colitis increases when anticholinergic drugs are associated. Case report: We report the case of a 38-year-old woman with a history of schizoaffective disorder who had been on chronic quetiapine for 3 years, and presented to the ER because of diarrhea for 5 days. Four months previously, olanzapine had been added to her psychiatric drug regimen. Physical examination revealed abdominal distension with abdominal tympanic sounds and tenderness. Emergency laboratory tests were notable for increased acute phase reagents. Tomography revealed a concentric thickening of the colonic wall in the transverse, descending and sigmoid segments, with no signs of intestinal perforation. Colonoscopy demonstrated severe mucosal involvement from the sigmoid to the hepatic flexure, with ulcerations and fibrinoid exudate. Biopsies confirmed the diagnosis of ischemic colitis. The only relevant finding in her history was the newly added drug to her baseline regimen. An adverse effect was suspected because of its anticholinergic action at the intestinal level, and the drug was withdrawn. After 6 months of follow-up clinical, laboratory and endoscopic recovery was achieved. Discussion: Antipsychotic medication should be considered as a potential cause of ischemic colitis, particularly atypical antipsychotics such as clozapine and olanzapine; despite being uncommon, this adverse event may result in high morbidity and mortality.

  11. Eosinophilic myocarditis during treatment with olanzapine

    DEFF Research Database (Denmark)

    Vang, Torkel; Rosenzweig, Mary; Bruhn, Christina Hedegaard

    2016-01-01

    -mortem toxicological examination demonstrated presence of olanzapine, morphine, venlafaxine and oxazepam. Syringes indicating substance abuse were found in his home. Case 2 was a 36-year-old Caucasian man diagnosed with schizophrenia was found dead unexpectedly. There was no history of substance abuse. Current...... fatal cases of eosinophilic myocarditis associated with the use of olanzapine. CASE PRESENTATION: Case 1 was a 39-year-old Caucasian man with known substance abuse and schizophrenia. He was found dead in his home. Olanzapine was prescribed at day -54, and dose at time of death was 40 mg/day. Post...

  12. Olanzapine-induced tardive oculogyric crises

    Directory of Open Access Journals (Sweden)

    Amar D Bavle

    2013-01-01

    Full Text Available Tardive syndromes are much lower in prevalence in second generation antipsychotics (SGA than in the typical antipsychotics. Although, olanzapine, which is an SGA, has a high risk of causing weight gain, metabolic syndrome, raised blood sugar, and dyslipidemias; it is widely used as the risk of developing extrapyramidal syndromes (EPS is low. Among the various forms of EPS, tardive syndromes are the most feared, tardive dyskinesia, tardive akathisia, and tardive dystonia are the commonest tardive syndromes, the others being less common. Tardive oculogyric crises (TOC are a rare form of tardive dystonia. This patient had TOC with prolonged unsupervised treatment with low-dose olanzapine. Added to that, she developed weight gain that was alarmingly high and such high gain in weight with olanzapine, to our knowledge, has not been reported. She responded to a low dose of trihexiphenydyl, and on stopping olanzapine and adding aripiprazole, has started losing weight.

  13. Eosinophilic myocarditis during treatment with olanzapine

    DEFF Research Database (Denmark)

    Vang, Torkel; Rosenzweig, Mary; Bruhn, Christina Hedegaard;

    2016-01-01

    BACKGROUND: Drug-induced eosinophilic myocarditis is a life-threatening and frequently overlooked condition. The prevalence of myocarditis in clozapine-treated patients may be as high as 3 %. An association between olanzapine and myocarditis has not previously been described, but given the chemical...... fatal cases of eosinophilic myocarditis associated with the use of olanzapine. CASE PRESENTATION: Case 1 was a 39-year-old Caucasian man with known substance abuse and schizophrenia. He was found dead in his home. Olanzapine was prescribed at day -54, and dose at time of death was 40 mg/day. Post......-mortem toxicological examination demonstrated presence of olanzapine, morphine, venlafaxine and oxazepam. Syringes indicating substance abuse were found in his home. Case 2 was a 36-year-old Caucasian man diagnosed with schizophrenia was found dead unexpectedly. There was no history of substance abuse. Current...

  14. Olanzapine discontinuation emergent recurrence in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Manu Arora

    2014-01-01

    Full Text Available Objective: The efficacy of atypical antipsychotics including olanzapine in acute treatment of manic episode has been established, whereas its role in maintenance treatment is not clear. Materials and Methods: Thirteen patients of bipolar disorder who were on regular treatment with mood stabilizer and subsequently relapsed into mania or depressive episode after discontinuation of olanzapine were studied for various socio-demographic and clinical factors using retrospective chart review. Results: There was no correlation found between the period of tapering olanzapine, time to recurrence of episode after discontinuation, and the dosage of olanzapine at the time of discontinuation. The predominant early signs of relapse after discontinuation of olanzapine included sleep disturbance (72.7%, lack of insight for change in behavior (72.7%, irritability (54.5%, and elevated mood (45.5%. Conclusion: Mood stabilizer alone as a maintenance therapy of bipolar disorder may be inadequate for long-term management. A low dose of olanzapine along with mood stabilizers might be useful for prevention of recurrence in bipolar disorder.

  15. Olanzapine versus haloperidol: Which can control stuttering better?

    Directory of Open Access Journals (Sweden)

    Vahid Shaygannejad

    2013-01-01

    Conclusions: It seems that olanzapine does have better impact in controlling stuttering, and it may be recommended to prescribe olanzapine for stutters as the first choice to control the stuttering under a careful follow-up.

  16. Short-term treatment with olanzapine does not modulate gut hormone secretion: olanzapine disintegrating versus standard tablets

    DEFF Research Database (Denmark)

    Vidarsdottir, Solrun; Roelfsema, Ferdinand; Streefland, Trea;

    2009-01-01

    BACKGROUND: Treatment with olanzapine (atypical antipsychotic drug) is frequently associated with various metabolic anomalies, including obesity, dyslipidemia, and diabetes mellitus. Recent data suggest that olanzapine orally disintegrating tablets (ODT), which dissolve instantaneously in the mouth...

  17. Cognitive effects of olanzapine treatment in schizophrenia.

    Science.gov (United States)

    McGurk, Susan R; Lee, M A; Jayathilake, K; Meltzer, Herbert Y

    2004-05-10

    Improvement in some but not all domains of cognition during treatment with the atypical antipsychotic drugs clozapine, quetiapine, olanzapine, and risperidone has been reported in some but not all studies. It has been recently suggested that these reports are an artifact, related to lessening of the impairment due to typical neuroleptic drugs and anticholinergic agents. The purpose of this study was to further test the hypothesis that olanzapine, an atypical antipsychotic drug reported to have anticholinergic properties, improves cognition in patients with schizophrenia, including domains of cognition related closely to work and social function (ie, verbal learning and memory) and that this improvement is independent of improvement in psychopathology. Thirty-four patients with schizophrenia who were partial responders to typical antipsychotic drug treatment were evaluated with a comprehensive neurocognitive battery, including measures of executive functioning; verbal and visual learning and memory; working memory; immediate, selective, and sustained attention; perceptual/motor processing; and motor skills prior to and following treatment with olanzapine for 6 weeks. The Brief Psychiatric Rating Scale (BPRS) was used to assess psychopathology in patients treated with typical antipsychotic drugs. Subjects were switched to olanzapine (average dose 13.4 mg, range 5-20 mg) and reassessed following 6 weeks and 6 months of treatment. Significant improvement was noted in 9 of 19 cognitive tests, including measures of selective attention, verbal learning and memory, and verbal fluency. No cognitive test was worsened by olanzapine treatment. Improvements in the BPRS Total and Positive Symptom Subscale scores were noted. Improvements in verbal learning and memory, sustained attention, and psychomotor tracking were independent of improvement in psychopathology. These data suggest that olanzapine improved some but not all cognitive deficits in schizophrenia, including verbal

  18. Olanzapine-Induced Hypertriglyceridemia Resulting in Necrotizing Pancreatitis

    Science.gov (United States)

    Roy-Chaudhury, Prabir; Yadlapalli, Ganesh

    2016-01-01

    Olanzapine is an atypical antipsychotic agent that was approved by the Food and Drug Administration in 1996 for treatment of psychotic disorders, bipolar disorder, and schizophrenia. Since that time, numerous case reports have been published that describe the association of olanzapine and the development of pancreatitis. Furthermore, 3 reports suggest the mechanism of olanzapine-induced hypertriglyceridemia as the etiology of this progression. We report a case of a 36-year-old man who developed necrotizing pancreatitis secondary to olanzapine-induced hypertriglyceridemia. This case, to our knowledge, is the most severe case of this progression and the first case requiring plasmapheresis for acute management.

  19. Olanzapine-Induced Neuroleptic Malignant Syndrome

    Directory of Open Access Journals (Sweden)

    Seyedhamze Hosseini

    2017-05-01

    Full Text Available Neuroleptic malignant syndrome (NMS is a rare but life-threatening idiosyncratic side effect resulting from neuroleptic drugs. NMS mainly occurs in patients treated with high-potency typical antipsychotics, but rarely caused by atypical antipsychotics. Although NMS is less common with atypical antipsychotic, but it seems that its incidence is rising due to increased administration of such drugs. We present the case of a 27-year-old man with a history of paranoid schizophrenia that showed signs consistent with NMS that occurred after treatment with olanzapine. The patient was adherent to treatment. He had decreased level of consciousness, muscle rigidity, diaphoresis, fever, drooling, urinary incontinence, and high blood pressure. This patient illustrates that NMS can occur due to treatment with atypical antipsychotic drugs like olanzapine, particularly in the presence of risk factors. This phenomenon is often unrecognized, underdiagnosed, or not treated properly. Physicians should be aware that NMS with extrapyramidal syndrome could occur with olanzapine at steady state doses without recent dosage adjustments or titration. It is essential that adequate and safe dose of medication is chosen and the patient is monitored by the signs and symptoms of this lethal syndrome.

  20. Olanzapine versus other atypical antipsychotics for schizophrenia

    Science.gov (United States)

    Komossa, Katja; Rummel-Kluge, Christine; Hunger, Heike; Schmid, Franziska; Schwarz, Sandra; Duggan, Lorna; Kissling, Werner; Leucht, Stefan

    2014-01-01

    Background In many countries of the industrialised world second generation (“atypical”) antipsychotics have become the first line drug treatment for people with schizophrenia. The question as to whether, and if so how much, the effects of the various second generation antipsychotics differ is a matter of debate. In this review we examined how the efficacy and tolerability of olanzapine differs from that of other second generation antipsychotics. Objectives To evaluate the effects of olanzapine compared to other atypical antipsychotics for people with schizophrenia and schizophrenia-like psychosis. Search methods 1. Electronic searching We searched the Cochrane Schizophrenia Group Trials Register (April 2007) which is based on regular searches of BIOSIS, CENTRAL, CINAHL, EMBASE, MEDLINE and PsycINFO. 2. Reference searching We inspected the reference of all identified studies for more trials. 3. Personal contact We contacted the first author of each included study for missing information. 4. Drug companies We contacted the manufacturers of all atypical antipsychotics included for additional data. Selection criteria We included all randomised trials that used at least single-blind (rater-blind) design, comparing oral olanzapine with oral forms of amisulpride, aripiprazole, clozapine, quetiapine, risperidone, sertindole, ziprasidone or zotepine in people with schizophrenia or schizophrenia-like psychosis. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random effects model. We calculated numbers needed to treat/harm (NNT/NNH) where appropriate. For continuous data, we calculated weighted mean differences (WMD) again based on a random effects model. Main results The review currently includes 50 studies and 9476 participants which provided data for six comparisons (olanzapine compared to amisulpride, aripiprazole

  1. Olanzapine affects locomotor activity and meal size in male rats

    NARCIS (Netherlands)

    van der Zwaal, Esther M.; Luijendijk, Mieneke C. M.; Evers, Simon S.; la Fleur, Susanne E.; Adan, Roger A. H.

    2010-01-01

    Olanzapine is an antipsychotic drug that frequently induces weight gain accompanied by increased fat deposition as a side effect To investigate how olanzapine affects different aspects of energy balance we used male rats to determine effects on meal patterns food preference locomotor activity and

  2. Immunosuppressant-Associated Neurotoxicity Responding to Olanzapine

    Directory of Open Access Journals (Sweden)

    James A. Bourgeois

    2014-01-01

    Full Text Available Immunosuppressants, particularly tacrolimus, can induce neurotoxicity in solid organ transplantation cases. A lower clinical threshold to switch from tacrolimus to another immunosuppressant agent has been a common approach to reverse this neurotoxicity. However, immunosuppressant switch may place the graft at risk, and, in some cases, continuation of the same treatment protocol may be necessary. We report a case of immunosuppressant-associated neurotoxicity with prominent neuropsychiatric manifestation and describe psychiatric intervention with olanzapine that led to clinical improvement while continuing tacrolimus maintenance.

  3. Naturalistic study of olanzapine in treatment-resistaant ...

    African Journals Online (AJOL)

    Naturalistic study of olanzapine in treatment-resistaant schizophrenia and acute mania, depression and obsessional disorder. ... depression, four obsessive compulsive disorder (OCD), one each had schizo-affective and delusional disorders, ...

  4. Long-acting injectable antipsychotics: focus on olanzapine pamoate

    Directory of Open Access Journals (Sweden)

    JP Lindenmayer

    2010-05-01

    Full Text Available JP LindenmayerDepartment of Psychiatry, New York University School of Medicine, New York NY, USAAbstract: Medication non-adherence in patients with schizophrenia continues to be a significant problem and threatens successful treatment outcomes. Medication non-adherence is often associated with negative consequences, including symptom exacerbation, more frequent emergency room visits, re-hospitalizations and relapse. Long-acting injectable (LAI forms of antipsychotics allow for rapid identification of non-adherence, obviate the need for the patient to take the medication on a daily basis and increase adherence to some significant degree. Eli Lilly has developed a long-acting depot formulation of olanzapine, olanzapine pamoate, which has recently been approved by the FDA for the US market, and which will be reviewed here. Olanzapine LAI appears to be an effective antipsychotic at dosages of 210 mg every 2 weeks, 300 mg every 2 weeks and 405 mg every 4 weeks in patients with acute schizophrenia, and at 150 mg every 2 weeks, 300 mg every 2 weeks and at 405 mg every 4 weeks for the maintenance treatment of stable patients. Oral supplementation appears not to be needed, particularly not at the onset of treatment with the LAI as is necessary with risperidone LAI. Its efficacy is in general comparable to the efficacy seen with oral olanzapine at a corresponding dose. The side effect profile is also comparable to the side effects observed with oral olanzapine, including lower rates of extrapyramidal symptoms, prolactin elevation and cardiovascular side effects, but significant metabolic effects. The latter include significant weight gain, lipid abnormalities and glucose dysregulation. While the injection site adverse events are overall mild, the most significant serious adverse event is the post-injection delirium sedation syndrome (PDSS. While rare, this syndrome results from inadvertent intravascular injection of olanzapine LAI and can cause a range of

  5. [Olanzapine improves chorea in patients with Huntington's disease].

    Science.gov (United States)

    Jiménez-Jiménez, F J; de Toledo, M; Puertas, I; Barón, M; Zurdo, M; Barcenilla, B

    The main treatment for choreatic movements associated to Huntington s disease are the neuroleptic drugs, however, its use causes long term troubles. We describe two patients with a predominantly choreic Huntington s disease, who experience improvement of choreatic movements after introduction of olanzapine to their treatment, being this drug well tolerated. The improvement of chorea suggests that olanzapine has a dopaminergic D2 receptors blocking action.

  6. Intramuscular Olanzapine – a UK case series of early cases

    Directory of Open Access Journals (Sweden)

    Taylor Mark

    2007-04-01

    Full Text Available Abstract Background Clinical trials assessing efficacy and safety of Intramuscular (IM Olanzapine in acute schizophrenia and acute mania have previously been undertaken in studies required for drug registration in patients who were required to give informed consent. These patients may have less severe forms of psychosis than patients treated in routine practice. Data derived from naturalistic practice following the launch of IM olanzapine may be helpful for clinicians in assessing efficacy and safety of IM olanzapine. The PANSS-EC scale used in the clinical studies may represent a tool that could be used in routine clinical practice. Case presentation We report on an early unselected case series of 7 patients who received IM olanzapine in routine clinical practice settings in the UK. In this case series, olanzapine IM was generally effective, and no adverse events were reported. Adjunctive benzodiazepines were given concomitantly in 1 of the 7 subjects. This is relevant as concomitant benzodiazepines are not recommended for a minimum of 1 hour post IM olanzapine administration. PANSS-EC data was collected in 2 of the 7 subjects. Conclusion Although patients had greater severity of psychosis than clinical trial patients there were no unexpected findings. In addition the PANSS-EC scale is a scale that may be useful in assessing the efficacy of IM antipsychotics in routine clinical practice.

  7. Preventing olanzapine-induced weight gain using betahistine: a study in a rat model with chronic olanzapine treatment.

    Science.gov (United States)

    Lian, Jiamei; Huang, Xu-Feng; Pai, Nagesh; Deng, Chao

    2014-01-01

    Olanzapine is the one of first line antipsychotic drug for schizophrenia and other serious mental illness. However, it is associated with troublesome metabolic side-effects, particularly body weight gain and obesity. The antagonistic affinity to histamine H1 receptors (H1R) of antipsychotic drugs has been identified as one of the main contributors to weight gain/obesity side-effects. Our previous study showed that a short term (2 weeks) combination treatment of betahistine (an H1R agonist and H3R antagonist) and olanzapine (O+B) reduced (-45%) body weight gain induced by olanzapine in drug-naïve rats. A key issue is that clinical patients suffering with schizophrenia, bipolar disease and other mental disorders often face chronic, even life-time, antipsychotic treatment, in which they have often had previous antipsychotic exposure. Therefore, we investigated the effects of chronic O+B co-treatment in controlling body weight in female rats with chronic and repeated exposure of olanzapine. The results showed that co-administration of olanzapine (3 mg/kg, t.i.d.) and betahistine (9.6 mg/kg, t.i.d.) significantly reduced (-51.4%) weight gain induced by olanzapine. Co-treatment of O+B also led to a decrease in feeding efficiency, liver and fat mass. Consistently, the olanzapine-only treatment increased hypothalamic H1R protein levels, as well as hypothalamic pAMPKα, AMPKα and NPY protein levels, while reducing the hypothalamic POMC, and UCP1 and PGC-1α protein levels in brown adipose tissue (BAT). The olanzapine induced changes in hypothalamic H1R, pAMPKα, BAT UCP1 and PGC-1α could be reversed by co-treatment of O+B. These results supported further clinical trials to test the effectiveness of co-treatment of O+B for controlling weight gain/obesity side-effects in schizophrenia with chronic antipsychotic treatment.

  8. Formulation and characterization of nanoemulsion of olanzapine for intranasal delivery.

    Science.gov (United States)

    Kumar, Mukesh; Misra, Ambikanandan; Pathak, Kamla

    2009-01-01

    The objective was to formulate an olanzapine nanoemulsion that could potentially deliver the drug directly to the brain following intranasal administration. The nanoemulsions were prepared using the water titration method. The mucoadhesive character was imparted by the addition of 0.5%w/w chitosan and 0.5%w/w polycarbophil and was characterized for drug content, pH, percentage transmittance, globule size, zeta potential, and PDI. The composition (%w/w) of the optimized olanzapine nanoemulsion was capmul MCM, tween 80, and a mixture of 1:1 ratio of polyethylene glycol 400 and ethanol, and aqueous phase in a ratio of 15:35:17.5:32.5. The optimized olanzapine nanoemulsion exhibited a high diffusion coefficient and no nasal cilio-toxicity. The drug release followed the Higuchi model. The optimized nanoemulsions were found to be stable for 3 months.

  9. Late Onset Anorexia Nervosa Treated With Olanzapine: A Case Report

    Directory of Open Access Journals (Sweden)

    Paolo Santonastaso

    2008-12-01

    Full Text Available A case of late onset anorexia nervosa (AN treated with olanzapine is reported. The patient suffered AN onset at the age of 53 and was brought to our attention four years later in a very poor state of health due to extreme starvation and laxative abuse. She presented severe obsessions about food, a very disturbed body image, and “ascetic” rituals of self-punishment. There was no improvement of her symptoms with cognitive behavioural therapy, antidepressant drugs and inpatient nutritional therapy. After the prescription of olanzapine, the patient was more cooperative and able to maintain a stable acceptable weight, although her psychiatric and anorexic symptoms only improved partially.

  10. Atypicality in presentation of neuroleptic malignant syndrome caused by olanzapine

    Directory of Open Access Journals (Sweden)

    Mishra Biswaranjan

    2007-10-01

    Full Text Available Neuroleptic malignant syndrome (NMS is the most serious of acute neurological side effects produced by antipsychotic medication, characterized by hyperthermia, rigidity, altered consciousness and autonomic dysfunction, the prevalence of which varies from 0.4-1.4%. NMS is usually seen in treatment with high potency typical antipsychotics and very rarely with atypical antipsychotics. However, NMS cases have been reported with risperidone, clozapine, olanzapine and quetiapine. The presentations of NMS have often varied, and we report another atypicality in presentation of NMS due to olanzapine use.

  11. Metabolic and behavioral effects of chronic olanzapine treatment and cafeteria diet in rats.

    Science.gov (United States)

    Muller, Alexandre P; Tort, Ana H; Gnoatto, Jussânia; Moreira, Julia D; Vinadé, Elsa R; Perry, Marcos L; Souza, Diogo O; Lara, Diogo R; Portela, Luis V

    2010-10-01

    Olanzapine and highly palatable diets can alter metabolism and brain function. We investigated the interaction of chronic treatment (4 months) with olanzapine and a cafeteria diet on metabolic parameters, memory tasks (spatial and aversive), the elevated plus maze and locomotor activity induced by d-amphetamine. Male Wistar rats were separated into the following groups: standard diet vehicle, standard diet and olanzapine, cafeteria diet vehicle and cafeteria diet and olanzapine. Olanzapine was administered in the drinking water (approximately 1.5 mg/kg/day), and after 3 days of treatment, the rats exhibited an expected anxiolytic effect and reduced amphetamine-induced hyperlocomotion. After 4 months of treatment, cafeteria diet vehicle and cafeteria diet olanzapine rats exhibited an increased body weight and heavier fat pads compared with the standard diet groups. Olanzapine increased only the epididymal and mesenteric fat pads. The cafeteria diet and olanzapine group showed greater glucose intolerance compared with all other groups. The cafeteria diet altered the effects of chronic olanzapine on the performance in the water maze and inhibitory avoidance tasks. Chronic olanzapine treatment failed to affect amphetamine-induced locomotion and to produce anxiolytic effects in the elevated plus maze task, regardless of the diet. Our results suggest that chronic olanzapine caused an increase in fat pads, which is putatively involved in the etiology of many metabolic diseases. Rats on the cafeteria diet were overweight and exhibited glucose intolerance. We did not observe these effects with olanzapine treatment with the standard diet. Moreover, the chronic treatment regimen caused tolerance to the antipsychotic and anxiolytic effects of olanzapine and seemed to potentiate some of the metabolic effects of the cafeteria diet. The cafeteria diet also modified the effects of chronic treatment with olanzapine on cognitive tasks, which may represent an undesirable effect of

  12. Preventing olanzapine-induced weight gain using betahistine: a study in a rat model with chronic olanzapine treatment.

    Directory of Open Access Journals (Sweden)

    Jiamei Lian

    Full Text Available Olanzapine is the one of first line antipsychotic drug for schizophrenia and other serious mental illness. However, it is associated with troublesome metabolic side-effects, particularly body weight gain and obesity. The antagonistic affinity to histamine H1 receptors (H1R of antipsychotic drugs has been identified as one of the main contributors to weight gain/obesity side-effects. Our previous study showed that a short term (2 weeks combination treatment of betahistine (an H1R agonist and H3R antagonist and olanzapine (O+B reduced (-45% body weight gain induced by olanzapine in drug-naïve rats. A key issue is that clinical patients suffering with schizophrenia, bipolar disease and other mental disorders often face chronic, even life-time, antipsychotic treatment, in which they have often had previous antipsychotic exposure. Therefore, we investigated the effects of chronic O+B co-treatment in controlling body weight in female rats with chronic and repeated exposure of olanzapine. The results showed that co-administration of olanzapine (3 mg/kg, t.i.d. and betahistine (9.6 mg/kg, t.i.d. significantly reduced (-51.4% weight gain induced by olanzapine. Co-treatment of O+B also led to a decrease in feeding efficiency, liver and fat mass. Consistently, the olanzapine-only treatment increased hypothalamic H1R protein levels, as well as hypothalamic pAMPKα, AMPKα and NPY protein levels, while reducing the hypothalamic POMC, and UCP1 and PGC-1α protein levels in brown adipose tissue (BAT. The olanzapine induced changes in hypothalamic H1R, pAMPKα, BAT UCP1 and PGC-1α could be reversed by co-treatment of O+B. These results supported further clinical trials to test the effectiveness of co-treatment of O+B for controlling weight gain/obesity side-effects in schizophrenia with chronic antipsychotic treatment.

  13. Risk of extrapyramidal syndromes with haloperidol, risperidone, or olanzapine

    NARCIS (Netherlands)

    Schillevoort, I; de Boer, A; Herings, R M; Roos, R A; Jansen, P A; Leufkens, H G

    2001-01-01

    OBJECTIVE: To compare the risk of extrapyramidal syndrome (EPS) between risperidone, olanzapine, and haloperidol, taking into account patients' past antipsychotic drug use and past EPS. METHODS: Data were obtained from the PHARMO-database, containing filled prescriptions of 450,000

  14. Olanzapine-induced tender pitting pre-tibial edema

    Directory of Open Access Journals (Sweden)

    Kaliaperumal Mathan

    2015-01-01

    Full Text Available Antipsychotic-induced edema is uncommonly encountered in clinical practice. We report a case of tender pitting pre-tibial edema with olanzapine in a woman with no medical comorbidities. The peculiar distribution of edema resulted in diagnostic confusion necessitating specific investigations. Eventually, the edema resolved following complete stoppage of the drug, but caused distress to the patient and the caregiver.

  15. Risk of extrapyramidal syndromes with haloperidol, risperidone, or olanzapine

    NARCIS (Netherlands)

    Schillevoort, I; de Boer, A; Herings, R M; Roos, R A; Jansen, P A; Leufkens, H G

    2001-01-01

    OBJECTIVE: To compare the risk of extrapyramidal syndrome (EPS) between risperidone, olanzapine, and haloperidol, taking into account patients' past antipsychotic drug use and past EPS. METHODS: Data were obtained from the PHARMO-database, containing filled prescriptions of 450,000 community-dwellin

  16. The Effect of Ranitidine on Olanzapine-Induced Weight Gain

    Directory of Open Access Journals (Sweden)

    Fatemeh Ranjbar

    2013-01-01

    Full Text Available Induced weight gain is a disturbing side effect of Olanzapine that affects the quality of life in psychotic patients. The aim of this study was to assess the efficacy of Ranitidine in attenuating or preventing Olanzapine-induced weight gain. A parallel 2-arm clinical trial was done on 52 patients with schizophrenia, schizoaffective and schizophreniform disorders who received Olanzapine for the first time. All these were first-episode admitted patients. They were randomly allocated to receive either Ranitidine or placebo. The trend of body mass index (BMI was compared between groups over 16-week course of treatment. Mean weight was 62.3 (SD: 9.6 kg at baseline. Thirty-three subjects (63.5% had positive family history of obesity. The average BMI increment was 1.1 for Ranitidine group and 2.4 for the placebo group. The multivariate analysis showed this effect to be independent of sex, family history of obesity, and baseline BMI value. The longitudinal modeling after controlling for baseline values failed to show the whole trend slope to be different. Although the slight change in trend’s slope puts forward a hypothesis that combined use of Ranitidine and Olanzapine may attenuate the weight gain long run, this needs to be retested in future larger scale long-term studies. This trial is registered with IRCT.ir 201009112181N5.

  17. H3 histamine receptor antagonist pitolisant reverses some subchronic disturbances induced by olanzapine in mice

    OpenAIRE

    Dudek, Magdalena; Kuder, Kamil; Kołaczkowski, Marcin; Olczyk, Adrian; Żmudzka, Elżbieta; Rak, Aleksandra; Bednarski, Marek; Pytka, Karolina; Sapa, Jacek; Kieć-Kononowicz, Katarzyna

    2016-01-01

    The use of atypical antipsychotic drugs like olanzapine is associated with side effects such as sedation and depression-like symptoms, especially during the initial period of the use. It is believed that the occurrence of these undesirable effectsis mainly the result of the histamine H1receptors blockade by olanzapine. In addition, use of olanzapine increases the level of triglycerides in the blood, which correlates with growing obesity. The aim of this study was to investigate the influence ...

  18. Glucagon receptor knockout mice are protected against acute olanzapine-induced hyperglycemia.

    Science.gov (United States)

    Castellani, Laura N; Peppler, Willem T; Sutton, Charles D; Whitfield, Jamie; Charron, Maureen J; Wright, David C

    2017-08-01

    To determine if glucagon is involved in mediating the increase in blood glucose levels caused by the second-generation antipsychotic drug olanzapine. Whole body glucagon receptor deficient mice (Gcgr(-/-)) or WT littermate controls were injected with olanzapine (5mg/kg BW IP) and changes in blood glucose measured over the following 120min. Separate cohorts of mice were treated with olanzapine and changes in pyruvate tolerance, insulin tolerance and whole body substrate oxidation were determined. Olanzapine treatment increased serum glucagon and lead to rapid increases in blood glucose concentrations in WT mice. Gcgr(-/-) mice were protected against olanzapine-induced increases in blood glucose but this was not explained by differences in terminal serum insulin concentrations, enhanced AKT phosphorylation in skeletal muscle, adipose tissue or liver or differences in RER. In both genotypes olanzapine induced an equivalent degree of insulin resistance as measured using an insulin tolerance test. Olanzapine treatment led to an exaggerated glucose response to a pyruvate challenge in WT but not Gcgr(-/-) mice and this was paralleled by reductions in the protein content of PEPCK and G6Pase in livers from Gcgr(-/-) mice. Gcgr(-/-) mice are protected against olanzapine-induced increases in blood glucose. This is likely a result of reductions in liver glucose output, perhaps secondary to decreases in PEPCK and G6Pase protein content. Our findings highlight the central role of the liver in mediating olanzapine-induced disturbances in glucose homeostasis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Postinjection Delirium/Sedation Syndrome with Olanzapine Depot Injection

    Science.gov (United States)

    Sarangula, Sadhvi Mythili; Mythri, Starlin Vijay; Sanjay, Y.; Reddy, M. S.

    2016-01-01

    After 1 year of introduction of olanzapine long-acting injectable (LAI) in India, many psychiatrists believe that it is a very affordable, well-tolerated, and effective second generation long-acting antipsychotic depot compared to not well tolerated but cheap first generation antipsychotic depots and to other second generation depots which are costly. However, reports of its possible adverse events in clinical settings are not yet published. We report what probably might be the first case of postinjection delirium/sedation syndrome (PDSS) in India. Although the occurrence is uncommon, incorrect understanding of this event may hinder the future use of the potentially useful olanzapine LAI. We review the available literature on the proposed diagnostic guidelines, mechanism of this event, precautions, and management of PDSS. PMID:27570354

  20. Olanzapine versus Placebo in Adolescents with Schizophrenia; a 6-Week, Randomized Double-Blind, Placebo-Controlled Trial

    Science.gov (United States)

    Kryzhanovskaya, Ludmila; Schulz, Charles; McDougle, Christopher; Frazier, Jean; Dittman, Ralf; Robertson-Plouch, Carol; Bauer, Theresa; Xu, Wen; Wang, Wei; Carlson, Janice; Tohen, Mauricio

    2009-01-01

    The efficacy of olanzapine in treating schizophrenia was tested through a placebo-controlled trial involving one hundred seven inpatient and outpatients adolescents. Patients who took olanzapine experienced significant symptom improvement.

  1. DEVELOPMENT AND BIOEQUIVALENCE STUDY OF OLANZAPINE 10mg TABLETS

    Directory of Open Access Journals (Sweden)

    Ravindra Waykar et al

    2012-09-01

    Full Text Available Generic drugs are lower-cost versions of patent-expired original brand-name medications. According to guidelines of regulatory agencies of the Canada, US and European Union, a generic drug must be “identical, or bioequivalent to a brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use”. Bioequivalence is decreed when the ratio of the generic to the reference compound for the area-under-the-curve and maximum plasma concentration (Cmax fall within a 0.80–1.25 range. The present study was to develop Olanzapine Tablets and compare pharmacokinetic profile of Zyprexa 10 mg film-coated tablets, Zyprexa Velotabs 10 mg orodispersible tablets and Olanzapine 10mg tablets. Multi media dissolution studies in 0.1N HCl, pH 4.5 acetate buffer and pH 6.8 phosphate buffer were carried out for Reference (Zyprexa Velotab 10 mg and Zyprexa 10 mg and test product (i.e. Olanzapine 10 mg. A single centre, open-label, single-dose, randomised, 3-way crossover bioequivalence study, performed under fasting conditions. Based on the results obtained, it can be concluded that the test olanzapine (Treatment A is bioequivalent to both references Zyprexa Velotab (Treatment B and Zyprexa (Treatment C following a 10 mg dose under fasting conditions. All formulations were well tolerated, with no major side effects and no relevant differences in safety profiles were observed between the preparations, particularly with respect to the number and pattern of adverse event.

  2. Acute camptocormia induced by olanzapine: a case report

    Directory of Open Access Journals (Sweden)

    Boyer Stéphane

    2010-06-01

    Full Text Available Abstract Introduction Camptocormia refers to an abnormal posture with flexion of the thoraco-lumbar spine which increases during walking and resolves in supine position. This symptom is an increasingly recognized feature of parkinsonian and dystonic disorders, but may also be caused by neuromuscular diseases. There is recent evidence that both central and peripheral mechanisms may be involved in the pathogenesis of camptocormia. We report a case of acute onset of camptocormia, a rare side effect induced by olanzapine, a second-generation atypical anti-psychotic drug with fewer extra-pyramidal side-effects, increasingly used as first line therapy for schizophrenia, delusional disorders and bipolar disorder. Case presentation A 73-year-old Caucasian woman with no history of neuromuscular disorder, treated for chronic delusional disorder for the last ten years, received two injections of long-acting haloperidol. She was then referred for fatigue. Physical examination showed a frank parkinsonism without other abnormalities. Routine laboratory tests showed normal results, notably concerning creatine kinase level. Fatigue was attributed to haloperidol which was substituted for olanzapine. Our patient left the hospital after five days without complaint. She was admitted again three days later with acute back pain. Examination showed camptocormia and tenderness in paraspinal muscles. Creatine kinase level was elevated (2986 UI/L. Magnetic resonance imaging showed necrosis and edema in paraspinal muscles. Olanzapine was discontinued. Pain resolved quickly and muscle enzymes were normalized within ten days. Risperidone was later introduced without significant side-effect. The camptocormic posture had disappeared when the patient was seen as an out-patient one year later. Conclusions Camptocormia is a heterogeneous syndrome of various causes. We believe that our case illustrates the need to search for paraspinal muscle damage, including drug

  3. Betahistine ameliorates olanzapine-induced weight gain through modulation of histaminergic, NPY and AMPK pathways.

    Science.gov (United States)

    Lian, Jiamei; Huang, Xu-Feng; Pai, Nagesh; Deng, Chao

    2014-10-01

    Olanzapine is widely used to treat schizophrenia and other disorders, but causes adverse obesity and other metabolic side-effects. Both animal and clinical studies have shown that co-treatment with betahistine (a histaminergic H1 receptor agonist and H3 receptor antagonist) is effective for ameliorating olanzapine-induced weight gain/obesity. To reveal the mechanisms underlying these effects, this study investigated the effects of co-treatment of olanzapine and betahistine (O+B) on expressions of histaminergic H1 receptor (H1R), AMP-activated protein kinase (AMPK), neuropeptide Y (NPY), and proopiomelanocortin (POMC) in the hypothalamus associated with reducing olanzapine-induced weight gain. Olanzapine significantly upregulated the mRNA and protein expressions of H1R, while O+B co-treatment significantly downregulated the H1R levels, compared to the olanzapine-only treatment group. The NPY mRNA expression was significantly enhanced by olanzapine, but it was significantly reversed by O+B co-treatment. The hypothalamic H1R expression was positively correlated with total food intake, and NPY expression. Olanzapine also increased AMPKα activation measured by the AMPKα phosphorylation (pAMPKα)/AMPKα ratio compared with controls, whereas O+B co-treatment decreased the pAMPKα/AMPKα ratio, compared with olanzapine only treatment. The pAMPKα/AMPKα ratio was positively correlated with total food intake and H1R expression. Although olanzapine administration decreased the POMC mRNA level, this level was not affected by O+B co-treatment. Therefore, these results suggested that co-treatment with betahistine may reverse olanzapine-induced body weight gain via the H1R-NPY and H1R-pAMPKα pathways.

  4. Determination of olanzapine by spectrophotometry using permanganate

    Directory of Open Access Journals (Sweden)

    Nagaraju Rajendraprasad

    2009-09-01

    Full Text Available Two new spectrophotometric methods using permanganate as the oxidimetric reagent for the determination of olanzapine (OLP were developed and validated as per the current ICH guidelines. The methods involved the addition of known excess of permanganate to OLP in either acid or alkaline medium followed by the determination of unreacted permanganate at 550 nm (method A or bluish-green color of manganate at 610 nm (method B. The decrease in absorbance in method A or increase in absorbance in method B as a function of concentration of OLP was measured and related to OLP concentration. Under optimized conditions, Beer's law was obeyed over the ranges 2.0 to 20 and 1.0 to 10 μg mL-1 in method A and method B, respectively. The calculated molar absorptivity values were 1.34 x 10(4 and 2.54 x 10(4 l mol-1cm-1 for method A and method B respectively, and the respective Sandell sensitivities were 0.0233 and 0.0123 μg cm-2. The LOD and LOQ for method A were calculated to be 0.37 and 1.13 μg mL-1and the corresponding values for method B were 0.16 and 0.48 μg mL-1. Intermediate precision, expressed as RSD was in the range 0.51 to 2.66 %, and accuracy, expressed as relative error ranged from 0.79 to 2.24 %. The proposed methods were successfully applied to the assay of OLP in commercial tablets with mean percentage recoveries of 102 ±1.59 % (method A and 101 ±1.53 % (method B. The accuracy and reliability of the methods were further confirmed by performing recovery tests via standard addition procedure.Dois métodos espectrofotométricos novos, usando o permanganato como o reagente oxidimétrico para a determinação da olanzapina (OLP foram utilizados e validados de acordo com as diretrizes atuais do ICH. Os métodos envolveram a adição de excesso conhecido de permanganato à OLP em meio ácido ou alcalino, determinando-se o permanganato que não reagiu em 550 nm (método A, ou pela cor verde-azulada do manganato a 610 nm (método B. A diminuição da

  5. [Olanzapine efficacy in the treatment of cocaine abuse in methadone maintenance patients. Interaction with plasma levels].

    Science.gov (United States)

    Baño, M D; Micó, J A; Agujetas, M; López, M L; Guillén, J L

    2001-01-01

    The aim of this study was to evaluate the efficacy of the treatment with antipsychotic olanzapine in cocaine abuse methadone patients. The decrease or interruption of cocaine consume as well as the possible pharmacokinetic interaction between olanzapine and methadone were studied. Patients (n= 21) include in a methadone maintenance program (14 months), with DSM-IV criteria for opioid and cocaine dependence and without schizophrenic diagnostic, were treated with olanzapine 5 to 10 mg/day. The therapeutic outcomes were assessed by personal interviews, cocaine consumption, changes of consumption patrons (via of administration) and secondary effects to olanzapine. Withdrawal symptoms were measured by means of the abbreviate version of the scale of Gossop. Cocaine used was measured by urine analysis (enzymoimmnuoassay). The possible pharmacokinetic interaction between olanzapine and methadone was measured in plasma before and during the treatment in 15 patients. Olanzapine combined with methadone in cocaine abusers was well tolerated in an important proportion of patients. Moreover the consumption of cocaine was decreased or stopped in 53,2% of the patients. In addition, no withdrawal syndrome was observed in any patients. Furthermore the ratios of methadone plasma levels did not change in relation to the dose before and during the treatment, suggesting a lack of pharmacokinetic interaction between methadone and olanzapine. In conclusion the results of this preliminary study, led us to advance that olanzapine could be a useful treatment for cocaine abuse at least in patients in a Methadone Maintenance Program, with the advantage of not to induce any pharmacokinetic interaction with methadone.

  6. A randomized open-label comparison of the impact of olanzapine versus risperidone on sexual functioning

    NARCIS (Netherlands)

    Knegtering, H; Boks, M; Blijd, C; Castelein, S; Van den Bosch, RJ; Wiersma, D

    2006-01-01

    The objective of this study was to compare sexual functioning in patients treated with olanzapine or risperidone. This open-label trial included 46 patients randomized to olanzapine (5-15mg/d) or risperidone (1-6mg/d) for 6 weeks. We used sexual dysfunction was assessed by a semistructured interview

  7. The antipsychotic olanzapine interacts with the gut microbiome to cause weight gain in mouse.

    Directory of Open Access Journals (Sweden)

    Andrew P Morgan

    Full Text Available The second-generation antipsychotic olanzapine is effective in reducing psychotic symptoms but can cause extreme weight gain in human patients. We investigated the role of the gut microbiota in this adverse drug effect using a mouse model. First, we used germ-free C57BL/6J mice to demonstrate that gut bacteria are necessary and sufficient for weight gain caused by oral delivery of olanzapine. Second, we surveyed fecal microbiota before, during, and after treatment and found that olanzapine potentiated a shift towards an "obesogenic" bacterial profile. Finally, we demonstrated that olanzapine has antimicrobial activity in vitro against resident enteric bacterial strains. These results collectively provide strong evidence for a mechanism underlying olanzapine-induced weight gain in mouse and a hypothesis for clinical translation in human patients.

  8. Effect of olanzapine treatment on INR of a patient receiving warfarin therapy

    Directory of Open Access Journals (Sweden)

    Derya Arslan

    2016-06-01

    Full Text Available Olanzapine is an atypical antipsychotic drug, commonly used in the management of psychotic symptoms in patients with schizoprenia and bipolar affective disorder. Deep venous thrombosis is a manifestation of venous thromboembolism. It is very well known that use of antipsychotic drugs increase the risk of thrombosis in a patient with schizophrenia. It has been reported in many studies the effects of olanzapine on thrombosis but there isn't any report about the effect of olanzapine on international normalized ratio (INR. in the medical literature. In this paper, a patient with schizophrenia and also family history of deep venous thrombosis who emerged deep venous thrombosis after being started on olanzapine treatment and effect of olanzapine treatment on INR has been reported. [Cukurova Med J 2016; 41(2.000: 370-373

  9. Effects of olanzapine on regional C-Fos expression in rat forebrain.

    Science.gov (United States)

    Robertson, G S; Fibiger, H C

    1996-02-01

    Compared to typical antipsychotic drugs, clozapine produces a unique pattern of Fos-like immunoreactive neurons in the rat forebrain. It has been proposed, therefore, that this approach may be useful in identifying other agents with clozapine's therapeutic profile. In the present study, we examined the ability of olanzapine to increase the number of Fos-like immunoreactive neurons in the striatum, nucleus accumbens, lateral septal nucleus, and prefrontal cortex. Olanzapine (5, 10 mg/kg) produced dose-dependent increases in the number of Fos-positive neurons in the nucleus accumbens and lateral septal nucleus, important components of the limbic system that may mediate some of the therapeutic actions of neuroleptics. Olanzapine also produced dose-dependent increases in the number of Fos-positive neurons in the dorsolateral striatum, an effect that correlates with the ability of neuroleptics to produce extrapyramidal side-effects. The effects of olanzapine on regional c-fos expression are not therefore identical to clozapine, which is without effect in the dorsolateral striatum. However, olanzapine-induced increases in the dorsolateral striatum were considerably smaller than those generated in the nucleus accumbens suggesting that at low, potentially therapeutic doses olanzapine may not generate significant extrapyramidal side effects. Olanzapine also increased the number of Fos-positive neurons in medical prefrontal cortex, an action unique to clozapine and a few other atypical antipsychotics. These findings are consistent with the hypothesis that olanzapine is an atypical antipsychotic in the sense that it does not produce significant extrapyramidal side-effects at low therapeutic doses. However, extrapyramidal side-effects at higher doses can be predicted by these results. Finally, olanzapine's actions in the medial prefrontal cortex may be predictive of a clozapine-like profile with respect to actions on negative symptoms in schizophrenia. Additional clinical

  10. Olanzapine for the treatment of bipolar disorder in children and adolescents.

    Science.gov (United States)

    Strawn, Jeffrey R; Delbello, Melissa P

    2008-02-01

    The second-generation antipsychotic olanzapine has been shown to be efficacious as a treatment for adults with bipolar disorder and is approved by the United States Food and Drug Administration for the treatment of acute manic or mixed episodes as well as for maintenance treatment in bipolar adults. This review examines the use of olanzapine for the treatment of children and adolescents with bipolar disorder and presents a discussion of the mechanism of action, pharmacokinetic and pharmacodynamic properties of olanzapine in children and adolescents. In addition, efficacy and safety data are reviewed and the risks and benefits of using olanzapine in bipolar youth are summarized. Articles published in English were identified using a search of the National Library of Medicine from 1990 to 2007 with manual review of references of each article as well as review of the US Clinical Trials database. Articles describing the use of olanzapine in children or adolescents were included. Olanzapine appears to have a rapid onset of action for mixed and manic episodes, but is associated with metabolic side effects including hyperprolactinemia, diabetes and weight gain. Therefore, olanzapine may best be used in the acute treatment of children and adolescents experiencing a manic or mixed episode as its side-effect profile may limit its use as a maintenance agent in this population.

  11. Effects of intracerebroventricular (ICV) olanzapine on insulin sensitivity and secretion in vivo: an animal model.

    Science.gov (United States)

    Hahn, Margaret K; Chintoh, Araba; Remington, Gary; Teo, Celine; Mann, Steve; Arenovich, Tamara; Fletcher, Paul; Lam, Loretta; Nobrega, Jose; Guenette, Melanie; Cohn, Tony; Giacca, Adria

    2014-03-01

    The atypical antipsychotics (AAPs) have been associated with an increased risk of type 2 diabetes. While weight gain associated with AAPs is a risk factor for diabetes, preclinical work suggests that among these medications, olanzapine, when given peripherally in a single dose, causes pronounced effects on insulin sensitivity and secretion. Given a critical role of the hypothalamus in control of glucose metabolism, we examined the effect of central administration of olanzapine. Sprague-Dawley rats were treated with a single 75 μg intracerebroventricular (ICV) dose of olanzapine and tested using separate hyperinsulinemic-euglycemic and hyperglycemic clamps. Dosing of olanzapine was established based on inhibition of amphetamine-induced locomotion. In contrast to the single dosing peripheral paradigm, there was no effect of central olanzapine on insulin sensitivity, either with respect to hepatic glucose production or peripheral glucose uptake. Analogous to the peripheral model, a single ICV dose of olanzapine followed by the hyperglycemic clamp decreased insulin (p=0.0041) and C-peptide response (p=0.0039) to glucose challenge as compared to vehicle, mirrored also by a decrease in the steady state glucose infusion rate required to maintain hyperglycemia (p=0.002). In conclusion, we demonstrate novel findings that at least part of the effect of olanzapine on beta-cell function in vivo is central.

  12. Amantadine for weight gain associated with olanzapine treatment.

    Science.gov (United States)

    Deberdt, Walter; Winokur, Andrew; Cavazzoni, Patrizia A; Trzaskoma, Quynh N; Carlson, Christopher D; Bymaster, Frank P; Wiener, Karen; Floris, Michel; Breier, Alan

    2005-01-01

    Patients with schizophrenia (Sch), schizoaffective, schizophreniform, or bipolar (BP) I disorders [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)]; not manic or acutely psychotic [Brief Psychiatric Rating Scale (BPRS) total score or =5% of their initial body weight were examined to determine whether amantadine could attenuate weight gain or promote weight loss. Olanzapine (Olz; 5-20 mg/day) was co-administered with double-blind treatment of 100-300 mg/day amantadine (Olz+Amt, n=60) or placebo (Olz+Plc, n=65). Visit-wise analysis of weight showed that weight change from baseline [last-observation-carried-forward (LOCF)] in the Olz+Amt group was significantly different from the Olz+Plc group at weeks 8 (P=0.042), 12 (P=0.029), and 16 (primary endpoint, mean+/-S.D.: -0.19+/-4.58 versus 1.28+/-4.26 kg, P=0.045). Mean BPRS total score, positive subscale, and anxiety-depression scores improved comparably in both groups, and Montgomery-Asberg Depression Rating Scale (MADRS) total score improved in the Olz+Amt group. Overall, amantadine was safe, was well tolerated, and attenuated weight gain or promoted weight loss in some patients who had gained weight during olanzapine therapy.

  13. How can lipid nanocarriers improve transdermal delivery of olanzapine?

    Science.gov (United States)

    Iqbal, Nimra; Vitorino, Carla; Taylor, Kevin M G

    2017-06-01

    The development of a transdermal nanocarrier drug delivery system with potential for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, is described. Lipid nanocarriers (LN), encompassing various solid:liquid lipid compositions were formulated and assessed as potential nanosystems for transdermal delivery of olanzapine. A previously optimized method of hot high pressure homogenization (HPH) was adopted for the production of the LN, which comprised solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC) and nanoemulsions (NE). Precirol( ®) was selected as the solid lipid for progression of studies. SLN exhibited the best performance for transdermal delivery of olanzapine, based on in vitro release and permeation studies, coupled with results from physicochemical characterization of several solid:liquid lipid formulations. Stability tests, performed to give an indication of long-term storage behavior of the formulations, were in good agreement with previous studies for the best choice of solid:liquid lipid ratio. Overall, these findings highlight the SLN-based formulation as promising for the further inclusion in and production of transdermal patches, representing an innovative therapeutic approach.

  14. Long-term functional improvements in the 2-year treatment of schizophrenia outpatients with olanzapine long-acting injection

    Directory of Open Access Journals (Sweden)

    Ascher-Svanum H

    2014-06-01

    Full Text Available Haya Ascher-Svanum,1 Diego Novick,2,3 Josep Maria Haro,4 Jordan Bertsch,4 David McDonnell,1 Holland Detke11Eli Lilly and Company, Indianapolis, IN, USA; 2Eli Lilly and Company, Windlesham, Surrey, UK; 3Departament de Psiquiatria, Universitat Autonoma de Barcelona, Spain; 4Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red en el Área de Salud Mental, Universitat de Barcelona, Barcelona, SpainBackground: Little is known about the long-term changes in the functioning of schizophrenia patients receiving maintenance therapy with olanzapine long-acting injection (LAI, and whether observed changes differ from those seen with oral olanzapine.Methods: This study describes changes in the levels of functioning among outpatients with schizophrenia treated with olanzapine-LAI compared with oral olanzapine over 2 years. This was a secondary analysis of data from a multicenter, randomized, open-label, 2-year study comparing the long-term treatment effectiveness of monthly olanzapine-LAI (405 mg/4 weeks; n=264 with daily oral olanzapine (10 mg/day; n=260. Levels of functioning were assessed with the Heinrichs–Carpenter Quality of Life Scale. Functional status was also classified as “good”, “moderate”, or “poor”, using a previous data-driven approach. Changes in functional levels were assessed with McNemar’s test and comparisons between olanzapine-LAI and oral olanzapine employed the Student’s t-test. Results: Over the 2-year study, the patients treated with olanzapine-LAI improved their level of functioning (per Quality of Life total score from 64.0–70.8 (P<0.001. Patients on oral ­olanzapine also increased their level of functioning from 62.1–70.1 (P<0.001. At baseline, 19.2% of the olanzapine-LAI-treated patients had a “good” level of functioning, which increased to 27.5% (P<0.05. The figures for oral olanzapine were 14.2% and 24.5%, respectively (P<0.001. Results did not significantly differ between

  15. Olanzapine Versus Placebo in the Treatment of Adolescents With Bipolar Mania

    National Research Council Canada - National Science Library

    Robertson-Plouch, Carol; DelBello, Melissa; Lin, Daniel; Kryzhanovskaya, Ludmila; Xu, Wen; Biederman, Joseph; Tohen, Mauricio; Wagner, Karen; Carlson, Gabrielle; Dittmann, Ralf W; Wozniak, Janet; Kowatch, Robert; Findling, Robert

    2007-01-01

    Objective: The purpose of this study was to evaluate the efficacy and safety of olanzapine for the treatment of acute manic or mixed episodes associated with bipolar disorder in adolescents. Method...

  16. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting

    Science.gov (United States)

    Navari, Rudolph M.; Qin, Rui; Ruddy, Kathryn J.; Liu, Heshan; Powell, Steven F.; Bajaj, Madhuri; Dietrich, Leah; Biggs, David; Lafky, Jacqueline M.; Loprinzi, Charles L.

    2016-01-01

    BACKGROUND We examined the efficacy of olanzapine for the prevention of nausea and vomiting in patients receiving highly emetogenic chemotherapy. METHODS In a randomized, double-blind, phase 3 trial, we compared olanzapine with placebo, in combination with dexamethasone, aprepitant or fosaprepitant, and a 5-hydroxytryptamine type 3–receptor antagonist, in patients with no previous chemotherapy who were receiving cisplatin (≥70 mg per square meter of body-surface area) or cyclophosphamide–doxorubicin. The doses of the three concomitant drugs administered before and after chemotherapy were similar in the two groups. The two groups received either 10 mg of olanzapine orally or matching placebo daily on days 1 through 4. Nausea prevention was the primary end point; a complete response (no emesis and no use of rescue medication) was a secondary end point. RESULTS In the analysis, we included 380 patients who could be evaluated (192 assigned to olanzapine, and 188 to placebo). The proportion of patients with no chemotherapy-induced nausea was significantly greater with olanzapine than with placebo in the first 24 hours after chemotherapy (74% vs. 45%, P = 0.002), the period from 25 to 120 hours after chemotherapy (42% vs. 25%, P = 0.002), and the overall 120-hour period (37% vs. 22%, P = 0.002). The complete-response rate was also significantly increased with olanzapine during the three periods: 86% versus 65% (P<0.001), 67% versus 52% (P = 0.007), and 64% versus 41% (P<0.001), respectively. Although there were no grade 5 toxic effects, some patients receiving olanzapine had increased sedation (severe in 5%) on day 2. CONCLUSIONS Olanzapine, as compared with placebo, significantly improved nausea prevention, as well as the complete-response rate, among previously untreated patients who were receiving highly emetogenic chemotherapy. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT02116530.) PMID:27410922

  17. Olanzapine-induced Priapism in a Child with Asperger’s Syndrome

    Science.gov (United States)

    Bozkurt, Hasan; Şahin, Serkan

    2017-01-01

    Background: Priapism is a potentially painful and prolonged erection that occurs in the absence of any stimulation. Olanzapine has been reported to induce priapism in several adult cases with schizophrenia and/or mood disorders but very rarely reported in children. Case Report: 9-year-old male with Asperger’s Syndrome (AS) referred to our clinic with the complaints of inattention, hyperactivity and impulsivity. He was diagnosed with attention deficit hyperactivity disorder (ADHD) and given methylphenidate treatment which ameliorated his ADHD symptoms. He started to have severe loss of appetite after methylphenidate treatment so olanzapine 2.5 mg/day was added to cope with severe inappetence. However he experienced priapism after olanzapine and priapism resolved after ceasing the drug. His mother restarted olanzapine because he benefited from olanzapine. But the same episodes occurred soon after olanzapine again and his mother had to stop the medication. Conclusion: Because atypical antipsychotics are now widely used in children, unusual side effects such as priapism should be taken into consideration for the differential diagnosis. PMID:28251031

  18. The promotion of olanzapine in primary care: an examination of internal industry documents.

    Science.gov (United States)

    Spielmans, Glen I

    2009-07-01

    Media reports have discussed how olanzapine was marketed off-label for dementia and subsyndromal bipolar disorder. Much of this marketing occurred in primary care settings. However, these reports have provided few details. In legal proceedings, Lilly disclosed internal documents that detail the strategies utilized to market olanzapine. The current paper addresses the marketing of olanzapine in detail based upon a review of these documents. All 358 documents released by Lilly are publicly available online. Documents were utilized for this review if they were relevant to the marketing of olanzapine in primary care settings in the United States. It was found that olanzapine was marketed off-label in primary care settings for relatively mild symptoms that were framed as bipolar disorder and schizophrenia. A key strategy in this campaign was the use of hypothetical patient profiles in detailing visits, most of which clearly failed to meet diagnostic criteria for any recognized mental disorder. Evidence emerged that olanzapine was also marketed off-label as a treatment for dementia.

  19. An unusual case of hypothermia associated with therapeutic doses of olanzapine: a case report

    Directory of Open Access Journals (Sweden)

    Ratnayake Shiroma L

    2011-05-01

    Full Text Available Abstract Introduction We report a case of a 42-year-old man who had symptomatic hypothermia as a result of taking olanzapine for paranoid schizophrenia. According to published data, only a few cases of hypothermia associated with olanzapine have been reported since its introduction into clinical use. Case presentation A 42-year-old Sri Lankan man with schizophrenia who was being treated with a therapeutic dose of olanzapine presented with reduced level of consciousness. He had a core temperature of 32°C and was bradycardic. At the time of admission, the electrocardiogram showed sinus bradycardia with J waves. He did not have any risk factors for developing hypothermia except the use of olanzapine. There was improvement in his clinical condition with reversal of electrocardiogram changes following gradual rewarming and the omission of olanzapine. Conclusion Hypothermia induced by antipsychotic medications is not uncommon, but olanzapine-induced hypothermia is rare and occurrence has been reported during initiation or increasing the dose. But here the patient developed hypothermia without dose adjustment.

  20. Betahistine decreases olanzapine-induced weight gain and somnolence in humans.

    Science.gov (United States)

    Barak, Nir; Beck, Yaffa; Albeck, Joseph H

    2016-03-01

    Olanzapine's efficacy in schizophrenia is attributed to antagonism of dopamine and serotonin receptors. Olanzapine is also a potent histamine-H1 antagonist that results in weight gain and somnolence. Betahistine is a centrally acting histamine-H1 agonist, and therefore may reduce olanzapine's effect on histamine receptors in the brain. Olanzapine's high affinity for the histamine-H1 receptor warrants the use of high doses of betahistine. Forty-eight healthy women were recruited and randomized to receive either betahistine 144 mg/day or matching placebo for 4 weeks. Due to the high dose of betahistine, olanzapine was started only on the second week and titrated up to 10 mg/day, and co-administration continued for an additional 2 weeks. Only nominal differences in adverse events were noted between the treatment groups. Betahistine caused a 37% reduction in mean weight gain (1.24 kg in the betahistine arm vs. 1.93 kg in the placebo arm; p=.049) and 60% reduction in the mean increase in daytime Epworth sleepiness scores (1.82 units in the betahistine group vs. 3.57 units in the placebo group; p=.042). The present study suggests that betahistine-olanzapine co-administration, in healthy female subjects, yields an acceptable safety profile with mitigation of weight gain and somnolence. This should be further tested in a patient cohort.

  1. A Comparative Study between Olanzapine and Risperidone in the Management of Schizophrenia

    Directory of Open Access Journals (Sweden)

    Saeed Shoja Shafti

    2014-01-01

    Full Text Available Introduction. Since a variety of comparisons between risperidone and olanzapine have resulted in diverse outcomes, so safety and efficacy of them were compared again in a new trial. Method. Sixty female schizophrenic patients entered into one of the assigned groups for random allocation to olanzapine or risperidone (n=30 in each group in a double-blind, 12-week clinical trial. Scale for Assessment of Positive Symptoms (SAPS and Scale for Assessment of Negative Symptoms (SANS were used as the primary outcome measures. Clinical Global Impressions-Severity Scale (CGI-S, Schedule for Assessment of Insight (SAI, and finally Simpson Angus Scale (SAS as well were employed as secondary scales. Results. While both of olanzapine and risperidone were significantly effective for improvement of positive symptoms (P<0.0001, as regards negative symptoms, it was so only by means of olanzapine (P<0.0003. CGI-S and SAI, as well, were significantly improved in both of the groups. SAS increment was significant only in the risperidone group (P<0.02. Conclusion. While both of olanzapine and risperidone were equally effective for improvement of positive symptoms and insight, olanzapine showed superior efficacy with respect to negative symptoms, along with lesser extrapyramidal side effects, in comparison with risperidone.

  2. Thrombocytopenia associated with olanzapine: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Swapnajeet Sahoo

    2016-01-01

    Full Text Available There is limited literature on olanzapine-associated thrombocytopenia. In this report, we present a case of a 32-year-old female, suffering from persistent delusional disorder who had thrombocytopenia (46,000/mm3 with the use of olanzapine 25 mg/day, 6 weeks after starting medication. Blood film did not reveal any evidence of any dysplastic cells, disturbance in the count of other cell lines, and autoimmune workup including antinuclear antibodies and anti-neutrophil cytoplasmic antibodies were found to be negative. Given no other etiology, olanzapine was gradually tapered, and platelet counts were monitored. Reduction in the dose of olanzapine led to an improvement in platelet counts which reached the normal range after complete stoppage of olanzapine. In view of continued psychotic symptoms, she was started on clozapine and which was gradually increased to 200 mg/day with biweekly monitoring of total platelet counts before each increment in the dose of clozapine. Thrombocytopenia did not recur with use of clozapine. With clozapine, her psychosis improved by nearly 60%. A review of literature revealed only eight case reports supporting the association of olanzapine and thrombocytopenia.

  3. Determination of olanzapine and N-desmethyl-olanzapine in plasma using a reversed-phase HPLC coupled with coulochemical detection: correlation of olanzapine or N-desmethyl-olanzapine concentration with metabolic parameters.

    Directory of Open Access Journals (Sweden)

    Mong-Liang Lu

    Full Text Available BACKGROUND: Olanzapine (OLZ is one of the most prescribed atypical antipsychotic drugs but its use is associated with unfavorable metabolic abnormalities. N-desmethyl-olanzapine (DMO, one of the OLZ metabolites by CYP1A2, has been reported to have a normalizing action on metabolic abnormalities, but this remains unclear. Our aim was to explore the correlation between the concentrations of OLZ or DMO with various metabolic parameters in schizophrenic patients. METHODS: The chromatographic analysis was carried out with a solvent delivery system coupled to a Coulochem III coulometric detector to determine OLZ and DMO simultaneously in OLZ-treated patients. The correlation between the concentration of OLZ or DMO and the metabolic parameters was analyzed by the Spearman rank order correlation method (r s. PRINCIPAL FINDINGS: The established analytical method met proper standards for accuracy and reliability and the lower limitation of quantification for each injection of DMO or OLZ was 0.02 ng. The method was successfully used for the analysis of samples from nonsmoking patients (n = 48 treated with OLZ in the dosage range of 5-20 mg per day. There was no correlation between OLZ concentrations and tested metabolic parameters. DMO concentrations were negatively correlated with glucose (r s = -0.45 and DMO concentrations normalized by doses were also negatively correlated with insulin levels (r s = -0.39; however, there was a marginally positive correlation between DMO and homocysteine levels (r s = +0.38. CONCLUSIONS: The observed negative correlations between levels of DMO and glucose or insulin suggest a metabolic normalization role for DMO regardless of its positive correlation with a known cardiovascular risk factor, homocysteine. Additional studies of the mechanisms underlying DMO's metabolic effects are warranted.

  4. Alterations to melanocortinergic, GABAergic and cannabinoid neurotransmission associated with olanzapine-induced weight gain.

    Directory of Open Access Journals (Sweden)

    Katrina Weston-Green

    Full Text Available BACKGROUND/AIM: Second generation antipsychotics (SGAs are used to treat schizophrenia but can cause serious metabolic side-effects, such as obesity and diabetes. This study examined the effects of low to high doses of olanzapine on appetite/metabolic regulatory signals in the hypothalamus and brainstem to elucidate the mechanisms underlying olanzapine-induced obesity. METHODOLOGY/RESULTS: Levels of pro-opiomelanocortin (POMC, neuropeptide Y (NPY and glutamic acid decarboxylase (GAD(65, enzyme for GABA synthesis mRNA expression, and cannabinoid CB1 receptor (CB1R binding density (using [(3H]SR-141716A were examined in the arcuate nucleus (Arc and dorsal vagal complex (DVC of female Sprague Dawley rats following 0.25, 0.5, 1.0 or 2.0 mg/kg olanzapine or vehicle (3×/day, 14-days. Consistent with its weight gain liability, olanzapine significantly decreased anorexigenic POMC and increased orexigenic NPY mRNA expression in a dose-sensitive manner in the Arc. GAD(65 mRNA expression increased and CB1R binding density decreased in the Arc and DVC. Alterations to neurotransmission signals in the brain significantly correlated with body weight and adiposity. The minimum dosage threshold required to induce weight gain in the rat was 0.5 mg/kg olanzapine. CONCLUSIONS: Olanzapine-induced weight gain is associated with reduced appetite-inhibiting POMC and increased NPY. This study also supports a role for the CB1R and GABA in the mechanisms underlying weight gain side-effects, possibly by altering POMC transmission. Metabolic dysfunction can be modelled in the female rat using low, clinically-comparable olanzapine doses when administered in-line with the half-life of the drug.

  5. H3 histamine receptor antagonist pitolisant reverses some subchronic disturbances induced by olanzapine in mice.

    Science.gov (United States)

    Dudek, Magdalena; Kuder, Kamil; Kołaczkowski, Marcin; Olczyk, Adrian; Żmudzka, Elżbieta; Rak, Aleksandra; Bednarski, Marek; Pytka, Karolina; Sapa, Jacek; Kieć-Kononowicz, Katarzyna

    2016-10-01

    The use of atypical antipsychotic drugs like olanzapine is associated with side effects such as sedation and depression-like symptoms, especially during the initial period of the use. It is believed that the occurrence of these undesirable effectsis mainly the result of the histamine H1receptors blockade by olanzapine. In addition, use of olanzapine increases the level of triglycerides in the blood, which correlates with growing obesity. The aim of this study was to investigate the influence of pitolisant - H3 histamine antagonist - on subchronic olanzapine-induced depresion-like symptoms, sedation and hypertriglicerydemia. Forced swim test was conducted to determinate depressive-like effect of olanzapine and antidepressive-like activity during the co-administered pitolisant. The test was performed after the first and fifteenth day of the treatment of the mice. The spontaneous activity of the mice was measured on the fourteenth day of the treatment with a special, innovative RFID-system (Radio-frequency identification system) - TraffiCage (TSE-Systems, Germany). Triglyceride levels were determined on the sixteenth day of the experiment after 15 cycles of drug administration. Daily olanzapine treatment (4 mg/kg b.w., i.p., d.p.d) for 15 days significantly induces sedation (p < 0.05) and prolongs immobility time in forced swim tests (FST) in mice (p < 0.05); and also elevates the level of triglycerides (p < 0.05). Administration of pitolisant (10 mg/kg b.w., i.p.) subsequentto olanzapine normalizes these adverse effects. This study presents a promising alternative for counteracting some behavioral changes and metabolic disturbances which occur in the early period of treatment with antipsychotic drugs.

  6. Olanzapine for the prevention and treatment of chronic nausea and chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Navari, Rudolph M

    2014-01-05

    Olanzapine is an atypical antipsychotic agent of the thiobenzodiazepine class. It blocks multiple neurotransmitter receptors including dopaminergic at D1, D2, D3, D4 brain receptors, serotonergic at 5-HT2a, 5-HT2c, 5-HT3, 5-HT6 receptors, catecholamines at alpha1 adrenergic receptors, acetylcholine at muscarinic receptors, and histamine at H1 receptors. Olanzapine has five times the affinity for 5-HT2 receptors than D2 receptors and has been used to treat schizophrenia and delirium. Olanzapine's activity at multiple receptors, particularly at the D2, 5-HT2c, and 5-HT3 receptors which appear to be involved in nausea and emesis, has prompted its use in the treatment of nausea and vomiting refractory to standard antiemetics. Case reports and formal clinical trials have demonstrated its efficacy in the treatment of chronic nausea, the prevention of chemotherapy-induced nausea and emesis, and the treatment of breakthrough chemotherapy-induced nausea and emesis. Phase II and phase III clinical trials have demonstrated that there is a significant improvement in nausea when olanzapine is added to guideline directed prophylactic antiemetic agents 5-HT3 receptor antagonists and tachykinin NK1 receptor antagonists in patients receiving moderately or highly emetogenic chemotherapy Common side effects of olanzapine when used over a period of months include weight gain as well as an association with the onset of diabetes mellitus, but these effects have not been seen with short term use of daily doses of less than one week.

  7. Spectrum of binge eating symptomatology in patients treated with clozapine and olanzapine.

    Science.gov (United States)

    Theisen, F M; Linden, A; König, I R; Martin, M; Remschmidt, H; Hebebrand, J

    2003-01-01

    The authors explored the binge eating symptomatology in 74 patients receiving clozapine (N = 57) or olanzapine (N = 17), and compared body mass index (BMI, kg/m(2)) and weight gain in patients with and without binge eating symptomatology. Subjects who screened positively for binge eating were interviewed using a modified version of the Questionnaire on Eating and Weight Patterns (QEWP). Current BMIs were assessed cross-sectionally, BMIs at initiation of clozapine/olanzapine treatment retrospectively. Thirty-seven subjects (50%) screened positively. Taking clozapine and olanzapine together, 6/27 (22.2%) females and 3/47 (6.4%) males fulfilled criteria for binge eating disorder, 3/27 (11.1%) females and 2/47 (4.3%) males for bulimia nervosa. Patients who screened positively showed higher current BMIs (26.8 +/- 3.9 vs. 24.7 +/- 3.7 kg/m(2)) and higher BMI increments during clozapine/olanzapine treatment (3.9 +/- 3.1 vs. 2.6 +/- 3.4 kg/m(2)) than patients who screened negatively. We conclude that clozapine/olanzapine may induce binge eating and full blown eating disorders which may have predictive value for weight gain. For future research in this field we suggest a novel DSM-IV research classification "Medication-induced eating disorders".

  8. A comparative study of olanzapine versus asenapine in acute treatment of manic episode: A 3-week prospective study

    Directory of Open Access Journals (Sweden)

    Ajeet Sidana

    2014-01-01

    Full Text Available Introduction: Treatment of bipolar disorders has evolved over the years from conventional mood stabilizers to second-generation antipsychotics. Among the atypical antipsychotics, few have been approved by Food and Drug Administration as treatment of bipolar disorders. Aim: To study the efficacy and tolerability of olanzapine and asenapine in the acute treatment of bipolar disorder-manic episode in a 3-week randomized prospective study. Materials and Methods: A 3-week randomized, prospective, comparative, flexible doses of olanzapine (5-30 mg/day and asenapine (10-20 mg/day for acute treatment of bipolar disorder-current manic episode with or without psychotic symptoms in hospitalized patients. Results: The end-point reduction in mean score of Young Mania rating scale in the olanzapine group was 15.82 in comparison to 6.88 in the asenapine group. Mean score on clinical global impression for bipolar disorder and positive and negative syndrome scale was significantly less in the olanzapine group at the end of the study. 81.81% patients in olanzapine group and 17.60% patients in asenapine group had clinical response. There was significant average weight gain in the olanzapine group - 1.9 kg in comparison to 0.87 kg in asenapine group. Conclusion: The clinical response with olanzapine is significantly higher than the asenapine in the treatment of bipolar disorder-manic episode with or without psychotic symptoms. However, there is significant weight gain in olanzapine-treated patients.

  9. Reducing olanzapine-induced weight gain side effect by using betahistine: a study in the rat model.

    Science.gov (United States)

    Deng, Chao; Lian, Jiamei; Pai, Nagesh; Huang, Xu-Feng

    2012-09-01

    Olanzapine is effective at treating multiple domains of schizophrenia symptoms. However, it induces serious metabolic side effects. Antipsychotic drug's antagonistic affinity to histamine H₁ receptors has been identified as a main contributor for weight gain/obesity side effects. This study therefore investigated whether a combined treatment of betahistine (a H₁ receptor agonist and H₃ receptor antagonist) could reduce the body weight/obesity induced by olanzapine. Female Sprague Dawley rats were treated orally with olanzapine (1 mg/kg, t.i.d.) and/or betahistine (2.67 mg/kg, t.i.d.), or vehicle for two weeks. Rats treated with olanzapine exhibited significant body weight gain and increased food intake. Co-treatment of olanzapine with betahistine significantly prevented (-45%) weight gain and reduced feeding efficiency compared to sole olanzapine treatment. Betahistine treatment alone had no effect on weight gain and food intake. Olanzapine reduced locomotor activity, but not betahistine. These findings demonstrate that olanzapine-induced body weight gain can partially be reduced by co-treatment with betahistine. Betahistine has H₃ receptor antagonistic effects to increase histamine release, which may augment its direct agonistic effects on H₁ receptors. These findings have important implications for clinical trials using betahistine to control antipsychotic-induced obesity side effects.

  10. Olanzapine induced biochemical and histopathological changes after its chronic administration in rats

    Directory of Open Access Journals (Sweden)

    Rehmat Shah

    2016-11-01

    Full Text Available Objective: Olanzapine is a second generation antipsychotic acting mainly as a dopamine D2 and serotonine 5-HT2 receptors antagonist prescribed in the treatment of schizophrenia and various other psychiatric illnesses. Even though olanzapine is widely used in psychiatry, its effects on the architecture of pancreas, liver and kidneys are little known. The histology of pancreas especially has never been studied. For these reasons, the current study was designed to elucidate the toxic effects of chronic administration of olanzapine on pancreas, liver and kidneys and the enzymes released by these tissues in an escalating dose manner. Methods: Fourteen male rats were divided into two groups equally, the olanzapine group and the controls. Olanzapine was administered in a dose of 5 mg/kg/d for the first eight weeks, 10 mg/kg/d for next four weeks and 15 mg/kg/d through the last two week period of 14 weeks experiment. The controls received acidified saline only. Both the groups received restricted diet (20 g/12 h. The body weight and level of random blood sugar (RBS were measured on a weekly basis. The levels of lipase, amylase, alanine transaminase (ALT and aspartate transaminase (AST were determined terminally. At the end of the experiment, the tissues were dissected out for histopathological evaluation. Results: Significant loss in body weight, change in the level of random blood sugar (∗∗P  0.05. The pancreas has shown derangement of beta cells and fibrotic growth. A mild to moderate focal increase in glomerular cellularity, cellular proliferation and glomerular capsules with negligible basement membranes were observed in the kidneys. No changes were observed in the architecture of the liver. Conclusion: The findings of this study indicated that the incidence of adverse effects associated with olanzapine could be prevented/alleviated/delayed by allowing restricted diet.

  11. RNA sequencing reveals a slow to fast muscle fiber type transition after olanzapine infusion in rats.

    Directory of Open Access Journals (Sweden)

    Christopher J Lynch

    Full Text Available Second generation antipsychotics (SGAs, like olanzapine, exhibit acute metabolic side effects leading to metabolic inflexibility, hyperglycemia, adiposity and diabetes. Understanding how SGAs affect the skeletal muscle transcriptome could elucidate approaches for mitigating these side effects. Male Sprague-Dawley rats were infused intravenously with vehicle or olanzapine for 24h using a dose leading to a mild hyperglycemia. RNA-Seq was performed on gastrocnemius muscle, followed by alignment of the data with the Rat Genome Assembly 5.0. Olanzapine altered expression of 1347 out of 26407 genes. Genes encoding skeletal muscle fiber-type specific sarcomeric, ion channel, glycolytic, O2- and Ca2+-handling, TCA cycle, vascularization and lipid oxidation proteins and pathways, along with NADH shuttles and LDH isoforms were affected. Bioinformatics analyses indicate that olanzapine decreased the expression of slower and more oxidative fiber type genes (e.g., type 1, while up regulating those for the most glycolytic and least metabolically flexible, fast twitch fiber type, IIb. Protein turnover genes, necessary to bring about transition, were also up regulated. Potential upstream regulators were also identified. Olanzapine appears to be rapidly affecting the muscle transcriptome to bring about a change to a fast-glycolytic fiber type. Such fiber types are more susceptible than slow muscle to atrophy, and such transitions are observed in chronic metabolic diseases. Thus these effects could contribute to the altered body composition and metabolic disease olanzapine causes. A potential interventional strategy is implicated because aerobic exercise, in contrast to resistance exercise, can oppose such slow to fast fiber transitions.

  12. Efficacy, tolerability and cost effectiveness of zotepine versus olanzapine in patients of acute schizophrenia

    Directory of Open Access Journals (Sweden)

    Saroj Kothari

    2013-10-01

    Full Text Available Background: Schizophrenia is a functional psychosis with severe personality changes and thought disorders without cerebral damage. No reports are available in literature regarding efficacy and tolerability of atypical antipsychotic drug zotepine over olanzapine a preferred drug worldwide for the treatment of schizophrenia. Therefore, present study is undertaken to evaluate efficacy, tolerability and cost effectiveness of zotepine over olanzapine in patients suffering from schizophrenia. Methods: A prospective, randomized, single blind, parallel, 6 weeks clinical study was conducted on a total of 112 patients, of schizophrenia attending psychiatry outpatient department at G. R. Medical College, Gwalior, India randomized into two groups (56 in each. Patients received either olanzapine (10-20mg or zotepine (75-150mg per day for a period of 6 week. Efficacy was measured by Positive and Negative Syndrome Scale (PANSS and Clinical Global Impression (CGI scale whereas tolerability was measured by dropout rate and frequency of adverse effects. Cost effectiveness was calculated in terms of cost incurred for improvement at the end of treatment period. Results: Both the drugs showed significant (P.0.05. Olanzapine showed significantly better (P0.05 between the two groups. Incidence of akathisia and drop out (16% and 23% with zotepine were significant (P<0.05 as compared to olanzapine (2% and 11% respectively. Conclusions: Though the efficacy of both the drugs is comparable, olanzapine appears to have better tolerability and cost effectiveness than zotepine in patients of schizophrenia. [Int J Basic Clin Pharmacol 2013; 2(5.000: 577-582

  13. Olanzapine as an antiemetic in refractory nausea and vomiting in advanced cancer.

    Science.gov (United States)

    Srivastava, Manish; Brito-Dellan, Norman; Davis, Mellar P; Leach, Marie; Lagman, Ruth

    2003-06-01

    Nausea and vomiting are difficult symptoms to manage in patients with advanced cancer. Several classes of antiemetics are available, including phenothiazines, butyrophenones, substituted benzamides and selective serotonin antagonists, as well as corticosteroids. Most patients will respond to either single agents or combinations that frequently include corticosteroids. A minority of patients will have nausea that fails to respond. The atypical antipsychotic, olanzapine, relieves nausea in some patients failing to respond to the usual antiemetics. Two case reports are presented and the rationale for olanzapine's benefit is discussed.

  14. [3-D ultrasound-assisted gait analysis of schizophrenic patients. Comparison between conventional neuroleptics and olanzapine].

    Science.gov (United States)

    Putzhammer, Albert; Heindl, Bernhard; Müller, Jürgen; Broll, Karin; Pfeiff, Liane; Perfahl, Maria; Hess, Linda; Koch, Horst

    2003-05-01

    Schizophrenic disorders as well as neuroleptic treatment can affect locomotion. The study assessed the influence of neuroleptic treatment on human gait via ultrasonic topometric gait analysis. In a control sample the test system proved high test-retest-reliability. Spatial and temporal gait parameters were assessed in schizophrenic patients without neuroleptic treatment (n = 12) and under treatment with conventional neuroleptics (n = 14) and re-assessed after treatment change to the atypical neuroleptic olanzapine in a repeated measures design. After switch from conventional neuroleptics to olanzapine patients showed an increase of gait velocity (p step length (p gait analysis.

  15. The metabolic effects of olanzapine and topiramate in rats and humans

    NARCIS (Netherlands)

    Evers, S.S.; van Dijk, G.; van Vliet, A.; Scheurink, A.J.W.

    2011-01-01

    In humans the anti-psychotic Olanzapine (OLZ) has negative side effects on metabolism: it causes weight gain and increases the risk of developing type 2 Diabetes. The anti-convulsant Topiramate (TPM) has the opposite effects: it reduces body weight and improves insulin sensitivity. Because of this,

  16. Open-label study of olanzapine in children with pervasive developmental disorder.

    NARCIS (Netherlands)

    Kemner, C.; Swinkels, S.H.N.; Jonge, M.J.A. de; Tuynman-Qua, H.G.; Engeland, H.M. van

    2002-01-01

    The effects of olanzapine on the symptomatology of children with pervasive developmental disorder with emphasis on problems of communication and the safety of the drug were investigated in a 3-month open-label, open-dosage study. Participating in the study were 25 children age 6 to 16 years with a d

  17. Microtitrimetric determination of a drug content of pharmaceuticals containing olanzapine in non-aqueous medium

    Directory of Open Access Journals (Sweden)

    KANAKAPURA BASAVAIAH

    2009-05-01

    Full Text Available Two simple, rapid, reliable and cost-effective methods based on titrimetry in non-aqueous medium are described for the determination of olanzapine in pharmaceuticals. In these methods, the drug dissolved in the glacial acetic acid was titrated with the acetous perchloric acid with visual and potentiometric end point detection, crystal violet being used as the indicator for visual titration. The methods are applicable over 1-15 mg range of olanzapine. The procedures were applied to determine olanzapine in pharmaceutical products and the results were found to be in a good agreement with those obtained by the reference method. Associated pharmaceutical materials did not interfere. The precision results, expressed by inter-day and intra-day relative standard deviation values, were satisfactory, higher than 2%. The accuracy was satisfactory as well. The methods proved to be suitable for the analysis of olanzapine in bulk drug and in tablets. The accuracy and reliability of the methods were further ascertained by recovery studies via a standard addition technique with percent recoveries in the range 97.51-103.7% with a standard deviation of less than 2%.

  18. The stress stability of olanzapine: studies of interactions with excipients in solid state pharmaceutical formulations.

    Science.gov (United States)

    Djordjević Filijović, Nataša; Antonijević, Milan D; Pavlović, Aleksandar; Vučković, Ivan; Nikolić, Katarina; Agbaba, Danica

    2015-03-01

    Stress stability testing represents an important part of the drug development process. It is used as an important tool for the identification of degradation products and degradation pathways, as well as for the assessment of changes in physical form of drug molecules. The impact of excipients on the stability of olanzapine confirms that levels of impurities and degradants are limiting parameters and are therefore used for stability evaluation. The major degradation product of olanzapine was identified as 2-methyl-5,10-dihydro-4H-thieno[2,3-b][1,5]benzodiazepine-4-one (III). The structure of III was determined by using LC-MS, IR and NMR. Compatibility and stress stability results demonstrated that tablet formulations of olanzapine are sensitive to temperature and moisture. In samples protected from moisture, the increase in concentration of III was shown to be highly temperature dependent and the degradation followed zero-order kinetics. In addition, studies of olanzapine with excipients and in formulated tablets revealed polymorphic phase changes in some samples, influenced by a combination of stress temperature and humidity conditions. Polymorphic transitions were monitored using x-ray powder diffraction (XRPD) analysis and exhibited no correlation between the phase change (appearance of a new polymorph) and the degradation process.

  19. Risperidone versus olanzapine in the acute treatment of Persistent Delusional Disorder: A retrospective analysis.

    Science.gov (United States)

    Kulkarni, Karishma; Arasappa, Rashmi; Prasad M, Krishna; Zutshi, Amit; Chand, Prabhat K; Murthy, Pratima; Philip, Mariamma; Muralidharan, Kesavan

    2017-07-01

    There is a dearth of prospective trials studying treatment response in Persistent Delusional Disorder (PDD) to guide clinical practice. Available retrospective data indicate good response to second-generation antipsychotics (SGAs). We selected the data of patients prescribed either olanzapine or risperidone from a retrospective chart review of PDD (n=455) at our centre. We compared the two groups olanzapine (n =86) versus risperidone (n =280) on dose, drug adherence, response and adverse effects. The two groups were comparable on socio-demographic and clinical characteristics of PDD. There was no statistically significant difference between the two groups on adherence (>80%) and response to treatment (>52% good response). Olanzapine was effective at lower mean chlorpromazine equivalents than risperidone. Logistic regression analysis identified shorter mean duration of illness, good adherence and absence of substance dependence as predictors of good response to both drugs. Our study indicates that acute PDD responds well to treatment with both risperidone and olanzapine, provided adherence can be ensured. In the absence of specific treatment guidelines and randomized controlled trials for PDD, our analysis reaffirms the efficacy of SGAs. Copyright © 2017. Published by Elsevier B.V.

  20. Olanzapine-induced Fos expression in the rat forebrain; cross-tolerance with haloperidol and clozapine

    NARCIS (Netherlands)

    Sebens, JB; Koch, T; Ter Horst, GJ; Korf, J

    1998-01-01

    Acute administration of the atypical antipsychotic drug olanzapine (5 mg kg(-1) i.p.) increased the number of Fos-positive cells moderately in the prefrontal cortex and the striatum; more pronounced were the effects in the nucleus accumbens, the lateral septum, the hypothalamic paraventricular nucle

  1. Olanzapine-Induced Mania in Bipolar Spectrum Disorder:A Case Report

    Directory of Open Access Journals (Sweden)

    Mehrdad Eftekhar

    2006-07-01

    Full Text Available Objective: To report the case of a 46-year old male with major depressive disorder, who represented manic symptoms, when olanzapine was added to his treatment. Method: A 46-year old female, with a diagnosis of treatment resistant depression was referred to the authors. He had past history of depression for more than 20 years. The symptoms were present nearly every day since 1981, without any distinct period of remission, nor any noticeable fluctuation. His irritability had been disruptive to his family all these years. His doctor had prescribed maprotiline 25 mg/day, and lorazepam, 2mg/day, in addition to fluoxetine for the last 5 months. He is also a father of two children with methylphenidateresistant and sodium valproate-responsive attention-deficit hyperactivity disorder. Considering the antidepressant effects of olanzapine and its positive effects on irritability, the authors added olanzapine, to the patient’s previous medications. Results: After one week, he showed new problems such as talkativeness and beginning to smoke for the first time in his life, elevated mood, grandiosity about his intelligence and abilities, talkativeness, and shopping sprees. The score on the mania rating scale was 14. Fluoxetine was discontinued and sodium valproate, were prescribed. It took around 2 months to completely control the manic symptoms. Conclusions: In the patients with depression who show bipolar spectrum disorder features, adding mood stabilizers may be preferred to the drugs as olanzapine which could induce mania.

  2. Olanzapine-induced cerebral metabolic changes related to symptom improvement in schizophrenia.

    Science.gov (United States)

    Molina, Vicente; Gispert, Juan D; Reig, Santiago; Pascau, Javier; Martínez, Raúl; Sanz, Javier; Palomo, Tomás; Desco, Manuel

    2005-01-01

    The pattern of brain metabolic changes produced by olanzapine has yet to be described, despite the theoretical and clinical interest of this new antipsychotic. We studied a group of 17 schizophrenic patients who underwent two fluoro-deoxyglucose-positron emission tomography (FDG-PET) studies under two different conditions: a baseline scan during treatment with either conventional antipsychotics (n=15) or risperidone (n=2) and a second scan performed 17-24 weeks after switching to olanzapine. PET scans were obtained while performing a standard cognitive paradigm (Continuous Performance Test) and analysed by means of Statistical Parametric Mapping. No significant metabolic changes were found in the comparison between pre- and post-olanzapine conditions. A brain map of the statistical power of our design showed that changes up to 3% in the frontal and up to 8% in the occipital region were not likely to exist (1-beta=0.8). The degree of improvement in positive symptoms was related to the amount of activity decrease in the right orbital region and to the amount of activity increase in the primary visual area. Improvement in negative symptoms was associated with an activity increase in the dorsal prefrontal cortex, and a higher baseline activity in both temporal poles. These correlation patterns suggest that the functional mechanism of action of olanzapine may share traits from both typical and atypical neuroleptics.

  3. Olanzapine-induced weight gain: lessons learned from developing rat models

    NARCIS (Netherlands)

    van der Zwaal, E.M.

    2011-01-01

    Olanzapine is an effective and commonly prescribed antipsychotic drug, used for the treatment of schizophrenia and bipolar disorder. Unfortunately significant weight gain is a common side effect. In order to effectively address this side effect, it is crucial to gain insight into the underlying mech

  4. Olanzapine orally-disintegrating tablet in severe psychotic agitation: a naturalistic study.

    Science.gov (United States)

    Pascual, J C; Pérez, V; Martín, J L R; Safont, G; Puigdemont, D; Alvarez, E

    2007-01-01

    This study was conducted to determine effectiveness and safety of olanzapine in patients with severe agitation. A naturalistic, open-label study in 80 acutely agitated psychotic patients visited in our psychiatric emergency department. Patients received either a 20-mg olanzapine orally-disintegrating tablet or conventional treatment depending on attending psychiatrist's preference. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC), the Agitation-Calmness Evaluation Scale (ACES) and pragmatic variables (second pharmacological intervention and need for physical restraints). 60 % patients completed a 6 hour trial. Both groups showed a significant reduction in mean PANSS-EC score. The olanzapine-treated group showed statistically significant improvements: PANSS-EC (F=122.9; df=2.4; p=0.000), ACES (F=68.2; df=2.8; p=0.000). Treatment was well-tolerated and no serious side-effects were observed. In this naturalistic study in patients with severe agitation, 20-mg oral olanzapine was effective, rapid and safe.

  5. Influence of olanzapine on QT variability and complexity measures of heart rate in patients with schizophrenia.

    Science.gov (United States)

    Bär, Karl-Jürgen; Koschke, Mandy; Berger, Sandy; Schulz, Steffen; Tancer, Manuel; Voss, Andreas; Yeragani, Vikram K

    2008-12-01

    Previous studies have shown that untreated patients with acute schizophrenia present with reduced heart rate variability and complexity as well as increased QT variability. This autonomic dysregulation might contribute to increased cardiac morbidity and mortality in these patients. However, the additional effects of newer antipsychotics on autonomic dysfunction have not been investigated, applying these new cardiac parameters to gain information about the regulation at sinus node level as well as the susceptibility to arrhythmias. We have investigated 15 patients with acute schizophrenia before and after established olanzapine treatment and compared them with matched controls. New nonlinear parameters (approximate entropy, compression entropy, fractal dimension) of heart rate variability and also the QT-variability index were calculated. In accordance with previous results, we have observed reduced complexity of heart rate regulation in untreated patients. Furthermore, the QT-variability index was significantly increased in unmedicated patients, indicating increased repolarization lability. Reduction of the heart rate regulation complexity after olanzapine treatment was seen, as measured by compression entropy of heart rate. No change in QT variability was observed after treatment. This study shows that unmedicated patients with acute schizophrenia experience autonomic dysfunction. Olanzapine treatment seems to have very little additional impact in regard to the QT variability. However, the decrease in heart rate complexity after olanzapine treatment suggests decreased cardiac vagal function, which may increase the risk for cardiac mortality. Further studies are warranted to gain more insight into cardiac regulation in schizophrenia and the effect of novel antipsychotics.

  6. Olanzapine-high potency antipsychotic drug inducing significant weight gain: A case report

    Directory of Open Access Journals (Sweden)

    Marić Nađa P.

    2008-01-01

    Full Text Available INTRODUCTION Olanzapine is a second generation antipsychotic (SGA with a high level of therapeutic effectiveness in schizophrenia and other psychotic disorders. Along with the positive therapeutic effects, an increase of the body weight frequently occurs. According to the literature, the average weight gain is about 6-7 kg during several months of treatment. This could be valued as a moderate weight increase. CASE OUTLINE This article presents a case of a young female with schizophrenia, without clinical improvement with several antipsychotics (clozapine, risperidone, haloperidol and with the occurrence of significant neurological side effects. The treatment started with olanzapine (baseline was associated with good initial response (PANSS reduction 20% in the first two weeks and the improvement was maintained further on (PANSS reduction 50% after 16 weeks. Significant increase (20 kg, 40% in weight appeared during the following 16 weeks (BMI at baseline 17.9 kg/m2; BMI 16 weeks later 25.1 kg/m2. CONCLUSION High effectiveness of olanzapine in schizophrenia symptoms reduction was accompanied by a significant weight gain. However, this drug leads to impaired glucoregulation, dyslipidaemia etc. It also increases the risk of diabetes and cardio-vascular diseases, i.e. the main causes of mortality in schizophrenia after a suicide. Therefore, clinicians are suggested to focus on possible predictors of weight gain during olanzapine therapy, and act accordingly in order to prevent serious health consequences.

  7. Role of Polymeric Excipients in the Stabilization of Olanzapine when Exposed to Aqueous Environments

    Directory of Open Access Journals (Sweden)

    Maria Paisana

    2015-12-01

    Full Text Available Hydrate formation is a phase transition which can occur during manufacturing processes involving water. This work considers the prevention of hydration of anhydrous olanzapine and hydrate conversions in the presence of water and polymers (polyethyleneglycol; hydroxypropylcellulose; polyvinylpyrrolidone in forming pellets by wet extrusion and spheronisation. Anhydrous olanzapine was added to water with or without those polymers prior to extrusion with microcrystalline cellulose. Assessment of olanzapine conversion was made by XRP-Diffraction; FTIR spectroscopy; calorimetry (DSC and microscopy (SEM for crystal size and shape. The addition of water converted the anhydrous form into dihydrate B and higher hydrate; whereas polyethyleneglycol promoted a selective hydrate conversion into the higher hydrate olanzapine form. Both polyvinylpyrrolidone and hydroxypropylcellulose prevented the hydrate transformations of the anhydrous drug; the latter even in the presence of hydrate seeds. This may be explained by the higher H-bond ability; higher network association and higher hydrophobicity of hydroxypropylcellulose by comparison with polyethyleneglycol and polyvinylpyrrolidone; which could contribute to its higher affinity to the crystal surfaces of the hydrate nuclei/initial crystals and promoting steric hindrance to the incorporation of other drug molecules into the crystal lattice; thus, preventing the crystal growth. The addition of microcrystalline cellulose needed for the pellets production (final product did not eliminate the protector effect of both hydroxypropylcellulose and polyvinylpyrrolidone during pellets’ processing and dissolution evaluation.

  8. Open-label study of olanzapine in children with pervasive developmental disorder.

    NARCIS (Netherlands)

    Kemner, C.; Swinkels, S.H.N.; Jonge, M.J.A. de; Tuynman-Qua, H.G.; Engeland, H.M. van

    2002-01-01

    The effects of olanzapine on the symptomatology of children with pervasive developmental disorder with emphasis on problems of communication and the safety of the drug were investigated in a 3-month open-label, open-dosage study. Participating in the study were 25 children age 6 to 16 years with a

  9. Olanzapine-induced weight gain: lessons learned from developing rat models

    NARCIS (Netherlands)

    van der Zwaal, E.M.

    2011-01-01

    Olanzapine is an effective and commonly prescribed antipsychotic drug, used for the treatment of schizophrenia and bipolar disorder. Unfortunately significant weight gain is a common side effect. In order to effectively address this side effect, it is crucial to gain insight into the underlying

  10. The role of hypothalamic pathways in the metabolic side effects of Olanzapine

    NARCIS (Netherlands)

    Girault, E.M.

    2013-01-01

    Atypical antipsychotic drugs such as Olanzapine (Ola) induce weight gain and metabolic changes associated with the development of type 2 diabetes. The mechanisms underlying these undesired side effects are currently unknown. In this thesis, we showed that both acute and chronic administration of Ola

  11. Cost effectiveness of olanzapine in prevention of affective episodes in bipolar disorder in the United Kingdom.

    Science.gov (United States)

    McKendrick, J; Cerri, K H; Lloyd, A; D'Ausilio, A; Dando, S; Chinn, C

    2007-08-01

    This study evaluated the cost effectiveness of olanzapine compared with lithium as maintenance therapy for patients with bipolar I disorder (BP1) in the UK. A Markov model was developed to assess costs and outcomes from the perspective of the UK National Health Service over a 1-year period. Patients enter the model after stabilization of a manic episode and are then treated with olanzapine or lithium. Using the findings of a recent randomized clinical trial, the model considers the monthly risk of manic or depressive episodes and of dropping out from allocated therapy. health care resources associated with acute episodes were derived primarily from a recent UK chart review. Costs of maintenance therapy and monitoring were also considered. Key factors influencing cost effectiveness were identified and included in a stochastic sensitivity analysis. The model estimated that, compared to lithium, olanzapine significantly reduced the annual number of acute mood episodes per patient from 0.81 to 0.58 (difference -0.23; 95% CI: -0.34, -0.12). Per patient average annual care costs fell by 799 UK pounds (95% CI: - 1,824 UK pounds, 59 UK pounds) driven by reduced inpatient days--but the cost difference was not statistically significant. Sensitivity analysis found the results to be robust to plausible variation in the model's parameters. The model estimated that using olanzapine instead of lithium as maintenance therapy for BP1 would significantly reduce the rate of acute mood events resulting in reduced hospital costs. Based on available evidence, there is a high likelihood that olanzapine would reduce costs of care compared to lithium.

  12. Midazolam-Droperidol, Droperidol, or Olanzapine for Acute Agitation: A Randomized Clinical Trial.

    Science.gov (United States)

    Taylor, David McD; Yap, Celene Y L; Knott, Jonathan C; Taylor, Simone E; Phillips, Georgina A; Karro, Jonathan; Chan, Esther W; Kong, David C M; Castle, David J

    2017-03-01

    We aim to determine the most efficacious of 3 common medication regimens for the sedation of acutely agitated emergency department (ED) patients. We undertook a randomized, controlled, double-blind, triple-dummy, clinical trial in 2 metropolitan EDs between October 2014 and August 2015. Patients aged 18 to 65 years and requiring intravenous medication sedation for acute agitation were enrolled and randomized to an intravenous bolus of midazolam 5 mg-droperidol 5 mg, droperidol 10 mg, or olanzapine 10 mg. Two additional doses were administered, if required: midazolam 5 mg, droperidol 5 mg, or olanzapine 5 mg. The primary outcome was the proportion of patients adequately sedated at 10 minutes. Three hundred forty-nine patients were randomized to the 3 groups. Baseline characteristics were similar across the groups. Ten minutes after the first dose, significantly more patients in the midazolam-droperidol group were adequately sedated compared with the droperidol and olanzapine groups: differences in proportions 25.0% (95% confidence interval [CI] 12.0% to 38.1%) and 25.4% (95% CI 12.7% to 38.3%), respectively. For times to sedation, the differences in medians between the midazolam-droperidol group and the droperidol and olanzapine groups were 6 (95% CI 3 to 8) and 6 (95% CI 3 to 7) minutes, respectively. Patients in the midazolam-droperidol group required fewer additional doses or alternative drugs to achieve adequate sedation. The 3 groups' adverse event rates and lengths of stay did not differ. Midazolam-droperidol combination therapy is superior, in the doses studied, to either droperidol or olanzapine monotherapy for intravenous sedation of the acutely agitated ED patient. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  13. Ziprasidone versus olanzapine, risperidone or quetiapine in patients with chronic schizophrenia: a 12-week open-label, multicentre clinical trial

    DEFF Research Database (Denmark)

    Lublin, Henrik; Haug, Hans-Joachim; Koponen, Hannu

    2009-01-01

    The efficacy, safety and tolerability of ziprasidone versus the comparators olanzapine, risperidone or quetiapine were investigated in adult patients with chronic schizophrenia, schizoaffective and schizophreniform disorders, with lack of efficacy or intolerance to their previous antipsychotic tr...

  14. Neuroanatomical substrates of the disruptive effect of olanzapine on rat maternal behavior as revealed by c-Fos immunoreactivity

    OpenAIRE

    Zhao, Changjiu; Li, Ming

    2012-01-01

    Olanzapine is one of the most widely prescribed atypical antipsychotic drugs in the treatment of schizophrenia. Besides its well-known side effect on weight gain, it may also impair human parental behavior. In this study, we took a preclinical approach to examine the behavioral effects of olanzapine on rat maternal behavior and investigated the associated neural basis using the c-Fos immunohistochemistry. On postpartum Days 6–8, Sprague-Dawley mother rats were given a single injection of ster...

  15. Enhancing the aqueous solubility and dissolution of olanzapine using freeze-drying

    Directory of Open Access Journals (Sweden)

    Mudit Dixit

    2011-12-01

    Full Text Available The aim of the present study was to develop an olanzapine freeze-dried tablet (FDT. The solubility and dissolution rate of poorly water-soluble olanzapine was improved by preparing a freeze-dried tablet of olanzapine using the freeze-drying technique . The FDT was prepared by dispersing the drug in an aqueous solution of highly water-soluble carrier materials consisting of gelatin, glycine, and sorbitol. The mixture was poured in to the pockets of blister packs and then was subjected to freezing and lyophilisation. The FDT was characterised by DSC, XRD and SEM and was evaluated for saturation solubility and dissolution. The samples were stored in a stability chamber to investigate their physical stability. Results obtained by DSC and X-ray were analysed and showed the crystalline state of olanzapine in FDT transformation to the amorphous state during the formation of FDT. Scanning electron microscope (SEM results suggest reduction in olanzapine particle size. The solubility of olanzapine from the FDT was observed to be nearly four and a half times greater than the pure drug. Results obtained from dissolution studies showed that olanzapine FDT significantly improved the dissolution rate of the drug compared with the physical mixture (PM and the pure drug. More than 90% of olanzapine in FDT dissolved within 5 minutes, compared to only 19.78% of olanzapine pure drug dissolved over the course of 60 minutes. In a stability test, the release profile of the FDT was unchanged, as compared to the freshly prepared FDT after 90 days of storing.O objetivo do presente estudo foi desenvolver comprimidos liofilizados de olanzapina (FDT. A solubilidade e a taxa de dissolução da olanzapina, fracamente solúvel em água, foram melhoradas com a preparação de comprimidos liofilizados de olanzapina usando a técnica de liofilização. O FDT foi preparado por dispersão do fármaco em solução aquosa de materiais altamente solúveis em água, como gelatina

  16. Olanzapine Prevents the PCP-induced Reduction in the Neurite Outgrowth of Prefrontal Cortical Neurons via NRG1.

    Science.gov (United States)

    Zhang, Qingsheng; Yu, Yinghua; Huang, Xu-Feng

    2016-01-19

    Accumulating evidence suggests that reducing neurite outgrowth and synaptic plasticity plays a critical role in the pathology of cognitive deficits in schizophrenia. The N-methyl-D-aspartate receptor antagonist phencyclidine (PCP) can induce symptoms of schizophrenia as well as reduce dendritic spine density and neurite growth. The antipsychotic drug olanzapine may improve these deficits. This study aimed to investigate: (1) if olanzapine prevents PCP-induced suppression of neurite outgrowth and synaptic protein expression; (2) if olanzapine affects the Akt-GSK3 signaling pathway; and (3) the role of neuregulin 1 (NRG1) in this process. Immunofluorescence revealed that PCP treatment for 24 hours reduces both neurite length (28.5%) and the number of neurite branches (35.6%) in primary prefrontal cortical neuron cultures. PCP reduced protein and mRNA expressions of synaptophysin (24.9% and 23.2%, respectively) and PSD95 (31.5% and 21.4%, respectively), and the protein expression of p-Akt (26.7%) and p-GSK3β (35.2%). Olanzapine co-treatment prevented these PCP-induced effects in normal neurons but not in neurons from NRG1-knockout mice. These results indicate that NRG1 mediates the preventive effects of olanzapine on the PCP-induced impairment of neurite outgrowth and synaptic protein expression. This study provides potential targets for interventions on improving the efficacy of olanzapine on preventing cognitive deficits in schizophrenia.

  17. Sulpiride augmentation of olanzapine in the management of treatment-resistant chronic schizophrenia: evidence for improvement of mood symptomatology.

    Science.gov (United States)

    Kotler, Moshe; Strous, Rael D; Reznik, Ilya; Shwartz, Sima; Weizman, Abraham; Spivak, Baruch

    2004-01-01

    Several recent studies, albeit limited in sample number, design and generalizability, have suggested that augmentation of atypical antipsychotic medication (such as clozapine and olanzapine) with sulpiride, a substituted benzamide antipsychotic medication, may play a role in the management of treatment-resistant psychotic conditions. The objective of this study was to investigate any change in clinical symptomatology or side-effect profile in treatment-resistant schizophrenia patients receiving sulpiride in addition to olanzapine. Seventeen patients with treatment-resistant chronic schizophrenia, who were receiving olanzapine monotherapy for at least 6 months before study commencement, were randomized in a 1:1 fashion to receive either adjunctive treatment with sulpiride (study group) or to continue their pre-study treatment with olanzapine with no medication augmentation (control group), each for a period of 8 weeks. Changes in measures of positive and negative symptoms, anxiety, depression and extrapyramidal symptoms were assessed at baseline and at 8 weeks. Study observations indicated no significant differences in the changes in positive or negative symptomatology between patients receiving a combined regimen of olanzapine with sulpiride (600 mg/ day) augmentation and controls. However, a significantly greater improvement of depressive symptomatology (P Depression) was noted in the sulpiride augmentation group. These data indicate improvement in depressive symptomatology with sulpiride augmentation of olanzapine in treatment-resistant chronic schizophrenia patients.

  18. Efficacy of amisulpride and olanzapine for negative symptoms and cognitive impairments: An open-label clinical study

    Directory of Open Access Journals (Sweden)

    Subodh Kumar

    2014-01-01

    Full Text Available Background: Negative symptoms and diminished cognitive ability are also considered as core features of schizophrenia. There are many studies in which negative symptoms and cognitive impairments are individually treated with atypical antipsychotic in comparison with either a placebo or a typical antipsychotic. There is paucity of studies comparing the efficacy of olanzapine and amisulpride on improvement of negative symptoms and cognitive impairments. Aim: To examine the effectiveness of amisulpride and olanzapine in treatment of negative symptoms and cognitive impairments in schizophrenia. Materials and Methods: Total 40 adult inpatients diagnosed as schizophrenia fulfilling inclusion/exclusion criteria were included in the study with their informed consent. These patients were recruited consecutively to one of the two drug regimen group, i.e. tab Amisulpride (100-300 mg/day and tab Olanzapine (10-20 mg. Patients were evaluated on day 0 and day 60 with various rating scales like Scale for the Assessment of Negative Symptoms (SANS, Scale for the Assessment of Positive Symptoms (SAPS, Schizophrenia Cognition Rating Scale (SCoRS, Brief Psychiatric Rating Scale (BPRS, Calgary Depression Scale for Schizophrenia (CDSS, and three different scales to measure drug side effects. Results: The mean SANS score in amisulpride and olanzapine group at day 0 and day 60 were 83.89 (±12.67 and 21.00 (±11.82 and 84.40 (±13.22 and 26.75 (±12.41, respectively. The mean rank of SCoRS global in amisulpride and olanzapine group at day 0 and day 60 were 4.78 (±1.13 and 2.78 (±0.63 and 4.85 (±1.18 and 3.30 (±1.12, respectively. The percentage improvement in SANS, SAPS, SCoRS interviewer, and SCoRS global in amisulpride group are 74.96%, 13.36%, 54.14%, and 42.00%, respectively. Similarly in olanzapine group percentage improvement in SANS, SAPS, SCoRS interviewer, and SCoRS global are 68.30%, 30.28%, 35.22%, and 31.95%, respectively. There is significant

  19. Pregnancy exposure to olanzapine, quetiapine, risperidone, aripiprazole and risk of congenital malformations. A systematic review

    DEFF Research Database (Denmark)

    Ennis, Zandra Nymand; Damkier, Per

    2015-01-01

    To review available data on first-trimester exposure to olanzapine, quetiapine, risperidone and aripiprazole and risk of congenital malformations. We performed a systematic literature search in accordance with PRISMA guidelines identifying studies containing original data on first......-trimester exposure and pregnancy outcome with respect to congenital malformations. Cumulated data for olanzapine were 1090 first-trimester-exposed pregnancies with 38 malformations resulting in a malformation rate of 3.5%. The corresponding numbers for quetiapine, risperidone and aripiprazole were 443/16 (3.6%), 432...... of congenital malformation. Data for quetiapine and risperidone do not suggest a substantially increased risk, while the risk estimate for aripiprazole remains imprecise owing to a low amount of data....

  20. A patient with schizophrenia presenting with post-lobotomy catatonia treated with olanzapine: a case report.

    Science.gov (United States)

    Kumagai, Ryo; Kitazawa, Maiko; Ishibiki, Yoshiro; Narumi, Kenji; Ichimiya, Yosuke

    2017-05-01

    A 79-year-old Japanese woman with schizophrenia was hospitalized because of idiopathic duodenal stenosis. Three days after discontinuing ingestion, including the administration of psychotropic drugs, the patient demonstrated incoherent behaviour and strong general muscle tension, and was unable to engage in conversation. Computed tomography indicated bilateral regions of low density in the frontal lobes, subsequent to which she was diagnosed with post-lobotomy catatonia. Administration of olanzapine (10 mg/day) improved the patient's condition within a short period. Previous studies have demonstrated an association between the dysfunction of frontal circuits and catatonia; therefore, the observed catatonic episode might relate to the disconnection of nerve fibres in the prefrontal lobes induced by her lobotomy. Olanzapine was likely effective in treating catatonia because of its reported efficacy in improving frontal lobe function. © 2016 The Authors. Psychogeriatrics © 2016 Japanese Psychogeriatric Society.

  1. Fever development in neuroleptic malignant syndrome during treatment with olanzapine and clozapine.

    Science.gov (United States)

    Szota, Anna; Ogłodek, Ewa; Araszkiewicz, Aleksander

    2013-01-01

    Neuroleptic malignant syndrome (NMS) is the most dangerous life-threatening complication of antipsychotic medication. It's development is connected with the blockade of dopaminergic transmission (D2 receptors) in the nigrostriatal system of the brain. Fever is one of the main symptoms of this syndrome and it's elevation is due to the activation of the immune system. Numerous studies report that treatment with clozapine (doses 37.5-600 mg) or olanzapine (doses 10-25 mg) or the use of these drugs in polytherapy cause pyrexia between 37.8-40.6 °C. Additionally, levels of proinflammatory interleukins such as IL-6, IL-1,TNF-α were increased. The aim of this article is to describe how olanzapine and clozapine influence fever development in NMS, in relation to the dose of the drug taken by schizophrenic patients including changes in immunological system.

  2. Acute-Onset Type 1 Diabetes that Developed During the Administration of Olanzapine

    Science.gov (United States)

    Iwaku, Kenji; Otuka, Fumiko; Taniyama, Matsuo

    2017-01-01

    The patient was 32-year-old man, who received olanzapine for schizophrenia and developed polyuria and thirst without drinking soft-drinks after 4 months. Five months after the initiation of treatment, he developed diabetic ketoacidosis (blood glucose: 490 mg/dL, HbA1c: 15.5%). He was diagnosed with type 1 diabetes (glutamic acid decarboxylase (GAD)-Ab: 5.6 U/mL, IA-2 Ab: 5.9 U/mL, fasting C-peptide: 0.12 ng/mL) and was put on intensive insulin therapy. At four months after the onset of 1A diabetes, he experienced a honeymoon phase that was sustained until the 40th month of treatment. We hypothesize that the administration of olanzapine to a patient with pre-type 1A diabetes induced marked hyperglycemia and accelerated the onset of type 1A diabetes. PMID:28154279

  3. Physiogenomic comparison of weight profiles of olanzapine- and risperidone-treated patients.

    Science.gov (United States)

    Ruaño, G; Goethe, J W; Caley, C; Woolley, S; Holford, T R; Kocherla, M; Windemuth, A; de Leon, J

    2007-05-01

    Atypical antipsychotics induce pre-diabetic symptoms in some but not all patients, characterized most notably by elevated weight. The side effect profiles of the various drugs in the class differ, however, raising the possibility of drug-specific mechanisms for similar side effects. We used physiogenomic analysis, an approach previously employed to study the genetics of drug and diet response, to discover and compare genetic associations with weight profiles observed in patients treated with olanzapine and risperidone as an approach to unraveling contrasting mechanistic features of both drugs. A total of 29 single nucleotide polymorphisms (SNPs) were selected from 13 candidate genes relevant to two potential pharmacological axes of psychotropic-related weight profiles, appetite peptides and peripheral lipid homeostasis. We applied physiogenomic analysis to a cross-section of 67 and 101 patients being treated with olanzapine and risperidone, respectively, and assessed genetic associations with the weight profiles. Weight profiles in patients treated with olanzapine were significantly associated with SNPs in the genes for apolipoprotein E, apolipoprotein A4 and scavenger receptor class B, member 1. Weight profiles in patients treated with risperidone were significantly associated with SNPs in the genes for leptin receptor, neuropeptide Y receptor Y5 and paraoxonase 1. These results are consistent with contrasting mechanisms for the weight profile of patients treated with these drugs. Genes associated with olanzapine weight profiles may be related to peripheral lipid homeostatic axes, whereas those associated with risperidone's may be related to brain appetite peptide regulation. Future physiogenomic studies will include neurotransmitter receptor SNPs and validation in independent samples.

  4. Schizophrenia relapse after stopping olanzapine treatment during pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Ifteni P

    2014-10-01

    Full Text Available Petru Ifteni,1,2 Marius A Moga,1 Victoria Burtea,1,2 Christoph U Correll3,4 1Faculty of Medicine, Transilvania University, Brasov, Romania; 2Psychiatry and Neurology Hospital, Brasov, Romania; 3Department of Psychiatry, The Zucker Hillside Hospital, North Shore-Long Island Jewish (LIJ Health System, New York, NY, USA; 4Hofstra North Shore-LIJ School of Medicine, New York, NY, USA Abstract: Women with schizophrenia have a high risk for symptom exacerbation or relapse during pregnancy and thereafter. Relapses are more frequent when antipsychotics are discontinued. This paper describes the case of a 28-year old woman with schizophrenia who continued treatment with olanzapine during the first trimester. Olanzapine, a second-generation antipsychotic, was administered at a therapeutic dose from week 1 of gestation until week 13 when she reported the pregnancy to her psychiatrist. Despite the psychiatrist’s recommendation to continue treatment, the patient stopped olanzapine at 20 weeks. She was hospitalized at week 36 for a schizophrenia relapse and was transferred to the obstetrics department where she gave birth by Cesarean section to a normal child. This case is important, illustrating the perils of unplanned pregnancy during antipsychotic treatment and abrupt discontinuation. Ultimately, clinical decisions should be made on a case-by-case basis, weighing the risks to the mother in terms of symptom exacerbation and relapse if antipsychotic treatment is discontinued, and the potential risk to the fetus regarding possible teratogenic effects of continued antipsychotic treatment. Keywords: relapse, pregnancy, schizophrenia, olanzapine

  5. Report of a Rare Case of Olanzapine and Risperidone Induced Hypomania

    Directory of Open Access Journals (Sweden)

    AR Zahiroddin

    2006-07-01

    Full Text Available Introduction & Objective: Hypomania is a mood disorder with symptoms of constantly high expansive or irritable mood. After a 4-day period, the patient feels to be in need of less sleep, being talkative, or feeling pressure if not treated kindly, having flight of ideas, distractibility, and increase in goal oriented activities (including social, occupational, educational or sexual activities and being extravagant. Hypomania could be a mood episode of bipolar I and II mood disorder or cyclothymia and could be resulted from consumption of drugs, materials, Electro Convulsive Therapy (ECT or photo therapy. Case: The present report is the case of a 57-year old married woman, who has had a record of bipolar I mood disorder since 30 years ago. The patient was hospitalized once in psychiatry hospital and referred to psychiatry office 2 years ago. She has been under medication therapy by lithium 600 mg, nortriptyline 75 mg, and colonazpam 1 mg. She has taken risperidone 2 mg, the symptoms of hypomania have revealed. After stopping the consumption of risperidone, the treatment continued by lithium tablet 900 mg, eskazina tablet 4 mg, nortriptyline 75 mg for one day. She was under care for 15 months and then due to muscle complications of lithium, pessimism, auditory and visual hallucination, she was recommended to take olanzapine tablet 5 mg once every night. Two days after taking olanzapine the symptoms of hypomania revealed. Consumption of olanzapine was then stopped and the symptoms disappeared and she was brought under control after taking sodiumvalproate tablet. Conclusion: Rarely could Hypomania be a mood episode induced by consuming atypical antipsychotics such as risperidone and olanzapine.

  6. Direct association between orbitofrontal atrophy and the response of psychotic symptoms to olanzapine in schizophrenia.

    Science.gov (United States)

    Molina, Vicente; Sanz, Javier; Benito, Carlos; Palomo, Tomás

    2004-07-01

    The study of cerebral variables associated with response to neuroleptics holds interest from both theoretical and clinical points of view. To date, no studies have aimed to identify predictors of response to olanzapine based on cerebral measurements. Here, we used magnetic resonance to assess the relationship between volumes of the prefrontal (dorsolateral and orbitofrontal) and temporal (temporal lobe and hippocampus) cortical regions and ventricles and, on the other hand, the response to olanzapine in 16 schizophrenic patients. Data from 42 healthy controls were used to calculate volume residuals in the patients, defined as deviations from the expected values, given individual age and intracranial volume. Residuals thus represent the effect of illness on regional measurements. The association between clinical change and those residuals was calculated separately for the positive, negative and total scores from the Positive and Negative Syndrome Scale (PANSS). There was a significant direct association between the degree of orbitofrontal atrophy and the improvement of positive symptoms with olanzapine. No predictors were found for change in the negative dimension. A trend was found for patients with larger ventricles to show a greater global decrease in total PANSS scores. Neither age nor duration of illness explained a significant proportion of the symptom improvement. This result, together with others from the literature, supports the idea that atypical antipsychotics may offer some benefit to patients with significant regional atrophy, and this may have implications for the choice of antipsychotic in clinical practice.

  7. Spectroscopic and molecular docking studies on the interaction of the drug olanzapine with calf thymus DNA

    Science.gov (United States)

    Shahabadi, Nahid; Bagheri, Somayeh

    2015-02-01

    The present study investigated the binding interaction between olanzapine and calf thymus DNA (ct-DNA) using emission, absorption, circular dichroism, viscosity measurements and molecular modeling. Thermodynamic parameters (ΔH < 0 and ΔS < 0) indicated that hydrogen bond and van der Waals play main roles in the binding of the drug to ct-DNA. Spectrophotometric studies of the interaction of olanzapine with DNA have shown that it could bind to ct-DNA (Kb = 2 × 103 M-1). The binding constant is comparable to standard groove binding drugs. Competitive fluorimetric studies with Hoechst 33258 have shown that olanzapine exhibits the ability to displace the DNA-bound Hoechst 33258 indicating that binds strongly in minor groove of DNA helix. Furthermore, the drug induces detectable changes in the CD spectrum of ct-DNA as well as changes in its viscosity. All of the experimental results prove that the groove binding must be predominant. The results obtained from experimental data were in good agreement with molecular modeling studies.

  8. Olanzapine-Induced Diabetic Ketoacidosis and Neuroleptic Malignant Syndrome with Rhabdomyolysis: A Case Report

    Directory of Open Access Journals (Sweden)

    Young Kyoung Sa

    2013-03-01

    Full Text Available Atypical antipsychotics have replaced conventional antipsychotics in the treatment of schizophrenia because they have less of a propensity to cause undesirable neurologic adverse events including extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome (NMS. However, atypical antipsychotics have been known to result in various metabolic complications such as impaired glucose tolerance, diabetes and even diabetic ketoacidosis (DKA. In addition, a number of NMS cases have been reported in patients treated with atypical antipsychotics, although the absolute incidence of neurologic side effects is currently significantly low. Here, we report a patient who simultaneously developed DKA, acute renal failure and NMS with rhabdomyolysis after olanzapine treatment. Olanzapine-induced metabolic complications and NMS were dramatically improved with cessation of the olanzapine treatment and initiation of supportive management including fluid therapy, hemodialysis, and intensive glycemic control using insulin. At short-term follow-up, insulin secretion was markedly recovered as evidenced by a restoration of serum C-peptide level, and the patient no longer required any hypoglycemic medications. Despite the dramatic increase in the use of atypical antipsychotics treatment, individualized treatments along with careful monitoring may be prudent for high risk or vulnerable patients in order to avoid the development of metabolic side effects.

  9. Plasma metabonomics study of first-Episode schizophrenia treated with olanzapine in female patients.

    Science.gov (United States)

    Qiao, Ying; Zhang, Lei; He, Shen; Wen, Hui; Yu, Yi-Min; Cao, Chun-Hua; Li, Hua-Fang

    2016-03-23

    Schizophrenia is a persistent chronic mental illness with an unknown pathogenic mechanism; no empirical laboratory-based tests are available to support the diagnosis of schizophrenia or to identify biomarkers correlated with the therapeutic effect of olanzapine. For this study, 15 female first-episode, drug-naïve patients with schizophrenia and 15 healthy female volunteers were recruited. Tests for blood glucose and lipids were conducted at baseline and after 4 weeks of treatment with olanzapine. UPLC-MS based metabonomic analysis was performed on both case and control groups to identify biomarkers of schizophrenia at baseline and to explore which biomarkers correlated with the therapeutic effect of olanzapine after a 4-week treatment. Compared with the control group, the case group showed significant changes in plasma metabolites. Thirteen distinct metabolites were identified. Among all the therapeutically effective cases, levels of these metabolites appeared to shift towards the normal trend; 8 of the identified 13 metabolites changed dramatically. The metabolites that we found are potential biomarkers for the diagnosis and treatment of schizophrenia.

  10. A double-blind comparison of the effect of the antipsychotics haloperidol and olanzapine on sleep in mania

    Directory of Open Access Journals (Sweden)

    R.A. Moreno

    2007-03-01

    Full Text Available The effects of haloperidol and olanzapine on polysomnographic measures made in bipolar patients during manic episodes were compared. Twelve DSM-IV mania patients were randomly assigned to receive either haloperidol (mean ± SD final dosage: 5.8 ± 3.8 mg or olanzapine (mean ± SD final dosage: 13.6 ± 6.9 mg in a 6-week, double-blind, randomized, controlled clinical trial. One-night polysomnographic evaluation was performed before and after the haloperidol or olanzapine treatment. Psychopathology and illness severity were rated respectively with the Young Mania Rating Scale (YMRS and the Clinical Global Impressions - Bipolar version (CGI-BP. There was a significant improvement in the YMRS and CGI-BP scores at the end of the study for both groups. Mixed ANOVA used to compare the polysomnographic measures of both drugs demonstrated significant improvement in sleep measures with olanzapine. In the olanzapine group, statistically significant time-drug interaction effects on sleep continuity measures were observed: sleep efficiency (mean ± SEM pre-treatment value: 6.7 ± 20.3%; after-treatment: 85.7 ± 10.9%, total wake time (pre-treatment: 140.0 ± 92.5 min; after-treatment: 55.2 ± 44.2 min, and wake time after sleep onset (pre-treatment: 109.7 ± 70.8 min; after-treatment: 32.2 ± 20.7 min. Conversely, improvement of polysomnographic measures was not observed for the haloperidol group (P > 0.05. These results suggest that olanzapine is more effective than haloperidol in terms of sleep-promoting effects, although olanzapine is comparatively as effective as haloperidol in treating mania. Polysomnography records should provide useful information on how manic states can be affected by psychopharmacological agents.

  11. Improvement in hyperprolactinemia and reproductive comorbidities in patients with schizophrenia switched from conventional antipsychotics or risperidone to olanzapine.

    Science.gov (United States)

    Kinon, Bruce J; Ahl, Jonna; Liu-Seifert, Hong; Maguire, Gerald A

    2006-06-01

    This open-label, prospective, 4-month study in hyperprolactinemic patients with schizophrenia explored whether prolactin levels decrease after switching antipsychotic therapy to olanzapine. A secondary objective was to determine if reproductive morbidities and sexual dysfunction occurring with hyperprolactinemia improved with prolactin normalization. Clinically stable patients with schizophrenia, who had hyperprolactinemia defined as >18.8 ng/ml for males and >24.2 ng/ml for females, were randomized to: remain on current therapy (n=27) or switch to olanzapine, 5-20 mg/day, (n=27). Baseline prolactin levels in female patients randomized to receive olanzapine (n=14) were 66.3+/-38.7 ng/ml and were 82.0+/-37.6 (p=.32) in those remaining on their pre-study antipsychotic medication (n=14). In male patients, baseline prolactin levels were 33.7+/-12.1 and 33.5+/-13.8 ng/ml (p=.97), respectively, for those randomized to olanzapine (n=13) or remaining on pre-study treatment (n=13). At study end, patients switched to olanzapine experienced significant reductions in mean serum prolactin levels of 19.8+/-18.1 ng/ml in males (p=.02), and 32.3+/-47.5 ng/ml in females (p=.01), but prolactin continued to be elevated in patients who remained on pre-study antipsychotic treatment. After switching to olanzapine treatment, male patients experienced significantly (p=.03) increased free testosterone levels but there were no significant improvements in total testosterone levels; some female patients experienced improved menstrual cycling, as well as resolution of galactorrhea and gynecomastia, and sexual functioning was significantly improved in both genders. Patients switched to olanzapine, as well as those remaining on their pre-study medication, maintained clinical stability, their symptoms continued to improve, although there were no significant between-treatment differences in improvement. Treatment-emergent adverse events did occur in both treatment groups; however, they were not

  12. Olanzapine-induced hepatopathy in albino rats: A newer model for screening putative hepatoprotective agents, namely silymarin

    Directory of Open Access Journals (Sweden)

    Sengupta Parama

    2010-01-01

    Full Text Available Backgrounds: This study was conducted to establish olanzapine-induced hepatopathy in Wistar albino rats as a newer model to screen putative hepatoprotective agents namely silymarin. Materials and Methods: Albino rats were divided into three groups, namely vehicle control group (CG, olanzapine-treated group (OZ, and olanzapine plus silymarin (OZS treated groups. Both the OZ and OZS groups were treated with the same dose of intraperitoneal olanzapine for 6 weeks and group OZS additionally received oral silymarin. Baseline and terminal hepatic enzymes (SGOT, SGPT, and ALP were measured in all three groups. Results: Histopathological examination of livers of both OZ and OZS groups showed degenerative changes, whereas those of control group showed normal architecture. Liver enzyme levels showed statistically significant rise in comparison to the control group as well as the respective base line values in both the test groups, but the differences in the rise of liver enzymes between the two test groups were not statistically significant. Conclusion: Olanzapine-induced hepatopathy in rats can be used as a model for screening putative hepatoprotective agents and in our setting silymarin has failed to provide any hepatoprotection.

  13. Intramuscular Olanzapine in the Management of Behavioral and Psychological Symptoms in Hospitalized Older Adults: A Retrospective Descriptive Study

    Directory of Open Access Journals (Sweden)

    Silvia Duong

    2015-01-01

    Full Text Available Background. While behavioral and psychological symptoms are frequent in hospitalized older adults with dementia or delirium, data supporting the off-label use of intramuscular atypical antipsychotics remain scarce. We examined the use of short-acting intramuscular (IM olanzapine in hospitalized older adults to manage behavioral and psychological symptoms. Methods. A retrospective observational study of inpatients 65 years or older with at least one order for olanzapine IM during admission in urban Ontario Canada was conducted. Patient demographics, prescriptions for olanzapine IM, reason for administration, perceived effectiveness, adverse events, concurrently prescribed psychotropics, comorbidities, and patient discharge destination were recorded. Results. Among 82 patients aged 65–96 years (mean ± SD 79.3 ± 7.7 85 cases were identified. Cognitive impairment or dementia affected 63.5% and 50.6% had comorbidities. Olanzapine IM was ordered 102 times and 34 patients (41% received at least one dose. The intended efficacy was achieved in 79.4% of 78 cases of 124 doses given (62.9%. Fourteen (41% patients who received doses experienced adverse events, with sedation and hypotension being the most common. Conclusions. Olanzapine IM appears effective in hospitalized older adults but is associated with potential adverse events. Structured monitoring and documentation are needed to ensure safe use in this high-risk population.

  14. Pharmaco-epidemiological description of the population of the Marche Region (central Italy treated with the antipsychotic drug olanzapine

    Directory of Open Access Journals (Sweden)

    Fiorenzo Mignini

    2013-03-01

    Full Text Available BACKGROUND. In Italy, even though olanzapine has been discouraged for treatment of behaviour disorders in older patients affected by dementia, some physicians chose to prescribe for them. In response to this situation, the Italian Drug Agency (Agenzia Italiana del Farmaco, AIFA promulgated a cautionary note. MATERIALS AND METHODS. This study examined epidemiological indices for olanzapine prescriptions between 2004 and 2007 in the Marche Region of central Italy and in its provinces, to assess physician compliance with the AIFA note, and to determine whether there were differences in drug prescription between populations of the same territory, or differences based on gender or age group. RESULTS. Our analyses revealed high olanzapine use among young men and mature women, suggesting that these groups are most prone to psychotic symptoms. Analysis revealed that olanzapine prescription in elderly patients was reduced in some provinces, in line with the AIFA note. CONCLUSIONS. Prudent use of olanzapine prescription, in compliance with the AIFA note, was noted throughout the Region. Furthermore, this work offers details that may be useful in future studies of adverse drug reactions.

  15. Chronic betahistine co-treatment reverses olanzapine's effects on dopamine D₂ but not 5-HT2A/2C bindings in rat brains.

    Science.gov (United States)

    Lian, Jiamei; Huang, Xu-Feng; Pai, Nagesh; Deng, Chao

    2015-01-02

    Olanzapine is widely prescribed for treating schizophrenia and other mental disorders, although it leads to severe body weight gain/obesity. Chronic co-treatment with betahistine has been found to significantly decrease olanzapine-induced weight gain; however, it is not clear whether this co-treatment affects the therapeutic effects of olanzapine. This study investigated the effects of chronic treatment of olanzapine and/or betahistine on the binding density of the serotonergic 5-HT2A (5-HT2AR) and 5-HT2C (5-HT2CR) receptors, 5-HT transporter (5-HTT), and dopaminergic D₂ receptors (D₂R) in the brain regions involved in antipsychotic efficacy, including the prefrontal cortex (PFC), cingulate cortex (Cg), nucleus accumbens (NAc), and caudate putamen (CPu). Rats were treated with olanzapine (1 mg/kg, t.i.d.) or vehicle for 3.5 weeks, and then olanzapine treatment was withdrawn for 19 days. From week 6, the two groups were divided into 4 groups (n=6) for 5 weeks' treatment: (1) olanzapine-only (1 mg/kg, t.i.d.), (2) betahistine-only (9.6 mg/kg, t.i.d.), (3) olanzapine and betahistine co-treatment (O+B), and (4) vehicle. Compared to the control, the olanzapine-only treatment significantly decreased the bindings of 5-HT2AR, 5-HT2CR, and 5-HTT in the PFC, Cg, and NAc. Similar changes were observed in the rats receiving the O+B co-treatment. The olanzapine-only treatment significantly increased the D₂R binding in the Cg, NAc, and CPu, while the betahistine-only treatment reduced D₂R binding. The co-treatment of betahistine reversed the D₂R bindings in the NAc and CPu that were increased by olanzapine. Therefore, chronic O+B co-treatment has similar effects on serotonin transmission as the olanzapine-only treatment, but reverses the D₂R that is up-regulated by chronic olanzapine treatment. The co-treatment maintains the therapeutic effects of olanzapine but decreases/prevents the excess weight gain.

  16. LC-MS/MS method applied to preclinical pharmacokinetic investigation of olanzapine-loaded lipid-core nanocapsules

    Directory of Open Access Journals (Sweden)

    Frantiescoli A. Dimer

    2014-01-01

    Full Text Available In spite of different methods reported in the literature to determine olanzapine in biological fluids, all of them used high volumes of plasma. Therefore, the purpose of this paper was to develop an LC-MS/MS method using small plasma volume (0.1 mL to apply in a preclinical pharmacokinetic investigation. The method was linear over the concentration ranges of 10 - 1000 ng mL-1. Extraction recoveries, stability, and validation parameters were evaluated. Results were within the acceptable limits of international guidelines. A significant decrease in clearance led to a significant 2.26-times increase in AUC0 - 6h of olanzapine-loaded lipid-core nanocapsules compared with free-olanzapine.

  17. Olanzapine-induced neuroleptic malignant syndrome in a patient with bipolar affective disorder: Does quetiapine holds the solution?

    Directory of Open Access Journals (Sweden)

    Praveen Tripathi

    2013-01-01

    Full Text Available Neuroleptic Malignant Syndrome (NMS is a rare, severe and life threatening condition induced by antipsychotic medications. It is commonly encountered with the use of first generation antipsychotics, however cases of NMS have been reported with the use of second generation antipsychotics like Olanzapine, Risperidone, Paliperidone, Aripiprazole, Ziprasidone, Amisulpride, Quetiapine and Clozapine, though the incidence of such reports is rare. Due to decreased use of first generation antipsychotics, NMS is reported less frequently now a days. In this case report- we highlight the management issues of a patient suffering from bipolar affective disorder, who had developed NMS following intramuscular injection of haloperidol, which was withdrawn and olanzapine was given later on. The patient had again developed NMS with olanzapine. Finally the patient was managed with modified electroconvulsive therapy and discharged on Lithium carbonate and Quetiapine.

  18. Cost-effectiveness model comparing olanzapine and other oral atypical antipsychotics in the treatment of schizophrenia in the United States

    Directory of Open Access Journals (Sweden)

    Smolen Lee J

    2009-04-01

    Full Text Available Abstract Background Schizophrenia is often a persistent and costly illness that requires continued treatment with antipsychotics. Differences among antipsychotics on efficacy, safety, tolerability, adherence, and cost have cost-effectiveness implications for treating schizophrenia. This study compares the cost-effectiveness of oral olanzapine, oral risperidone (at generic cost, primary comparator, quetiapine, ziprasidone, and aripiprazole in the treatment of patients with schizophrenia from the perspective of third-party payers in the U.S. health care system. Methods A 1-year microsimulation economic decision model, with quarterly cycles, was developed to simulate the dynamic nature of usual care of schizophrenia patients who switch, continue, discontinue, and restart their medications. The model captures clinical and cost parameters including adherence levels, relapse with and without hospitalization, quality-adjusted life years (QALYs, treatment discontinuation by reason, treatment-emergent adverse events, suicide, health care resource utilization, and direct medical care costs. Published medical literature and a clinical expert panel were used to develop baseline model assumptions. Key model outcomes included mean annual total direct cost per treatment, cost per stable patient, and incremental cost-effectiveness values per QALY gained. Results The results of the microsimulation model indicated that olanzapine had the lowest mean annual direct health care cost ($8,544 followed by generic risperidone ($9,080. In addition, olanzapine resulted in more QALYs than risperidone (0.733 vs. 0.719. The base case and multiple sensitivity analyses found olanzapine to be the dominant choice in terms of incremental cost-effectiveness per QALY gained. Conclusion The utilization of olanzapine is predicted in this model to result in better clinical outcomes and lower total direct health care costs compared to generic risperidone, quetiapine, ziprasidone, and

  19. Neuroanatomical substrates of the disruptive effect of olanzapine on rat maternal behavior as revealed by c-Fos immunoreactivity.

    Science.gov (United States)

    Zhao, Changjiu; Li, Ming

    2012-12-01

    Olanzapine is one of the most widely prescribed atypical antipsychotic drugs in the treatment of schizophrenia. Besides its well-known side effect on weight gain, it may also impair human parental behavior. In this study, we took a preclinical approach to examine the behavioral effects of olanzapine on rat maternal behavior and investigated the associated neural basis using the c-Fos immunohistochemistry. On postpartum days 6-8, Sprague-Dawley mother rats were given a single injection of sterile water or olanzapine (1.0, 3.0 or 5.0mg/kg, sc). Maternal behavior was tested 2h later, after which rats were sacrificed and brain tissues were collected. Ten brain regions that were either implicated in the action of antipsychotic drugs and/or in the regulation of maternal behavior were examined for c-Fos immunoreactivity. Acute olanzapine treatment dose-dependently disrupted various components of maternal behavior (e.g., pup retrieval, pup licking, nest building, crouching) and increased c-Fos immunoreactivity in the medial prefrontal cortex (mPFC), nucleus accumbens shell and core (NAs and NAc), dorsolateral striatum (DLSt), ventral lateral septum (LSv), central amygdala (CeA) and ventral tegmental area (VTA), important brain areas generally implicated in the incentive motivation and reward processing. In contrast, olanzapine treatment did not alter c-Fos in the medial preoptic nucleus (MPN), ventral bed nucleus of the stria terminalis (vBST) and medial amygdala (MeA), the core brain areas directly involved in the mediation of rat maternal behavior. These findings suggest that olanzapine disrupts rat maternal behavior primarily by suppressing incentive motivation and reward processing via its action on the mesocorticolimbic dopamine systems, other limbic and striatal areas, but not by disrupting the core processes involved in the mediation of maternal behavior in particular.

  20. Predictors of antipsychotic monotherapy with olanzapine during a 1-year naturalistic study of schizophrenia patients in Japan

    Directory of Open Access Journals (Sweden)

    Ye W

    2012-01-01

    Full Text Available Wenyu Ye1, Haya Ascher-Svanum2, Jennifer A Flynn3, Yuka Tanji3, Michihiro Takahashi3,41Lilly Suzhou Pharmaceutical Co, Shanghai, People's Republic of China; 2Eli Lilly and Company, Indianapolis, IN, USA; 3Lilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, 4Terauchi-Takahashi Psychiatric Clinic, Ashiya, JapanPurpose: Although expert guidelines for the treatment of schizophrenia recommend antipsychotic monotherapy, the use of antipsychotic polypharmacy is common. This study identified characteristics that differentiate patients with schizophrenia who are treated with olanzapine monotherapy versus polypharmacy in usual care in Japan.Patients and methods: In a large (N = 1850 prospective, observational study, Japanese patients with schizophrenia who initiated treatment with olanzapine were followed for 1 year. Consistent with past research, antipsychotic polypharmacy was defined as the concurrent use of olanzapine and another antipsychotic for at least 60 days. Switching was defined as discontinuing a prior antipsychotic therapy rather than augmenting the medication regimen. Predictors of antipsychotic monotherapy were based on information available at the time of olanzapine initiation. Baseline characteristics were compared using t-tests and Χ2 tests. Stepwise logistic regression was used to identify independent predictors of monotherapy.Results: Patients treated with olanzapine monotherapy (43.2% differed from those treated with antipsychotic polypharmacy (56.8% on demographics, treatment history, baseline symptom levels, functional levels, and treatment-emergent adverse events. Stepwise logistic regression identified multiple variables that significantly predicted monotherapy: older age, shorter duration of schizophrenia, outpatient status, comorbid medical conditions, lower body mass index, no prior anticholinergic use, no prior mood stabilizer use, and switching from a previous antipsychotic (typical or atypical

  1. Pharmacogenetics and olanzapine treatment: CYP1A2*1F and serotonergic polymorphisms influence therapeutic outcome.

    Science.gov (United States)

    Laika, B; Leucht, S; Heres, S; Schneider, H; Steimer, W

    2010-02-01

    Psychiatric pharmacotherapy with olanzapine is commonplace. We investigated the influence of CYP1A2*1F (-163A, rs762551) and serotonergic polymorphisms on olanzapine serum concentrations and clinical outcome in a naturalistic clinical setting. Included were 124 Caucasian psychiatric inpatients treated with olanzapine for at least 4 weeks with steady-state serum concentrations available for 73 patients. The CYP1A2*1F polymorphism was reported to affect the inducibility of CYP1A2. In our study population, CYP1A2*1F/*1F genotype alone resulted in a 22% reduction of dose-/body weight-normalized olanzapine serum concentrations compared to homo- and heterozygote carriers of CYP1A2*1A (both groups without inducers). This effect was independent of the well-known effect of inducing agents (here tobacco smoke and carbamazepine which led to on average 28% lower concentrations in CYP1A2*1A carriers and 26% lower concentrations in CYP1A2*1F/*1F carriers). Consistently, patients with the CYP1A2*1F/*1F genotype taking inducers had 22% lower concentrations compared to CYP1A2*1A carriers taking inducers. The influence of genotype alone remained significant after Bonferroni's post hoc test. Higher olanzapine concentrations were significantly correlated with better improvement of paranoid and depressive symptoms in patients with schizophrenic disorders (Spearman's r=0.5, P=0.026 and P=0.006, respectively). No relationship between serum concentrations and the side effects (DOTES) score was detected. However, patients with the 5-HTR2A intron 2 (rs7997012) AA genotype suffered from more pronounced side effects compared to carriers of the GA or GG genotype (P=0.018 and P=0.002). Short-term weight gain under olanzapine therapy was significantly lower for 5-HTR2C -759 T-allele carriers (P=0.011). Our data suggest that the CYP1A2*1F/*1F genotype exhibits a significant influence on olanzapine concentrations independent of other inducing factors. Thus, CYP1A2*1F genotyping may be useful for

  2. Gabapentin adjunctive to risperidone or olanzapine in partially responsive schizophrenia: an open-label pilot study

    Directory of Open Access Journals (Sweden)

    Adel Gabriel

    2010-10-01

    Full Text Available Adel GabrielDepartments of Psychiatry and Community Health Sciences, University of Calgary, Alberta, CanadaBackground: There is a great need in the treatment of schizophrenia for a drug, or drug ­combinations, to improve clinical response with fewer serious side effects. The objective of this study was to explore the therapeutic effects and tolerability of the anticonvulsant gabapentin as an adjunctive in the treatment of patients with partially responsive schizophrenia.Methods: Ten consenting patients with a confirmed Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision diagnosis of schizophrenia were identified. All patients failed at least one 12-week treatment trial with risperidone or olanzapine. Gabapentin was added to ongoing antipsychotic treatment with olanzapine or risperidone for eight weeks. The primary outcome measure was the Positive and Negative Syndrome Scale (PANSS. Other scales included the Calgary Depression Scale (CDSS and the Abnormal Involuntary Movement Scale (AIMS. Repeated-measures multivariate analysis of variance was utilized to examine changes in outcome measures over time with adjunctive treatment with gabapentin.Results: There was a significant drop in the PANSS and CDSS scores at endpoint (week 8. There were no significant differences between the two treatment groups with regard to changes in all outcome measures or in AIMS score. The adjunctive treatments were well tolerated and side effects were transient.Conclusion: Gabapentin could be used successfully as an adjunct to novel antipsychotics in partially responsive schizophrenia. However, large controlled studies are needed to examine the effectiveness of gabapentin in psychotic disorders.Keywords: schizophrenia, refractory, adjunctive treatment, gabapentin, risperidone, olanzapine

  3. Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy

    Directory of Open Access Journals (Sweden)

    Novin Nikbakhsh

    2016-01-01

    Full Text Available Background: Considering the incidence and prevalence rates of gastric cancer in Mazandaran Province of Iran, this research was performed to evaluate the efficacy and safety of olanzapine in symptom relief and quality of life (QOL improvement of gastric patients receiving chemotherapy. Materials and Methods: This clinical trial was conducted on thirty new cases of gastric cancer patients whose treatment protocol was planned on chemotherapy and were allocated into two groups by simple random sampling. Intervention group (15 patients received olanzapine tablets (2.5–10 mg/day a day before the beginning of chemotherapy; in the 1st day of chemotherapy to 8 weeks after chemotherapy, besides the routine treatment regimens. The control group received only the routine treatment regimens. The patients were followed for 8 weeks after intervention. All of the patients were assessed with Hospital Anxiety and Depression Scale (HADS and WHO-QOL-BREF questionnaires; further, Rhodes index was used to evaluate nausea and vomiting (N/V status. Results: All the recruited patients continued the allocated interventions (no lost to follow-up. N/V decreased in the case group, but the difference was not statistically significant (P = 0.438. The patients' appetite and body mass index increased (P = 0.006. Anxiety and depression subscales of HADS had significant differences between the two groups (P 0.05. No significant increase was observed in fasting and 2-h postprandial blood glucose and lipid profile (P > 0.05. Conclusion: Olanzapine can be considered as an effective drug to increase appetite and decrease anxiety and depression in patients with gastric cancer.

  4. Single dose bioequivalence study of two brands of olanzapine 10 mg tablets in Iranian healthy volunteers.

    Science.gov (United States)

    Zakeri-Milani, P; Islambulchilar, Z; Ghanbarzadeh, S; Valizadeh, H

    2013-07-01

    This single dose, randomized, open label, 2-period and crossover study in healthy Iranian adult volunteers was conducted to compare the bioavailability of 2 branded formulations of olanzapine 10 mg tablets. 24 volunteers received one tablet of each olanzapine 10 mg formulation. Drugs were administered after a 12 h overnight fast in each of 2 treatment days which separated by a 2-week washout period. Serial blood samples were collected over a period of 72 h. Plasma was analyzed using a validated high performance liquid chromatography method with ultraviolet detection in the range of 2-24 ng/mL with a lower limit of quantitation of 1.25 ng/mL. A non-compartmental method was employed to determine the pharmacokinetic properties (Cmax, Tmax, AUC0-t, AUC0-∞ and T1/2) to test to bioequivalence. Cmax, AUC0-t and AUC0-∞ were used to test the bioequivalence after log-transformation of plasma data. The mean (SD) Cmax, AUC0-t and AUC0-∞ for the test formulation were 15.82 (3.15) ng/mL, 447.19 (100.64) ng.h/L and 570.75 (130.55) ng.h/L respectively. Corresponding values for the test formulation were 15.72 (4.25) ng/mL, 440.37 (98.75) ng.h/mL and 558.66 (129.57) ng.h/mL. For test formulation vs. the reference formulation, the 90% CIs of the least squares mean test/reference ratios of Cmax, AUC0-t and AUC0-∞ were 97.6-110.0%, 96.4-109.4% and 97.3-109.2%. In these volunteers, based on the FDA regulatory definition, results from the pharmacokinetic analysis suggested that the test and reference formulations of olanzapine 10 mg tablets were bioequivalent.

  5. Long-term treatment with olanzapine in hospital conditions: Prevalence and predictors of the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Popović Irena

    2015-01-01

    Full Text Available Introduction. The risk of metabolic abnormalities is greatly increased in schizophrenic patients started on an atypical antipsychotic medication. Patients with psychiatric disorders exceed mortality ranges resulting from, among others, increased risk of cardiovascular events. Other factors contributing to the development of metabolic syndrome include prolonged duration of illness, increasing age, female sex and lifestyle factors. Objective. This cross-sectional study was taken up to assess the prevalence of the metabolic syndrome (MetS in schizophrenic patients receiving olanzapine monotherapy for at least six months and to determine the most important risk factors associated with metabolic syndrome presence in these patients. Methods. A total of 93 long term hospitalized schizophrenic patients (71 men, 22 women, had a screening of the following: case-history data, psychiatric scales, anthropometric measures, blood (fasting glucose, lipid status, C-reactive protein - CRP and urine samples (microalbuminuria. Results. Prevalence of MetS according to International Diabetes Federation criteria in our study was 34.4%. The multivariate analysis distinguished the following significant predictors of MetS presence (in order of appearance: data about diabetes mellitus in family history (p=0.002, body mass index >25 kg/m2 (p=0.002, hyperlipidemia in family history (p=0.008, and elevated CRP value (p=0.042. Conclusion. High rate of MetS in patients treated with olanzapine in this study exceeds MetS prevalence in general population. Among observed parameters, our study pointed to several “high risk” predictors associated with MetS presence. Regular monitoring of cardiometabolic risk factors is highly recommended. Positive heredity distress mentioned above may direct a psychiatrist to prescribe some other drug than olanzapine in the long term treatment of schizophrenia.

  6. 'Myxoedema madness' with Capgras syndrome and catatonic features responsive to combination olanzapine and levothyroxine.

    Science.gov (United States)

    Shlykov, Maksim A; Rath, Swapnil; Badger, Alison; Winder, Gerald Scott

    2016-09-09

    We present the case of an elderly woman with hypothyroidism and no psychiatric history who presented with new onset of psychosis, paranoia, catatonic features and Capgras syndrome (CS). This case illustrates the spectrum of neuropsychiatric symptoms that may accompany hypothyroidism and the importance of considering thyroid dysfunction as a primary contributor to severe psychiatric symptoms, especially in previously stable patients. We demonstrate the effectiveness of combination levothyroxine and olanzapine, with its favourable cardiac profile, in the treatment of myxoedema madness. Antipsychotics can be weaned once psychiatric symptoms resolve and hormone levels are stabilised. 2016 BMJ Publishing Group Ltd.

  7. Use of Orally Disintegrating Olanzapine During Electroconvulsive Therapy for Prevention of Postictal Agitation.

    Science.gov (United States)

    Hermida, Adriana P; Janjua, A Umair; Tang, Yilang; Syre, Sharyn R; Job, Gregory; McDonald, William M

    2016-11-01

    A major medical problem for patients undergoing electroconvulsive therapy (ECT) is the occurrence of postictal agitation (PIA). This phenomenon is associated with confusion and disorientation that can have severe clinical implications for the safety of the patient and health care professionals. Many different pharmacological strategies have been used to prevent PIA. We present data on 40 patients who suffered from PIA after a course of ECT and evaluate the prophylactic use of orally disintegrating olanzapine in the prevention of PIA in subsequent ECT treatments.

  8. Management of symptoms associated with advanced cancer: olanzapine and mirtazapine. A World Health Organization project.

    Science.gov (United States)

    Davis, Mellar P; Khawam, Elias; Pozuelo, Leo; Lagman, Ruth

    2002-08-01

    Advanced cancer patients are polysymptomatic and often receive multiple medications for symptom relief. Common symptoms include anorexia, weight loss, delirium and depression. Olanzapine and mirtazapine may have several advantages over older agents despite increased acquisition costs. Both medications can treat several symptoms with a low risk for drug-drug interactions and with only once- or twice-daily dosing. Drug side effects are low, compared with more conventionally used agents. The pharmacokinetics and pharmacodynamics of both agents are unique and explain many of the benefits. More research and clinical experience will be necessary to define their role in the palliation of advanced cancer.

  9. Simultaneous determination of olanzapine and fluoxetine hydrochloride in capsules by spectrophotometry, TLC-spectrodensitometry and HPLC.

    Science.gov (United States)

    Tantawy, Mahmoud A; Hassan, Nagiba Y; Elragehy, Nariman A; Abdelkawy, Mohamed

    2013-03-01

    This paper describes sensitive, accurate and precise spectrophotometric, TLC-spectrodensitometric and high performance liquid chromatographic (HPLC) methods for simultaneous determination of olanzapine and fluoxetine HCl. Two spectrophotometric methods were developed, namely; first derivative (D (1)) and derivative ratio (DD (1)) methods. The TLC method employed aluminum TLC plates precoated with silica gel GF254 as the stationary phase and methanol:toluene:ammonia (7:3:0.1, by volume) as the mobile phase, where the chromatogram was scanned at 235 nm. The developed HPLC method used a reversed phase C18 column with isocratic elution. The mobile phase composed of phosphate buffer pH 4.0:acetonitrile:triethylamine (53:47:0.03, by volume) at flow rate of 1.0 mL min(-1). Quantitation was achieved with UV detection at 235 nm. The methods were validated according to the International Conference on Harmonization (ICH) guidelines. The selectivity of the proposed methods was tested using laboratory-prepared mixtures. The developed methods were successfully applied for the determination of olanzapine and fluoxetine HCl in bulk powder and combined capsule dosage form.

  10. Olanzapine use in a manic patient during second and third trimester pregnancy

    Directory of Open Access Journals (Sweden)

    Choi L

    2014-02-01

    Full Text Available Lynn Choi, Soo-Hyun Joo, Jong-Hyun Jeong Department of Psychiatry, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea Abstract: Women with bipolar disorder have a high risk for symptom exacerbation during pregnancy and the risk is elevated further when mood stabilizers are discontinued. This report describes a 31-year-old bipolar woman who discontinued medication before pregnancy but had to resume her pharmacotherapy due to manic episodes that recurred during the second trimester. Olanzapine, an atypical antipsychotic, was administered from week 25 of gestation and then replaced with quetiapine in week 35 of gestation. Even though a consensus on clinical interventions for pregnant patients with symptom relapse has not been reached, clinicians should still discuss pregnancy and therapeutic management with every female bipolar patient of childbearing age. This discussion is important because treatment can be managed most effectively in these individuals if pregnancy is planned. Ultimately, clinical decisions should be made on a case-by-case basis, weighing the risks to the mother and fetus between the disorder itself and the teratogenicity of pharmacotherapy. Keywords: pregnancy, bipolar disorder, olanzapine, manic

  11. Olanzapine reduces physical activity in rats exposed to activity-based anorexia : possible implications for treatment of anorexia nervosa?

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; van Elburg, Annemarie A; Kas, Martien J H; van Engeland, Herman; Adan, Roger A H

    2005-01-01

    BACKGROUND: Anorexia nervosa (AN) patients often show extreme hypophagia and excessive physical activity. Activity-based anorexia (ABA) is considered an animal model of AN and mimics food restriction and hyperactivity in rats. This study investigated whether treatment with olanzapine (Zyprexa) reduc

  12. Comparison of the effect of Olanzapine and Sertraline on patients suffering from personality disorder, receiving methadone maintenance therapy

    Directory of Open Access Journals (Sweden)

    mozhgan Jariani

    2009-03-01

    Full Text Available Background: Borderline Personality disorder is a disabling disease affecting 2% of general population. Various drugs have been suggested for treatment of borderline Personality disorder. If a drug could alleviate a wide range of symptoms, it would be more suitable. In these disorders drug addiction is very common. This fact makes the symptoms complicated and the treatment more difficult. This study is designed to evaluate the effect of Olanzapine and Sertraline in patients suffering from personality disorders who are on methadone maintenance therapy. Materials and Methods: This clinical trial study was carried out on 120 male and female cases chosen for methadone maintenance therapy through interview by a psychiatrist based on DSM-IV-TR diagnostic criteria for BPD. Afterwards they were randomly divided into two groups. These groups separately received Olanzapine (5-10 mg daily and Sertraline (50-100 mg daily therapy. The SCL-90 questionnaire was filled out by the participants before treatment and at the 4th, 8th and 12th weeks of the treatment. Results: According to this clinical trial, Olanzapine and Sertraline were effective in ameliorating symptoms of depression, anxiety and aggression, reducing sensitivity in interpersonal relationship and alleviating obsessive symptoms, pessimistic behaviors and somatization disorders in patients with personality disorders on methadone maintenance therapy. Conclusion: As results of this study stated that Olanzapine and Sertraline are definitely effective in alleviating symptoms of patients with personality disorder, prescribing theses drugs are highly recommended for these patients. .

  13. Mechanism-Based Pharmacokinetic-Pharmacodynamic Modeling of the Dopamine D-2 Receptor Occupancy of Olanzapine in Rats

    NARCIS (Netherlands)

    Johnson, Martin; Kozielska, Magdalena; Reddy, Venkatesh Pilla; Vermeulen, An; Li, Cheryl; Grimwood, Sarah; de Greef, Rik; Groothuis, Geny M. M.; Danhof, Meindert; Proost, Johannes H.

    2011-01-01

    A mechanism-based PK-PD model was developed to predict the time course of dopamine D-2 receptor occupancy (D2RO) in rat striatum following administration of olanzapine, an atypical antipsychotic drug. A population approach was utilized to quantify both the pharmacokinetics and pharmacodynamics of ol

  14. Translation of randomised controlled trial findings into clinical practice: comparison of olanzapine and valproate in the EMBLEM study

    DEFF Research Database (Denmark)

    Novick, D; Gonzalez-Pinto, A; Haro, J M

    2009-01-01

    OBJECTIVES: The aim of this study was to compare the outcomes of olanzapine- and valproate-treated patients in an observational study of acute mania with the results of a randomised controlled trial (RCT) assessing the same treatments. METHODS: EMBLEM (European Mania in Bipolar Evaluation...

  15. Subjective response to antipsychotic treatment and compliance in schizophrenia. A naturalistic study comparing olanzapine, risperidone and haloperidol (EFESO Study

    Directory of Open Access Journals (Sweden)

    Sacristán Jose A

    2001-12-01

    Full Text Available Abstract Background In order to compare the effectiveness of different antipsychotic drugs in the treatment of schizophrenia it is very important to evaluate subjective response and compliance in patient cohorts treated according to routine clinical practice. Method Outpatients with schizophrenia entered this prospective, naturalistic study when they received a new prescription for an antipsychotic drug. Treatment assignment was based on purely clinical criteria, as the study did not include any experimental intervention. Patients treated with olanzapine, risperidone or haloperidol were included in the analysis. Subjective response was measured using the 10-item version of the Drug Attitude Inventory (DAI-10, and treatment compliance was measured using a physician-rated 4 point categorical scale. Results A total of 2128 patients initiated treatment (as monotherapy with olanzapine, 417 with risperidone, and 112 with haloperidol. Olanzapine-treated patients had significantly higher DAI-10 scores and significantly better treatment compliance compared to both risperidone- and haloperidol-treated patients. Risperidone-treated patients had a significantly higher DAI-10 score compared to haloperidol-treated patients. Conclusion Subjective response and compliance were superior in olanzapine-treated patients, compared to patients treated with risperidone and haloperidol, in routine clinical practice. Differences in subjective response were explained largely, but not completely, by differences in incidence of EPS.

  16. Determination of olanzapine in whole blood using simple protein precipitation and liquid chromatography-tandem mass spectrometry

    DEFF Research Database (Denmark)

    Nielsen, Marie Katrine Klose; Johansen, Sys Stybe

    2009-01-01

    A simple, sensitive, and reproducible liquid chromatography-tandem mass spectrometry method has been developed and validated for the quantification of the antipsychotic drug olanzapine in whole blood using dibenzepine as internal standard (IS). After acidic methanol-induced protein precipitation...

  17. Olanzapine reduces physical activity in rats exposed to activity-based anorexia : possible implications for treatment of anorexia nervosa?

    NARCIS (Netherlands)

    Hillebrand, Jacquelien J G; van Elburg, Annemarie A; Kas, Martien J H; van Engeland, Herman; Adan, Roger A H

    2005-01-01

    BACKGROUND: Anorexia nervosa (AN) patients often show extreme hypophagia and excessive physical activity. Activity-based anorexia (ABA) is considered an animal model of AN and mimics food restriction and hyperactivity in rats. This study investigated whether treatment with olanzapine (Zyprexa) reduc

  18. Mucoadhesive Amphiphilic Methacrylic Copolymer-Functionalized Poly(ε-caprolactone) Nanocapsules for Nose-to-Brain Delivery of Olanzapine.

    Science.gov (United States)

    Fonseca, Francisco N; Betti, Andresa H; Carvalho, Flávia C; Gremião, Maria P D; Dimer, Frantiescoli A; Guterres, Sílvia S; Tebaldi, Marli L; Rates, Stela M K; Pohlmann, Adriana R

    2015-08-01

    Nose-to-brain drug delivery has been proposed to overcome the low absorption of drugs in central nervous system due to the absence of brain-blood barrier in the olfactory nerve pathway. However, the presence of a mucus layer and quick clearance limit the use of this route. Herein, amphiphilic methacrylic copolymer-functionalized poly(ε-caprolactone) nanocapsules were proposed as a mucoadhesive system to deliver olanzapine after intranasal administration. In vitro evaluations showed that these nanocapsules were able to interact with mucin (up to 17% of increment in particle size and 30% of reduction of particle concentration) and nasal mucosa (2-fold higher force for detaching), as well as to increase the retention of olanzapine (about 40%) on the nasal mucosa after continuous wash. The olanzapine-loaded amphiphilic methacrylic copolymer-functionalized PCL nanocapsules enhanced the amount of drug in the brain of rats (1.5-fold higher compared to the drug solution). In accordance with this finding, this formulation improved the prepulse inhibition impairment induced by apomorphine, which is considered as an operational measure of pre-attentive sensorimotor gating impairment present in schizophrenia. Besides, nanoencapsulated olanzapine did not affect the nasal mucosa integrity after repeated doses. These data evidenced that the designed nanocapsules are a promising mucoadhesive system for nose-to-brain delivery of drugs.

  19. A case of catatonia status-post left middle cerebral artery cerebrovascular accident, treated successfully with olanzapine.

    Science.gov (United States)

    Spiegel, David R; Klaiber, Nicholas

    2013-01-01

    Catatonia is a psychomotor phenomenon associated with psychiatric/medical conditions. We present a patient who developed catatonia status-post left middle cerebral artery infarct. With a Bush Francis Catatonia Rating Scale score of 43 on admission, treatment with olanzapine reduced this score to 2, by discharge.

  20. Heart rate variability in schizophrenic patients switched from typical antipsychotic agents to amisulpride and olanzapine. 3-month follow-up.

    Science.gov (United States)

    Wang, Ying-Chieh; Yang, Cheryl C H; Bai, Ya-Mei; Kuo, Terry B J

    2008-01-01

    Schizophrenia is a severe mental disorder that requires lifelong treatment, and therefore information on the cardiovascular safety and tolerance of antipsychotics is of significant clinical importance. Atypical antipsychotics have been used to treat schizophrenia patients since the 1990s, and more and more patients have been switched to these from typical antipsychotics; however, there is still no accessible evaluation tool for assessing cardiovascular safety. In this study, we used a computer-assisted 5-min measurement of resting heart rate variability (HRV) in schizophrenia patients who were switched to atypical antipsychotic agents (amisulpride and olanzapine) due to severe side effects (tardive dyskinesia). In 15 patients who switched to amisulpride and 18 to olanzapine, HRV was evaluated before the medication was switched, and patients were followed up every month for 3 months after the switch. Frequency-domain analyses of short-term and stationary respiratory rate (RR) intervals were performed to evaluate low-frequency power (LF; 0.04-0.15 Hz), high-frequency power (HF; 0.15-0.40 Hz), the ratio of LF to HF (LF/HF), and LF in normalized units (LF%). Our results showed significant increases in the mean, variance and HF of RR intervals in the amisulpride group, but not in the olanzapine group. These results indicate that amisulpride has a more vagotonic effect, suggesting greater cardiovascular safety as compared with olanzapine when subjects are switched from typical antipsychotic agents.

  1. Sertindole, in contrast to clozapine and olanzapine, does not disrupt water maze performance after acute or chronic treatment

    DEFF Research Database (Denmark)

    Didriksen, Michael; Kreilgaard, Mads; Arnt, Jørn

    2006-01-01

    Cognitive deficits in schizophrenia are associated with poor functional outcome, and may be further aggravated by treatment with antipsychotics. In the present study the acute and chronic (3 weeks of treatment) effects of clozapine, olanzapine, and sertindole on performance in the Morris water ma...

  2. GABA, Selank, and Olanzapine Affect the Expression of Genes Involved in GABAergic Neurotransmission in IMR-32 Cells

    Science.gov (United States)

    Filatova, Elena; Kasian, Anastasiya; Kolomin, Timur; Rybalkina, Ekaterina; Alieva, Anelya; Andreeva, Lyudmila; Limborska, Svetlana; Myasoedov, Nikolay; Pavlova, Galina; Slominsky, Petr; Shadrina, Maria

    2017-01-01

    Clinical studies have shown that Selank had an anxiolytic effect comparable to that of classical benzodiazepine drugs, which can enhance the inhibitory effect of GABA by allosteric modulation of GABAA receptors. These data suggest that the molecular mechanism of the effect of Selank may also be related to its ability to affect the performance of the GABAergic system. To test this hypothesis, we studied the changes in expression of 84 genes involved in the functioning of the GABAergic system and in the processes of neurotransmission in the culture of neuroblastoma IMR-32 cells using qPCR method. As test substances, in addition to Selank, we selected the major GABAA receptor ligand, GABA, the atypical antipsychotic, olanzapine, and combinations of these compounds (Selank and GABA; Selank and olanzapine). We found no changes in the mRNA levels of the genes studied under the effect of Selank. The combined effect of GABA and Selank led to nearly complete suppression of changes in expression of genes in which mRNA levels changed under the effect of GABA. When Selank was used in conjunction with olanzapine, the expression alterations of more genes were observed compared with olanzapine alone. The data obtained indicate that Selank has no direct effect on the mRNA levels of the GABAergic system genes in neuroblastoma IMR-32 cells. At the same time, our results partially confirm the hypothesis that the peptide may affect the interaction of GABA with GABAA receptors. Our data also suggest that Selank may enhance the effect of olanzapine on the expression of the genes studied. PMID:28293190

  3. Natural oils as skin permeation enhancers for transdermal delivery of olanzapine: in vitro and in vivo evaluation.

    Science.gov (United States)

    Aggarwal, Geeta; Dhawan, Sanju; HariKumar, S L

    2012-03-01

    The feasibility of development of transdermal delivery system of olanzapine utilizing natural oils as permeation enhancers was investigated. Penetration enhancing potential of corn (maize) oil, groundnut oil and jojoba oil on in vitro permeation of olanzapine across rat skin was studied. The magnitude of flux enhancement factor with corn oil, groundnut oil and jojoba oil was 7.06, 5.31 and 1.9 respectively at 5mg/ml concentration in solvent system. On the basis of in vitro permeation studies, eudragit based matrix type transdermal patches of olanzapine were fabricated using optimized concentrations of natural oils as permeation enhancers. All transdermal patches were found to be uniform with respect to physical characteristics. The interaction studies carried out by comparing the results of ultraviolet, HPLC and FTIR analyses for the pure drug, polymers and mixture of drug and polymers indicated no chemical interaction between the drug and excipients. Corn oil containing unsaturated fatty acids was found to be promising natural permeation enhancer for transdermal delivery of olanzapine with greatest cumulative amount of drug permeated (1010.68 μg/cm²/h) up to 24 h and caused no skin irritation. The fabricated transdermal patches were found to be stable. The pharmacokinetic characteristics of the final optimized matrix patch (T2) were determined after transdermal application to rabbits. The calculated relative bioavailability of TDDS was 113.6 % as compared to oral administration of olanzapine. The therapeutic effectiveness of optimized transdermal system was confirmed by tranquillizing activity in rotarod and grip mice model.

  4. Effects of lactational exposure of olanzapine and risperidone on hematology and lymphoid organs histopathology: a comparative study in mice neonates.

    Science.gov (United States)

    Mishra, Akash C; Mohanty, Banalata

    2010-05-25

    Body weight gain, sexual/reproductive dysfunction and hematological abnormalities are serious consequences of atypical antipsychotics treatment. No attempts however have been made preclinically to elucidate the adverse hematological impacts. Presently, effects of lactational exposure of olanzapine (4, 8 and 10 mg/kg) and risperidone (1 and 2 mg/kg) on hematology as well as lymphoid organ histopathology of mice neonates were investigated. Both olanzapine and risperidone transfers through milk and make the neonates susceptible to their adverse side effects. Corticosterone elevation tendency of both the drugs further enhance the susceptibility for immune dysfunction. Analysis of total and differential leukocytes counts revealed neutropenia with all the doses of olanzapine but only with risperidone 2mg/kg. Weight analysis and histopathology of thymus and spleen indicated a state of suppression; less in the risperidone-exposed groups. Significant plasma corticosterone elevation occurred on 4 and 8 mg/kg olanzapine exposures but not with 10 mg/kg as well as with both the risperidone doses. Elevation of plasma prolactin levels occurred dose-dependently for both the drugs. Hematological toxicity (neutropenia) might be the direct toxic effects of the drugs/unstable metabolites on circulating neutrophils and/or on the bone marrow hemopoietic cells. Direct toxicity of the drugs might also have suppressed the lymphoid organs thymus and spleen. Further, it could be associated to hormonal imbalance induced by adverse pharmacological effects of the drugs on the endocrine system. Suppression of lymphoid organs in olanzapine groups might have resulted because of corticosteronemia and hyperprolactinemia, while in risperidone it could be mediated by pronounced hyperprolactinemic effect alone.

  5. Effects of olanzapine and betahistine co-treatment on serotonin transporter, 5-HT2A and dopamine D2 receptor binding density.

    Science.gov (United States)

    Lian, Jiamei; Huang, Xu-Feng; Pai, Nagesh; Deng, Chao

    2013-12-02

    Olanzapine is widely used in treating multiple domains of schizophrenia symptoms but induces serious metabolic side-effects. Recent evidence has showed that co-treatment of betahistine (a histaminergic H1 receptor agonist and H3 receptor antagonist) is effective for preventing olanzapine-induced weight gain/obesity, however it is not clear whether this co-treatment affects on the primary therapeutic receptor binding sites of olanzapine such as serotonergic 5-HT2A receptors (5-HT2AR) and dopaminergic D2 receptors (D2R). Therefore, this study investigated the effects of this co-treatment on 5-HT2AR, 5-HT transporter (5-HTT) and D2R bindings in various brain regions involved in antipsychotic efficacy. Female Sprague Dawley rats were administered orally (t.i.d.) with either olanzapine (1mg/kg), betahistine (2.7 mg/kg), olanzapine plus betahistine (O+B), or vehicle (control) for 2 weeks. Quantitative autoradiography was used to detect the density of [(3)H]ketanserin, [(3)H]paroxetine and [(3)H]raclopride binding site to 5-HT2AR, 5-HTT and D2R. Compared to the controls, olanzapine significantly decreased [(3)H]ketanserin bindings to 5-HT2AR in the prefrontal cortex, cingulate cortex, and nucleus accumbens. Similar changes in 5-HT2AR bindings in these nuclei were also observed in the O+B co-treatment group. Olanzapine also significantly decreased [(3)H]paroxetine binding to 5-HTT in the ventral tegmental area and substantia nigra, however, both olanzapine only and O+B co-treatment did not affect [(3)H]raclopride binding to D2R. The results confirmed the important role of 5-HT2AR in the efficacy of olanzapine, which is not influenced by the O+B co-treatment. Therefore, betahistine co-treatment would be an effective combination therapy to reduce olanzapine-induced weight gain side-effects without affecting olanzapine's actions on 5-HT2AR transmissions.

  6. Evaluation of proximal therapeutic effect and distal social function restoration of olanzapine on schizophrenia patients%奥氮平对精神分裂症患者近期疗效及远期社会功能恢复效果评价

    Institute of Scientific and Technical Information of China (English)

    王长虹; 赵峥; 李晏; 潘苗; 刘旭

    2002-01-01

    Objective To evaluate the efficacy and prognosis of olanzapine in treatment of the schizophrenia. Methods A randomized controlled clinical study was performed to compare the efficacy and prognosis of olanzapine to that of chlorpromazine. 60 patients with schizophrenia were divided two groups. 32cases were treated with olanzapine. 28 cases were treated with chlorpromazine .Results The significant effect rate and effective rate on olanzapine group were 63% and 82% respectively ; which in chlorpromazine group were 32% and 50% .There were less side effects, and less recurrent rate in olanzapine. Conclusion Olanzapine is one of the safe and effective atypical antipsychotic for schizophrenia with significantly fewer side effects.

  7. Olanzapine promotes fat accumulation in male rats by decreasing physical activity, repartitioning energy and increasing adipose tissue lipogenesis while impairing lipolysis

    OpenAIRE

    Albaugh, Vance L.; Judson, Jessica G.; She, Pengxiang; Lang, Charles H.; Maresca, Kevin P.; Joyal, John L.; Christopher J Lynch

    2010-01-01

    Olanzapine and other atypical antipsychotics cause metabolic side effects leading to obesity and diabetes; while these continue to be an important public health concern, their underlying mechanisms remain elusive. Therefore, an animal model of these side effects was developed in male Sprague-Dawley rats. Chronic administration of olanzapine elevated fasting glucose, impaired glucose and insulin tolerance, increased fat mass but, in contrast to female rats, did not increase body weight or food...

  8. Cost-effectiveness of olanzapine long-acting injection in the treatment of patients with schizophrenia in the United States: a micro-simulation economic decision model.

    Science.gov (United States)

    Furiak, Nicolas M; Ascher-Svanum, Haya; Klein, Robert W; Smolen, Lee J; Lawson, Anthony H; Montgomery, William; Conley, Robert R

    2011-04-01

    To compare, from the perspective of third-party payers in the United States health care system, the cost-effectiveness of olanzapine long-acting injection (LAI, depot) with alternative antipsychotic agents including risperidone-LAI, paliperidone-LAI, haloperidol-LAI, and oral olanzapine, in the treatment of patients with schizophrenia who have been non-adherent or partially adherent with oral antipsychotics. A 1-year micro-simulation economic decision model was developed to simulate the dynamics of usual care of patients with schizophrenia who continue, discontinue, switch, or restart their medication. The model uses a range of clinical and cost parameters including adherence levels, relapse with and without hospitalization, quality-adjusted life years (QALYs), treatment discontinuation rates by reason, treatment-emergent adverse events, suicide, health care resource utilization, and direct health care costs. Published medical literature and a clinical expert panel were used to develop baseline model assumptions. Key model outputs include annual total direct cost (US$) per treatment and incremental cost-effectiveness values per additional QALY gained. Model results found that the olanzapine-LAI treatment strategy was more effective (greater QALYs) and less costly than risperidone-LAI, paliperidone-LAI, and haloperidol-LAI. In addition, olanzapine-LAI was both more effective and more costly, with an estimated incremental cost/QALY of $26,824 compared to oral olanzapine. The base-case and multiple sensitivity analyses found olanzapine-LAI to remain within acceptable cost-effective ranges (micro-simulation model finds the olanzapine-LAI treatment strategy to result in better effectiveness and to be a cost-effective alternative compared to oral olanzapine and the LAI formulations of risperidone, paliperidone, and haloperidol in the treatment of non-adherent and partially adherent patients with schizophrenia in the United States. A key limitation is the assumption how

  9. Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder in adolescent patients

    Directory of Open Access Journals (Sweden)

    Ann E Maloney

    2010-11-01

    Full Text Available Ann E Maloney1,2, Linmarie Sikich31Maine Medical Center Research Institute, Scarborough, ME, USA; 2Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA; 3Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USABackground: Severe and persistent mental illnesses in children and adolescents, such as early-onset schizophrenia spectrum (EOSS disorders and pediatric bipolar disorder (pedBP, are increasingly recognized. Few treatments have demonstrated efficacy in rigorous clinical trials. Enduring response to current medications appears limited. Recently, olanzapine was approved for the treatment of adolescents with schizophrenia or acute manic/mixed episodes in pedBP.Methods: PubMed searches were conducted for olanzapine combined with pharmacology, schizophrenia, or bipolar disorder. Searches related to schizophrenia and bipolar disorder were limited to children and adolescents. The bibliographies of the retrieved articles were hand-checked for additional relevant studies. The epidemiology, phenomenology, and treatment of EOSS and pedBP, and olanzapine’s pharmacology are reviewed. Studies of olanzapine treatment in youth with EOSS and pedBP are examined.Results: Olanzapine is efficacious for EOSS and pedBP. However, olanzapine is not more efficacious than risperidone, molindone, or haloperidol in EOSS and is less efficacious than clozapine in treatment-resistant EOSS. No comparative trials have been done in pedBP. Olanzapine is associated with weight gain, dyslipidemia, and transaminase elevations in youth. Extrapyramidal symptoms, neuroleptic malignant syndrome, and blood dyscrasias have also been reported but appear rare.Conclusions: The authors conclude that olanzapine should be considered a second-line agent in EOSS and pedBP due to its risks for significant weight gain and lipid dysregulation. Awareness of the consistent weight and metabolic changes observed in olanzapine

  10. Clinical utility of orally disintegrating olanzapine in Chinese patients with schizophrenia: a review of effectiveness, patient preference, adherence, and other properties

    Directory of Open Access Journals (Sweden)

    Zhao J

    2014-02-01

    Full Text Available Jingping Zhao,1 Jianjun Ou,1 Haibo Xue,2 Li Liu,2 William Montgomery,3 Tamas Treuer4 1Mental Health Institute of The Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 2Lilly Suzhou Pharmaceutical Co, Ltd, Jiangsu, People's Republic of China; 3Global Health Outcomes, Eli Lilly and Company, Sydney, Australia; 4Emerging Markets Business Unit (Neuroscience, Eli Lilly and Company, Budapest, Hungary Abstract: The primary objective of this systematic review was to examine the evidence for the efficacy, effectiveness, and safety of orally disintegrating olanzapine in Chinese populations. A systematic literature search was conducted using databases covering international and Chinese journals, ClinicalTrials.gov, and internal and external trial registries at Eli Lilly and Company using search terms related to target countries (People's Republic of China, Hong Kong, and Taiwan and orally disintegrating olanzapine treatment. A publication and one clinical study report were retrieved. The clinical study showed orally disintegrating olanzapine and the standard oral tablet to have similar efficacy and tolerability profiles. A bioequivalence study has shown that orally disintegrating olanzapine and the standard oral tablet have similar pharmacokinetic profiles. Orally disintegrating olanzapine and the standard oral tablet have similar efficacy and tolerability profiles. Keywords: orally disintegrating, olanzapine, Chinese, schizophrenia, patients

  11. Case report of adjunctive use of olanzapine with an antidepressant to treat sleep paralysis

    Institute of Scientific and Technical Information of China (English)

    Jinfeng DUAN; Wanli HUANG; Mincong ZHOU; Xujuan LI; Wei CAI

    2013-01-01

    Sleep paralysis (SP) is a condiiton of unknown eitology that usually occurs when falling asleep or when awakening in which the individual remains conscious but is unable to control their voluntary movements. This case report is about a 68-year-old man with a 40-year history of symptoms of SP and associated panic attacks upon awakening. Neurological examination and neuroimaging identified no abnormaliites. Five years before the current evaluaiton he had been diagnosed with depression and treated with various anit-depressants which ameliorated, but did not cure, his SP. However, this 40-year history of SP was abruptly terminated-and did not return over the subsequent two years-atfer adjuncitve treatment with 2.5 mg olanzapine each night was added to his anitdepressant.

  12. Case report of adjunctive use of olanzapine with an antidepressant to treat sleep paralysis.

    Science.gov (United States)

    Duan, Jingfeng; Huang, Wanli; Zhou, Mincong; Li, Xujuan; Cai, Wei

    2013-10-01

    Sleep paralysis (SP) is a condition of unknown etiology that usually occurs when falling asleep or when awakening in which the individual remains conscious but is unable to control their voluntary movements. This case report is about a 68-year-old man with a 40-year history of symptoms of SP and associated panic attacks upon awakening. Neurological examination and neuroimaging identified no abnormalities. Five years before the current evaluation he had been diagnosed with depression and treated with various anti-depressants which ameliorated, but did not cure, his SP. However, this 40-year history of SP was abruptly terminated - and did not return over the subsequent two years - after adjunctive treatment with 2.5 mg olanzapine each night was added to his antidepressant.

  13. Change in level of productivity in the treatment of schizophrenia with olanzapine or other antipsychotics

    Directory of Open Access Journals (Sweden)

    Osuntokun Olawale

    2011-05-01

    Full Text Available Abstract Background When treating schizophrenia, improving patients' productivity level is a major goal considering schizophrenia is a leading cause of functional disability. Productivity level has been identified as the most preferred treatment outcome by patients with schizophrenia. However, little has been done to systematically investigate productivity levels in schizophrenia. We set out to better understand the change in productivity level among chronically ill patients with schizophrenia treated with olanzapine compared with other antipsychotic medications. We also assessed the links between productivity level and other clinical outcomes. Methods This post hoc analysis used data from 6 randomized, double-blind clinical trials of patients with schizophrenia or schizoaffective disorder, with each trial being of approximately 6 months duration. Change in productivity level was compared between olanzapine-treated patients (HGBG, n = 172; HGHJ, n = 277; HGJB, n = 171; HGLB, n = 281; HGGN, n = 159; HGDH, n = 131 and patients treated with other antipsychotic medications (separately vs. haloperidol [HGGN, n = 97; HGDH, n = 132], risperidone [HGBG, n = 167; HGGN, n = 158], quetiapine [HGJB, n = 175], ziprasidone [HGHJ, n = 271] and aripiprazole [HGLB, n = 285]. Productivity was defined as functional activities/work including working for pay, studying, housekeeping and volunteer work. Productivity level in the prior 3 months was assessed on a 5-point scale ranging from no useful functioning to functional activity/work 75% to 100% of the time. Results Chronically ill patients treated with olanzapine (OLZ experienced significantly greater improvement in productivity when compared to patients treated with risperidone (RISP (OLZ = 0.22 ± 1.19, RISP = -0.03 ± 1.17, p = 0.033 or ziprasidone (ZIP (OLZ = 0.50 ± 1.38, ZIP = 0.25 ± 1.27, p = 0.026, but did not significantly differ from the quetiapine, aripiprazole or haloperidol treatment groups. Among

  14. Olanzapine treatment of adolescent rats causes enduring specific memory impairments and alters cortical development and function.

    Directory of Open Access Journals (Sweden)

    Jean A Milstein

    Full Text Available Antipsychotic drugs are increasingly used in children and adolescents to treat a variety of psychiatric disorders. However, little is known about the long-term effects of early life antipsychotic drug treatment. Most antipsychotic drugs are potent antagonists or partial agonists of dopamine D2 receptors; atypical antipsychotic drugs also antagonize type 2A serotonin receptors. Dopamine and serotonin regulate many neurodevelopmental processes. Thus, early life antipsychotic drug treatment can, potentially, perturb these processes, causing long-term behavioral- and neurobiological impairments. Here, we treated adolescent, male rats with olanzapine on post-natal days 28-49. As adults, they exhibited impaired working memory, but normal spatial memory, as compared to vehicle-treated control rats. They also showed a deficit in extinction of fear conditioning. Measures of motor activity and skill, habituation to an open field, and affect were normal. In the orbital- and medial prefrontal cortices, parietal cortex, nucleus accumbens core and dentate gyrus, adolescent olanzapine treatment altered the developmental dynamics and mature values of dendritic spine density in a region-specific manner. Measures of motor activity and skill, habituation to an open field, and affect were normal. In the orbital- and medial prefrontal cortices, D1 binding was reduced and binding of GABA(A receptors with open Cl(- channels was increased. In medial prefrontal cortex, D2 binding was also increased. The persistence of these changes underscores the importance of improved understanding of the enduring sequelae of pediatric APD treatment as a basis for weighing the benefits and risks of adolescent antipsychotic drug therapy, especially prophylactic treatment in high risk, asymptomatic patients. The long-term changes in neurotransmitter receptor binding and neural circuitry induced by adolescent APD treatment may also cause enduring changes in behavioral- and

  15. Olanzapine Injection

    Science.gov (United States)

    ... of bed slowly, resting your feet on the floor for a few minutes before standing up.you should know that you may experience hyperglycemia (increases in your blood sugar) while you are taking this medication, even ...

  16. Betahistine co-treatment ameliorates dyslipidemia induced by chronic olanzapine treatment in rats through modulation of hepatic AMPKα-SREBP-1 and PPARα-dependent pathways.

    Science.gov (United States)

    Liu, Xuemei; Lian, Jiamei; Hu, Chang-Hua; Deng, Chao

    2015-10-01

    Second-generation antipsychotics including olanzapine are associated with weight gain, dyslipidemia and other metabolic disorders. Both animal and clinical studies have shown that co-treatment with betahistine (a histamine H1 receptor agonist/H3 receptor antagonist) is effective in controlling olanzapine-induced weight gain. In the present study, we investigate whether co-treatment with betahistine is able to prevent dyslipidemia induced by chronic olanzapine treatment and the underlying mechanisms. Female rats were orally administered with olanzapine (1 mg/kg, t.i.d.) for 3.5 consecutive weeks and then a 2.5-week drug withdrawal. Then, rats were divided into 4 groups for 5 weeks treatment: (1) vehicle, (2) olanzapine-only (1 mg/kg, t.i.d.), (3) betahistine-only (9.6 mg/kg, t.i.d.), and (4) olanzapine and betahistine (O+B) co-treatment. After completing treatment, hepatic mRNA expression was measured by qRT-PCR, while the protein levels were detected by western blot. In our study, olanzapine-only treatment significantly increased triglyceride accumulation and non-esterified fatty acids (NEFA), and upregulated mRNA expression of sterol regulatory element binding protein 1 (SREBP-1) and its target genes, while these alterations were ameliorated by O+B co-treatment. Hepatic AMP-activated protein kinase α (AMPKα) was activated in the O+B co-treatment group, with a significant reduction in nuclear SREBP-1 protein expression but an increased expression of peroxisome proliferator-activated receptor-α (PPARα) and its-responsive molecule(CPT1A), compared with olanzapine-only treatment. In addition, olanzapine significantly increased hepatic histamine H1 receptors, while O+B co-treatment significantly reversed them to normal levels. This study provided the first evidence that betahistine could act on hepatic H1 receptors via modulation of AMPKα-SREBP-1 and PPARα-dependent pathways to ameliorate olanzapine-induced dyslipidemia in rats.

  17. A VALIDATED RP-HPLC METHOD FOR THE SIMULTANEOUS ESTIMATION OF FLUOXETINE HYDROCHLORIDE AND OLANZAPINE IN PHARMACEUTICAL DOSAGE FORM

    Directory of Open Access Journals (Sweden)

    M.M.Eswarudu

    2012-04-01

    Full Text Available A simple, sensitive and precise reverse phase high performance liquid chromatographic method has been developed for the simultaneous estimation of Fluoxetine hydrochloride and Olanzapine in pharmaceutical dosage forms. The mobile phase consisted of Acetonitrile: pot.dihydrogen phosphate buffer: Triethylamine (0.2 % (0.1% v/v ortho phosphoric acid, PH 3.1 in the ratio of 40:60:0.2 v/v/v delivered at a flow rate of 1.0 ml / min and wavelength of detection at 233 nm. The retention times of Fluoxetine and Olanzapine were 1.96 min and 5.59 min respectively. The developed method was validated according to ICH guidelines. The proposed method can be used for determination of these drugs in combined dosage forms.

  18. Simultaneous Estimation of Fluoxetine HCl and Olanzapine in Bulk Drug and Pharmaceutical Formulation by Using UV-Visible Spectroscopy Method

    Directory of Open Access Journals (Sweden)

    Rubesh kumar S

    2011-01-01

    Full Text Available Present work is to carry out an analytical method development and validation of Fluoxetine HCl (FLU and Olanzapine (OLZ in bulk drug and pharmaceutical dosage form. The developed method is based upon simultaneous equations (Vierodt’s method by using UV/Visible spectroscopy. Both drugs come in the categories of anti- depressant and anti-psychotic agent. The developed method can be used for the simultaneous estimation of FLU and OLZ in pharmaceutical dosage form without separating from each other or from the excipients. Primarily the λ max of Fluoxetine HCl (FLU and Olanzapine (OLZ was determined as 226 and 258 nm respectively. The suggested method is validated by using ICH validation parameters like accuracy, precession, linearity and LOD and LOQ respectively. Accuracy study showed percentage recovery in the range of 97-102% w/w respectively. Precision studies were carried out for 6 successive absorbance and studied for their percentage relative standard deviation (%RSD was < 2%, LOD and LOQ was studied and the limit of detection and limit of quantification were found to be was 1-100 µg/ml for Olanzapine and Fluoxetine HCl, the slope of interception Y=0.23x6+0.054 (R2 0.993 and Y=0.222x6-0.014 (R 2 0.995 respectively. Relative standard deviation for Fluoxetine hydrochloride and Olanzapine were 0.4904 and 0.53969, the co-relation coefficient were 0.997 and 0.825 respectively. This procedure was applied successfully for the analysis of FLU and OLZ in bulk drug and Pharmaceutical preparations.

  19. Effects of quetiapine and olanzapine in patients with psychosis and violent behavior: a pilot randomized, open-label, comparative study

    Directory of Open Access Journals (Sweden)

    Gobbi G

    2014-05-01

    Full Text Available Gabriella Gobbi,1,2 Stefano Comai,1 Guy Debonnel1,2,† 1Neurobiological Psychiatric Unit, Department of Psychiatry, McGill University and McGill University Health Center, 2Institut Philippe Pinel, Department of Psychiatry, Université de Montréal, Montréal, QC, Canada †Guy Debonnel passed away on November 4, 2006 Objective: Patients suffering from psychosis are more likely than the general population to commit aggressive acts, but the therapeutics of aggressive behavior are still a matter of debate. Methods: This pilot randomized, open-label study compared the efficacy of quetiapine versus olanzapine in reducing impulsive and aggressive behaviors (primary endpoints and psychotic symptoms (secondary endpoints from baseline to days 1, 7, 14, 28, 42, 56, and 70, in 15 violent schizophrenic patients hospitalized in a maximum-security psychiatric hospital. Results: Quetiapine (525±45 mg and olanzapine (18.5±4.8 mg were both efficacious in reducing Impulsivity Rating Scale from baseline to day 70. In addition, both treatments reduced the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale, and Clinical Global Impression Scale scores at day 70 compared to baseline, and no differences were observed between treatments. Moreover, quetiapine, but not olanzapine, yielded an improvement of depressive symptoms in the items “depression” in Brief Psychiatric Rating Scale and “blunted affect” in Positive and Negative Syndrome Scale. Modified Overt Aggression Scale scores were also decreased from baseline to the endpoint, but due to the limited number of patients, it was not possible to detect a significant difference. Conclusion: In this pilot study, quetiapine and olanzapine equally decreased impulsive and psychotic symptoms after 8 weeks of treatment. Double-blind, large studies are needed to confirm the validity of these two treatments in highly aggressive and violent schizophrenic patients. Keywords: schizophrenia, aggression

  20. Association study of olanzapine-induced weight gain and therapeutic response with SERT gene polymorphisms in female schizophrenic patients.

    Science.gov (United States)

    Bozina, Nada; Medved, Vesna; Kuzman, Martina Rojnic; Sain, Ivica; Sertic, Jadranka

    2007-09-01

    We investigated the relationships between L/S promoter (SERTPR) and l/s intron2 (SERTin2) genetic variants of serotonin transporter (SERT) polymorphisms with olanzapine-induced weight gain and treatment response in 94 female schizophrenic patients treated with olanzapine for up to 3 months. Body mass index (BMI) was calculated for each patient prior to olanzapine administration and 3 months afterwards. To assess and evaluate improvement of clinical psychotic symptoms and therapeutic response to the antipsychotic, all patients were rated using the Positive and Negative Syndrome ScaLe (PANSS). Overall, the presence of S SERTPR allelic variant and SS genotype was associated with significantly higher weight gain in subjects who were non-obese at the time of admission. The presence of L SERTPR variant was associated with significantly better treatment response measured with total PANSS and general PANSS subscale, while the presence of l SERTin2 variant determined better treatment response only in several items. No evidence of linkage disequilibrium between the two loci was found in the sample. These findings identify genetic factors associated with oLanzapine-induced weight gain and treatment response in femaLe schizophrenic patients.

  1. Olanzapine and Betamethasone Are Effective for the Treatment of Nausea and Vomiting due to Metastatic Brain Tumors of Rectal Cancer

    Directory of Open Access Journals (Sweden)

    M. Suzuki

    2014-01-01

    Full Text Available Brain lesions originating from metastasis of colorectal cancer represent 3-5% of all brain metastases and are relatively rare. Of all distant metastases of colorectal cancer, those to the liver are detected in 22-29% of cases, while those to the lungs are detected in 8-18% of cases. In contrast, brain metastasis is quite rare, with a reported incidence ranging from 0.4 to 1.8%. Treatments for metastatic brain tumors include surgery, radiotherapy, chemotherapy and supportive care with steroids, etc. Untreated patients exhibit a median survival of only approximately 1 month. The choice of treatment for brain metastasis depends on the number of lesions, the patient's general condition, nerve findings and presence of other metastatic lesions. We herein report the case of a 78-year-old male who presented with brain metastases originating from rectal carcinoma. He suffered from nausea, vomiting, anorexia and vertigo during body movement. He received antiemetics, glycerol and whole brain radiation therapy; however, these treatments proved ineffective. Olanzapine therapy was started at a dose of 1.25 mg every night. The persistent nausea disappeared the next day, and the frequency of vomiting subsequently decreased. The patient was able to consume solid food. Olanzapine is an antipsychotic that has recently been used as palliative therapy for refractory nausea and vomiting in patients receiving chemotherapy. We consider that olanzapine was helpful as a means of supportive care for the treatment of nausea and vomiting due to brain metastasis.

  2. A Randomized, Double-Blind, Placebo-Controlled Pilot Study of Betahistine to Counteract Olanzapine-Associated Weight Gain.

    Science.gov (United States)

    Barak, Nir; Beck, Yaffa; Albeck, Joseph H

    2016-06-01

    Patients with schizophrenia experience higher rates of obesity and related morbidity and mortality than the general population does. Given preclinical studies revealing the role of histamine H1 receptor in human eating behavior, and the potential of olanzapine to block with this system, we hypothesized that histamine H1 receptor agonists may be beneficial in reducing antipsychotic-associated weight gain. In the present study, 36 patients with a diagnosis of schizophrenia or schizoaffective disorder and treated with olanzapine were randomized to betahistine (48 mg/d) or matching placebo for 16 weeks. Study outcomes were change in body weight from baseline and effect on antipsychotic efficacy of olanzapine. The patients in the betahistine group had less weight gain (-1.95 kg) compared with placebo group (5.6 + 5.5 kg vs 6.9 + 5.6 kg, respectively). Positive and Negative Syndrome Scale Questionnaire showed improvement within each group and that subjects treated with betahistine enjoyed an improvement (reduction) by a mean of 35.7 points, higher when compared with placebo subjects who had a reduction of 26.6 points (P = 0.233). An almost equal amount of subjects in both groups experienced adverse effects during the course of this study (87.5% of betahistine vs 85.0% of placebo-treated subjects). Overall, there were no clinically marked differences in safety signals between both groups. A larger study addressing the weaknesses of this pilot study is warranted.

  3. Predictors of continuation with olanzapine during the 1-year naturalistic treatment of patients with schizophrenia in Japan

    Directory of Open Access Journals (Sweden)

    Ye W

    2011-12-01

    Full Text Available Wenyu Ye1, Haya Ascher-Svanum2, Yuka Tanji3, Jennifer A Flynn3, Michihiro Takahashi3,41Lilly Suzhou Pharmaceutical Co, Shanghai, People’s Republic of China; 2Eli Lilly and Company, Indianapolis, IN, USA; 3Lilly Research Laboratories Japan, Eli Lilly Japan KK, Kobe, 4Terauchi-Takahashi Psychiatric Clinic, Ashiya, JapanPurpose: Treatment continuation is considered an important measure of antipsychotic effectiveness in schizophrenia, reflecting the medication’s efficacy, safety, and tolerability from both patients’ and clinicians’ perspectives. This study identified characteristics of patients with schizophrenia who continue olanzapine therapy for a 1-year period in Japan.Methods: In a large (N = 1850, prospective, observational study, Japanese patients with schizophrenia who initiated treatment with olanzapine were followed for 1 year. Baseline characteristics were compared using t-tests and chi-square tests. Stepwise logistic regression was used to identify independent baseline predictors of treatment continuation.Results: Most patients (68.2% continued with olanzapine therapy for the full 1-year study period, with an average duration of 265.5 ± 119.4 days. At baseline, patients who continued were significantly more likely to be male, older, and inpatients; have longer illness duration, higher negative and cognitive symptoms, better health-related quality of life, and prior anticholinergic use. Continuers were significantly less likely to engage in social activities, live independently, work for pay, or have prior antidepressant use. Continuers showed significantly greater early (3-month improvement in global symptom severity. Logistic regression found that continuation was significantly predicted by longer illness duration, lower positive symptoms, higher negative symptoms, and better health-related quality of life.Conclusions: In this large naturalistic study in Japan, most patients with schizophrenia stayed on olanzapine therapy for

  4. A double blind, placebo-controlled, randomized crossover study of the acute metabolic effects of olanzapine in healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Vance L Albaugh

    Full Text Available Atypical antipsychotics exhibit metabolic side effects including diabetes mellitus and obesity. The adverse events are preceded by acute worsening of oral glucose tolerance (oGTT along with reduced plasma free fatty acids (FFA and leptin in animal models. It is unclear whether the same acute effects occur in humans.A double blind, randomized, placebo-controlled crossover trial was conducted to examine the potential metabolic effects of olanzapine in healthy volunteers. Participants included male (8 and female (7 subjects [18-30 years old, BMI 18.5-25]. Subjects received placebo or olanzapine (10 mg/day for three days prior to oGTT testing. Primary endpoints included measurement of plasma leptin, oral glucose tolerance, and plasma free fatty acids (FFA. Secondary metabolic endpoints included: triglycerides, total cholesterol, high- and low-density lipoprotein cholesterol, heart rate, blood pressure, body weight and BMI. Olanzapine increased glucose Area Under the Curve (AUC by 42% (2808±474 vs. 3984±444 mg/dl·min; P = 0.0105 during an oGTT. Fasting plasma leptin and triglycerides were elevated 24% (Leptin: 6.8±1.3 vs. 8.4±1.7 ng/ml; P = 0.0203 and 22% (Triglycerides: 88.9±10.1 vs. 108.2±11.6 mg/dl; P = 0.0170, whereas FFA and HDL declined by 32% (FFA: 0.38±0.06 vs. 0.26±0.04 mM; P = 0.0166 and 11% (54.2±4.7 vs. 48.9±4.3 mg/dl; P = 0.0184, respectively after olanzapine. Other measures were unchanged.Olanzapine exerts some but not all of the early endocrine/metabolic changes observed in rodent models of the metabolic side effects, and this suggest that antipsychotic effects are not limited to perturbations in glucose metabolism alone. Future prospective clinical studies should focus on identifying which reliable metabolic alterations might be useful as potential screening tools in assessing patient susceptibility to weight gain and diabetes caused by atypical antipsychotics.ClinicalTrials.gov NCT00741026.

  5. Olanzapine-induced changes in glucose metabolism are independent of the melanin-concentrating hormone system.

    Science.gov (United States)

    Girault, Elodie M; Toonen, Pim W; Eggels, Leslie; Foppen, Ewout; Ackermans, Mariëtte T; la Fleur, Susanne E; Fliers, Eric; Kalsbeek, Andries

    2013-11-01

    Atypical antipsychotic drugs such as Olanzapine (Ola) induce weight gain and metabolic changes associated with the development of type 2 diabetes. The mechanisms underlying these undesired side-effects are currently unknown. Chagnon et al. showed that the common allele rs7973796 of the prepro-melanin-concentrating hormone (PMCH) gene is associated with a greater body mass index in Ola-treated schizophrenic patients. As PMCH encodes for the orexigenic neuropeptide melanin-concentrating hormone (MCH), it was hypothesized that MCH is involved in Ola-induced metabolic changes. We have recently reported that the intragastric infusion of Ola results in hyperglycaemia and insulin resistance in male rats. In order to test in vivo the possible involvement of the PMCH gene in the pathogenesis of Ola side-effects, we administered Ola intragastrically in wild-type (WT) and PMCH knock-out (KO) rats. Our results show that glucose and corticosterone levels, as well as endogenous glucose production, are elevated by the infusion of Ola in both WT and KO animals. Thus, the lack of MCH does not seem to affect the acute effects of Ola on glucose metabolism. On the other hand, these effects might be obliterated by compensatory changes in other hypothalamic systems. In addition, possible modulatory effects of the MCH KO on the long term effects of Ola, i.e. increased adiposity, body weight gain, have not been investigated yet.

  6. Zonisamide prevents olanzapine-associated hyperphagia, weight gain, and elevated blood glucose in rats.

    Science.gov (United States)

    Wallingford, Nicholas M; Sinnayah, Puspha; Bymaster, Frank P; Gadde, Kishore M; Krishnan, Ranga K; McKinney, Anthony A; Landbloom, Ronald P; Tollefson, Gary D; Cowley, Michael A

    2008-11-01

    Olanzapine (OLZ), one of the second-generation atypical antipsychotics (SGAs), has shown relative advantages in patient adherence and outcomes. However, OLZ has also been associated with a higher incidence of weight gain than most other SGAs. Excessive weight gain may in turn contribute to long-term health concerns for some individuals. Zonisamide (ZNS), a medication approved in the United States as an adjunct in the management of epilepsy, has a diverse pharmacological profile, including sodium channel blockade, monoamine enhancement, and inhibition of carbonic anhydrase. ZNS has also been reported to cause weight loss in both humans and rodents. We hypothesized that this profile might be beneficial when co-administered with OLZ. To test this hypothesis, we evaluated the effects of OLZ on body weight, as well as the pathways known to regulate feeding behavior and arousal in the Sprague-Dawley rat. As indicated via c-Fos expression, we found an OLZ-induced activation in the nucleus accumbens and orexin neurons in the lateral hypothalamus. An OLZ-associated development of hyperphagia, weight gain and elevated blood glucose in the rat was also found. These outcomes were attenuated and reversed in the presence of concomitant ZNS. These results suggest the hypothesis that ZNS may effectively treat or prevent weight gain or metabolic changes associated with the SGAs. Future studies of this combination in patients through appropriately designed human clinical studies are encouraged.

  7. Evaluation of striatal dopamine transporter density using ({sup 123}I)-{beta}-CIT SPECT in schizophrenic patients treated with olanzapine: pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chul Eung; Moon, Hey Won; Choe, Won Sick; Kim, Chang Ho; Chi, Dae Yoon [Inha Univ., Incheon (Korea, Republic of)

    2002-08-01

    This pilot study was performed to understand the pharmacological effect of olanzapine, an atypical antipsychotic agent, on dopamine transporter in schizophrenic patients. Six patients (3 male, 3 female) with schizophrenia, who had not taken any psychotropic drugs for at least four weeks, were studied. Nuclear imaging using ({sup 123}I)-{beta}-CIT SPECT was obtained before and after 4-week treatment with olanzapine. Analysis of ROI on the striatum, caudate nucleus, and putamen was performed. Post-treatment uptake was significantly increased in all the ROIs compared with pre-treatment uptake. This preliminary study with the small number of schizophrenic patients suggested an increase in uptake of dopamine transporter in the striatum, caudate nucleus, and putamen after 4-week treatment with olanzapine, which warrants a large-scaled controlled study to confirm the current findings.

  8. Delirium with anticholinergic symptoms after a combination of paliperidone and olanzapine pamoate in a patient known to smoke cannabis: an unfortunate coincidence.

    Science.gov (United States)

    Kokalj, Anja; Rijavec, Nikolina; Tavčar, Rok

    2016-06-22

    We report a case of delirium with anticholinergic symptoms in a 19-year-old female patient with schizophrenia. On the day the symptoms emerged, the patient received olanzapine long-acting injection and a higher dose of paliperidone. We observed symptoms ranging from confusion to delirium as well as some anticholinergic symptoms. The delirium lasted 24 hours and was managed by intravenous fluid substitution and oral benzodiazepines. Olanzapine pamoate, paliperidone and cannabis are central nervous system (CNS) depressants, and their combination can increase the risks of CNS depression. In this case report, we review the symptoms of delirium in a case of antipsychotic overdose and provide general guidelines for managing these symptoms. We also review possible complications in combined use of cannabis, olanzapine and paliperidone. 2016 BMJ Publishing Group Ltd.

  9. Improvement of dumping syndrome and oversecretion of glucose-dependent insulinotropic polypeptide following a switch from olanzapine to quetiapine in a patient with schizophrenia.

    Science.gov (United States)

    Watanabe, Aiko; Fukui, Naoki; Suzuki, Yutaro; Motegi, Takaharu; Igeta, Hirofumi; Tsuneyama, Nobuto; Someya, Toshiyuki

    2015-01-01

    Among the most important adverse effects of antipsychotics is abnormal glucose metabolism, which includes not only hyperglycemia but hyperinsulinemia and hypoglycemia. We have previously described five patients who experienced hypoglycemia during treatment with antipsychotics. Thus, an anamnesis of gastric surgery, which often causes dumping syndrome, and treatment with antipsychotics may synergistically induce hypoglycemia. We describe here a patient with schizophrenia under treatment of olanzapine and an anamnesis of gastric surgery, who experienced late dumping syndrome, hyperinsulinemia and overactivation of glucose-dependent insulinotropic polypeptide. Dumping syndrome, however, was improved after the patient was switched from olanzapine to quetiapine.

  10. Berberine Alleviates Olanzapine-Induced Adipogenesis via the AMPKα–SREBP Pathway in 3T3-L1 Cells

    OpenAIRE

    Yanjie Li; Xiaomin Zhao; Xiyu Feng; Xuemei Liu; Chao Deng; Chang-Hua Hu

    2016-01-01

    The aim of this study was to investigate the mechanisms underlying the inhibitory effects of berberine (BBR) on olanzapine (OLZ)-induced adipogenesis in a well-replicated 3T3-L1 cell model. Oil-Red-O (ORO) staining showed that BBR significantly decreased OLZ-induced adipogenesis. Co-treatment with OLZ and BBR decreased the accumulation of triglyceride (TG) and total cholesterol (TC) by 55.58% ± 3.65% and 49.84% ± 8.31%, respectively, in 3T3-L1 adipocytes accompanied by reduced expression of S...

  11. Clozapine and sulpiride but not haloperidol or olanzapine activate brain DNA demethylation.

    Science.gov (United States)

    Dong, E; Nelson, M; Grayson, D R; Costa, E; Guidotti, A

    2008-09-09

    Cortical GABAergic dysfunction, a hallmark of both schizophrenia (SZ) and bipolar (BP) disorder pathophysiologies may relate to the hypermethylation of GABAergic gene promoters (i.e., reelin and GAD67). Benefits elicited by a combination of atypical antipsychotics with valproate (VPA) (a histone deacetylase inhibitor that may also activate brain DNA demethylation) in SZ or BP disorder treatment prompted us to investigate whether the beneficial action of this association depends on induction of a putative DNA demethylase activity. To monitor this activity, we measured the ratio of 5-methyl cytosine to unmethylated cytosine in reelin and GAD67 promoters in the mouse frontal cortex and striatum. We compared normal mice with mice pretreated with l-methionine (5.2 mmol/kg s.c. twice a day for 7 days) to hypermethylate promoters, including reelin and GAD67. Clinically relevant doses of clozapine (CLZ) (3.8 to 15 micromol/kg twice a day s.c. for 3 days) and sulpiride (SULP) (12.5 to 50 micromol/kg twice a day for 3 days) but not clinically relevant doses of haloperidol (HAL) (1.3 to 4 micromol/kg twice a day s.c. for 3 days) or olanzapine (OLZ) (4 to 15 micromol/kg twice a day for 3 days) exhibited dose-related increases in the cortical and striatal demethylation of hypermethylated reelin and GAD67 promoters. These effects of CLZ and SULP were dramatically potentiated by a clinically relevant VPA dose (0.5 mmol/kg twice a day for 3 days). By activating a DNA demethylase, the association of CLZ or SULP with VPA may facilitate a chromatin remodeling that normalizes the GABAergic gene expression down-regulation detected in the telencephalic regions of SZ and BP patients.

  12. Acute Metabolic Effects of Olanzapine Depend on Dose and Injection Site

    Directory of Open Access Journals (Sweden)

    Candice M. Klingerman

    2015-11-01

    Full Text Available Atypical antipsychotics (AAPs, such as olanzapine (OLZ, are associated with metabolic side effects, including hyperglycemia. Although a central mechanism of action for the acute effects on glycemia has been suggested, evidence for peripheral versus central effects of AAPs has been mixed and has not been explored for an effect of OLZ on the respiratory exchange ratio (RER. Here, we tested the hypothesis that some inconsistencies in the glycemic responses are likely a result of different doses and central sites of injection. We also compared the effects of central versus peripherally administered OLZ on the RER of unsedated rats. Third ventricle infusion of OLZ at 0.3 mg/kg caused hyperglycemia within 30 minutes, with a higher dose (1.8 mg/kg needed to elicit a similar response in the lateral ventricles. In contrast, 3 mg/kg of OLZ was needed to raise blood glucose within 30 minutes when given intragastrically, and 10 mg/kg resulted in a prolonged hyperglycemia lasting at least 60 minutes. Third ventricle injection of OLZ significantly decreased RER after 75 minutes, whereas intragastric OLZ resulted in a faster drop in RER after 30 minutes. Since changes in glycemia were most sensitive when OLZ was infused into the third ventricle, but effects on RER were more rapidly and efficaciously observed when the drug was given peripherally, these results raise the likelihood of a dual mechanism of action involving hypothalamic and peripheral mechanisms. Some discrepancies in the literature arising from central administration appear to result from the injection site and dose.

  13. Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study

    Directory of Open Access Journals (Sweden)

    Strzelecki D

    2015-02-01

    Full Text Available Dominik Strzelecki, Justyna Szyburska, Magdalena Kotlicka-Antczak, Olga KałużyńskaDepartment of Affective and Psychotic Disorders, Medical University of Lódz, Central Clinical Hospital, Lódz, PolandAbstract: Glutamate is the main excitatory neurotransmitter in the central nervous system. Dysfunction of the glutamatergic system plays an important and well-established role in the pathogenesis of schizophrenia. Agents with glutamatergic properties such as N-methyl-D-aspartate receptor coagonists (ie, glycine, D-cycloserine and glycine transporter type 1 inhibitors (eg, sarcosine, bitopertin are investigated in schizophrenia with special focus on negative and cognitive symptomatology. In this article, we describe a case of a 34-year-old woman with diagnosis of schizophrenia with persistent moderate negative and cognitive symptoms, a participant of the Polish Sarcosine Study (PULSAR treated with olanzapine (25 mg per day and venlafaxine (75 mg per day. During ten weeks of sarcosine administration (2 g per day the patient’s activity and mood improved, but in the following 2 weeks, the patient reported decreased need for sleep, elevated mood, libido and general activity. We diagnosed drug-induced hypomania and recommended decreasing the daily dose of venlafaxine to 37.5 mg per day, which resulted in normalization of mood and activity in about 1 week. After this change, activity and mood remained stable and better than before adding sarcosine, and subsequent depressive symptoms were not noted. We describe here the second case report where sarcosine induced important affect changes when added to antidepressive and antipsychotic treatment, which supports the hypothesis of clinically important glutamate–serotonin interaction.Keywords: MNDA receptor, glutamatergic system, serotoninergic system

  14. Preparation of olanzapine and methyl-β-cyclodextrin complexes using a single-step, organic solvent-free supercritical fluid process: An approach to enhance the solubility and dissolution properties.

    Science.gov (United States)

    Rudrangi, Shashi Ravi Suman; Trivedi, Vivek; Mitchell, John C; Wicks, Stephen Richard; Alexander, Bruce David

    2015-10-15

    The purpose of this study was to evaluate a single-step, organic solvent-free supercritical fluid process for the preparation of olanzapine-methyl-β-cyclodextrin complexes with an express goal to enhance the dissolution properties of olanzapine. The complexes were prepared by supercritical carbon dioxide processing, co-evaporation, freeze drying and physical mixing. The prepared complexes were then analysed by differential scanning calorimetry, X-ray powder diffraction, scanning electron microscopy, solubility and dissolution studies. Computational molecular docking studies were performed to study the formation of molecular inclusion complexation of olanzapine with methyl-β-cyclodextrin. All the binary mixtures of olanzapine with methyl-β-cyclodextrin, except physical mixture, exhibited a faster and greater extent of drug dissolution than the drug alone. Products obtained by the supercritical carbon dioxide processing method exhibited the highest apparent drug dissolution. The characterisation by different analytical techniques suggests complete complexation or amorphisation of olanzapine and methyl-β-cyclodextrin complexes prepared by supercritical carbon dioxide processing method. Therefore, organic solvent-free supercritical carbon dioxide processing method proved to be novel and efficient for the preparation of solid inclusion complexes of olanzapine with methyl-β-cyclodextrin. The preliminary data also suggests that the complexes of olanzapine with methyl-β-cyclodextrin will lead to better therapeutic efficacy due to better solubility and dissolution properties.

  15. Factorial design based preparation, optimization, characterization and in vitro drug release studies of olanzapine loaded PLGA nanoparticles

    Science.gov (United States)

    Bohrey, Sarvesh; Chourasiya, Vibha; Pandey, Archna

    2016-12-01

    The objective of the present work was to develop and optimize olanzapine loaded polymeric nanoparticles using a factorial design. The presented work developed and optimized olanzapine loaded polymeric nanoparticles by using a 33 factorial design. The 33 factorial design was used for studying the effect of the main preparation variables on particle size and percent drug entrapment efficiency of the nanoparticles. A modified nanoprecipitation method was used to prepare nanoparticles successfully by using the biodegradable polymer poly(lactic-co-glycolic)acid (PLGA), and they were characterized for various parameters such as particle size, shape, zeta potential, percent drug entrapment efficiency, percent process yield and in vitro drug release behavior. Examination of the interaction between the excipients used as well as investigation of the nature of the drug, the formulation and the nature of the drug in the formulations was carried out by FTIR studies. Different kinetic models were used to analyze the in vitro drug release data. The preferred formulation showed a particle size of 127.6 ± 1.9 nm, PDI of 0.239 ± 0.013, zeta potential of -29.2 mV, entrapment efficiency of 72.46 ± 3.8% and process yield of 89.65 ± 1.3%. TEM results showed that these nanoparticles were spherical in shape and follow the Korsmeyer-Peppas model with different release exponent values.

  16. Characterization of rheology and release profiles of olanzapine-loaded lipid-core nanocapsules in thermosensitive hydrogel.

    Science.gov (United States)

    Dimer, F A; Pohlmann, A R; Guterres, S S

    2013-12-01

    In this study we developed a new drug delivery system for olanzanpine comprised of drug-loaded lipid-core nanocapsules incorporated in a thermosensitive hydrogel, intended to sustain the drug release. Firstly, olanzapine, a hydrophobic drug, was loaded in poly(epsilon-caprolactone) lipid core nanocapsules prepared by interfacial deposition of preformed polymer. The effects of the presence of ethanol and the amounts of sorbitan monostearate and medium-chain triglycerides on the particle size, zeta potential, polydispersity index, presence of microparticles and encapsulation efficiency were investigated using a 2(3) factorial design. The optimized nanocapsules were incorporated into a hydrophilic polymer (Poloxamer 407) dispersion in order to obtain a thermosensitive gel. The formulation containing 0.077 g of sorbitan monostearate, 0.22 ml of medium-chain triglycerides, 3 ml of ethanol and 18% of the thermosensitive polymer was selected according to the physicochemical properties. The rheology and release profiles of the mixed hydrophobic and hydrophilic delivery system were successfully characterized and revealed its great potential for the administration of hydrophobic drugs such as olanzapine with sustained in situ drug release.

  17. Efficacy and safety of olanzapine/fluoxetine combination in the treatment of treatment-resistant depression: a meta-analysis of randomized controlled trials

    Science.gov (United States)

    Luan, Shuxin; Wan, Hongquan; Wang, Shijun; Li, He; Zhang, Baogang

    2017-01-01

    Background Whether olanzapine/fluoxetine combination (OFC) is superior to olanzapine or fluoxetine monotherapy in patients with treatment-resistant depression (TRD) remains controversial. Thus, we conducted this meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of OFC with olanzapine or fluoxetine monotherapy for patients with TRD. Materials and methods RCTs published in PubMed, Embase, Web of Science, and the ClinicalTrials.gov registry were systematically reviewed to assess the efficacy and safety of OFC. Outcomes included mean changes from baseline in Montgomery–Asberg Depression Rating Scale (MADRS), Clinical Global Impression-Severity (CGI-S), Hamilton Rating Scale for Anxiety (HAM-A), Brief Psychiatric Rating Scale (BPRS) scores, response rate, remission rate, and adverse events. Results were expressed with weighted mean difference (WMD) with 95% confidence intervals (CIs) and risk ratio (RR) with 95% CIs. Results A total of five RCTs with 3,020 patients met the inclusion criteria and were included in this meta-analysis. Compared with olanzapine or fluoxetine monotherapy, OFC was associated with greater changes from baseline in MADRS (WMD =−3.37, 95% CI: −4.76, −1.99; Pfluoxetine monotherapy in the treatment of patients with TRD. Our results provided supporting evidence for the use of OFC in TRD. However, considering the limitations in this study, more large-scale, well-designed RCTs are needed to confirm these findings. PMID:28280343

  18. Bilateral lesions of the entorhinal cortex differentially modify haloperidol- and olanzapine-induced c-fos mRNA expression in the rat forebrain.

    Science.gov (United States)

    Seillier, A; Coutureau, E; Thiriet, N; Herbeaux, K; Zwiller, J; Di Scala, G; Will, B; Majchrzak, M

    2003-08-01

    Lesions of the entorhinal cortex are now an accepted model for mimicking some of the neuropathological aspects of schizophrenia, since evidence has accumulated for the presence of cytoarchitectonic abnormalities within this cortex in schizophrenic patients. The present study was undertaken to address the functional consequences of bilateral entorhinal cortex lesions on antipsychotic-induced c-fos expression. After a 15-day recovery period, the effect of a typical antipsychotic, haloperidol (1 mg/kg), on c-fos mRNA expression was compared with that of an atypical one, olanzapine (10 mg/kg), in both sham-lesioned and entorhinal cortex-lesioned rats. In sham-lesioned rats, both haloperidol and olanzapine induced c-fos expression in the caudal cingulate cortex, dorsomedial and dorsolateral caudate-putamen, nucleus accumbens core and shell and lateral septum. In addition, olanzapine, but not haloperidol, increased c-fos expression within the central amygdala. In entorhinal cortex-lesioned rats, haloperidol-induced c-fos expression was markedly reduced in most areas. In contrast, the olanzapine-induced c-fos expression was not altered in the nucleus accumbens shell and lateral septum of the lesioned rats. These findings reveal that entorhinal cortex lesions affect c-fos expression in a compound- and regional-dependent manner. Our results further emphasize the importance of the exploration of the mechanisms of action of antipsychotic drugs in the context of an associated cortical pathology.

  19. Schizophrenic patients treated with clozapine or olanzapine perform better on theory of mind tasks than those treated with risperidone or typical antipsychotic medications.

    Science.gov (United States)

    Savina, Ioulia; Beninger, Richard J

    2007-08-01

    Theory of mind (ToM), the ability to attribute mental states to others, is associated with medial prefrontal cortical (mPFC) activity and is impaired in schizophrenia. Olanzapine or clozapine but not typical antipsychotics or risperidone preferentially affect c-fos expression in mPFC in animals. We tested the hypothesis that schizophrenic patients treated with different antipsychotics would perform differently on ToM tasks. Groups receiving Typicals (n=23), Clozapine (n=18), Olanzapine (n=20) or Risperidone (n=23) and a Control group of healthy volunteers (n=24) were matched for age, gender, handedness and education. ToM functioning was assessed with picture sequence, second-order belief and faux-pas tests. Schizophrenic groups performed similarly to controls on non-ToM conditions. The Olanzapine and Clozapine groups performed similarly to Controls on ToM tasks. The Typicals and Risperidone groups performed worse than the other groups on ToM tasks. We concluded that ToM performance of schizophrenic patients is influenced by the antipsychotic they are taking. Our results suggest that olanzapine or clozapine but not typicals or risperidone may improve or protect ToM ability.

  20. Antiemetic Therapy With or Without Olanzapine in Preventing Chemotherapy-Induced Nausea and Vomiting in Patients With Cancer Receiving Highly Emetogenic Chemotherapy | Division of Cancer Prevention

    Science.gov (United States)

    This randomized phase III trial studies antiemetic therapy with olanzapine to see how well they work compared to antiemetic therapy alone in preventing chemotherapy-induced nausea and vomiting in patients with cancer receiving highly emetogenic (causes vomiting) chemotherapy. Antiemetic drugs, such as palonosetron hydrochloride, ondansetron, and granisetron hydrochloride, may help lessen or prevent nausea and vomiting in patients treated with chemotherapy. |

  1. One-year, randomized, open trial comparing olanzapine, quetiapine, risperidone and ziprasidone effectiveness in antipsychotic-naive patients with a first-episode psychosis.

    Science.gov (United States)

    San, Luis; Arranz, Belen; Perez, Victor; Safont, Gemma; Corripio, Iluminada; Ramirez, Nicolas; Dueñas, Rosa; Alvarez, Enric

    2012-12-30

    The aim of this study was to compare the 12-month effectiveness of several second-generation antipsychotic drugs, with that of haloperidol in never-treated patients with first-episode psychosis. In total, 114 patients without life time exposure to any psychotropic medication were randomized to haloperidol, olanzapine, risperidone, quetiapine or ziprasidone. Primary outcome was time to all-cause discontinuation. Secondary outcomes included discontinuation rates and symptom change as measured by the Positive and Negative Syndrome Scale (PANSS). The overall discontinuation rate 64%. At 12 months, the proportion of patients discontinuing treatment was 40.0% for olanzapine, 56.5% for quetiapine, 64.0% for risperidone, 80.0% for ziprasidone and 85.7% for haloperidol. Mean time to antipsychotic discontinuation was higher in patients randomized to second-generation antipsychotics than in those taking haloperidol. Significantly lower discontinuation was noted in patients on olanzapine than on haloperidol, or ziprasidone. Our results suggest that olanzapine might lead to longer treatment continuation in treatment naïve FEP patients than haloperidol and, possibly ziprasidone. Global psychopathology was significantly less reduced by haloperidol than with each individual SGA in this earliest phase of treatment. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Effect of olanzapine combined with modified electroconvulsive therapy on cytokines, sTNFRs and neural electrophysiological characteristics in patients with schizophrenia

    Institute of Scientific and Technical Information of China (English)

    Wei Cheng

    2016-01-01

    Objective:To analyze the effect of olanzapine combined with modified electroconvulsive therapy on cytokines, sTNFRs and neural electrophysiological characteristics in patients with schizophrenia.Methods:Patients with schizophrenia treated in our hospital between March 2013 and March 2016 were selected and randomly divided into two groups, the observation group received olanzapine combined with modified electroconvulsive therapy, and the control group received olanzapine therapy. After 6 weeks of treatment, serum levels of soluble tumor necrosis factor receptor (sTNFR), acute phase reaction proteins and brain function indexes as well as the neural electrophysiological characteristics were compared between the two groups.Results:After 6 weeks of treatment, serum sTNFRs, CRP, CER and AAG content of observation group were lower than those of control group while TRF content was higher than that of control group; serum brain function indexes NGF and BDNF content were higher than those of control group while GFAP, S100B, NSE and Hcy content were lower than those of control group; nerve electrophysiology indexes P300, LPP and ERN amplitude were higher than those of control group while LPP amplitude was lower than that of control group. Conclusions:Olanzapine combined with modified electroconvulsive therapy can optimize the condition of schizophrenia, reduce the abnormal degree of nerve electrophysiology and help to improve treatment outcome.

  3. Ziprasidone Vs Olanzapine in Recent-Onset Schizophrenia and Schizoaffective Disorder : Results of an 8-Week Double-Blind Randomized Controlled Trial

    NARCIS (Netherlands)

    Grootens, K. P.; van Veelen, N. M. J.; Peuskens, J.; Sabbe, B. G. C.; Thys, E.; Buitelaar, J. K.; Verkes, R. J.; Kahn, R. S.

    Introduction: Head-to-head comparisons of antipsychotics have predominantly included patients with chronic conditions. The aim of the present study was to compare the efficacy and tolerability of ziprasidone and olanzapine in patients with recent-onset schizophrenia. Methods: The study was an

  4. [Pattern and evolution of the prescription of olanzapine during one year: Results of the cohort study ECOL].

    Science.gov (United States)

    Gasquet, I; Flandre, P; Heurtebize, N; Deal, C; Perrin, E; Chartier, F; Fourrier-Réglat, A

    2009-02-01

    The necessary evidence of new therapies of clinical interest extends beyond clinical trials in a less controlled population and closer to clinical practice justified since several years the need of conducting observational, noninterventional studies. Observational studies must include epidemiological (quantitative observational) data to define prevalence and natural history of the target conditions. Moreover, pharmacological interventions in "naturalistic" patients populations, selected by clinicians as per clinical judgment within the scope of the target disease will allow to generate data to complement clinical trials. Clinical trials designed to show robust data on efficacy and tolerability particularly during registration trials must be complemented by robust observational research to confirm and better describe clinical effectiveness in the target population. A noninterventional, observational trial is a study where the medicinal product(s) is (are) prescribed in the usual manner in accordance with the terms of the marketing authorization. The assignment of the patient to a particular therapeutic strategy is not decided in advance by a trial protocol but falls within current practice and the prescription of the medicine is clearly separated from the decision to include the patient in the study. No additional diagnosis or monitoring procedures shall be applied to the patients and epidemiological methods shall be used for the analysis of collected data. Olanzapine is a new antipsychotic therapy registered in Europe for the treatment of schizophrenia since 1996. The primary objective of this observational research was to study the evolution of the olanzapine dosage under naturalistic settings. Secondary objectives included patients characteristics, severity of disease, therapeutic evolution and coprescriptions, in a patient's cohort, suffering from schizophrenia, adult patients, diagnosis based on ICD-10; patients were followed during a total of 12 months. The

  5. A randomized, double-blind, placebo-controlled study of rapid-acting intramuscular olanzapine in Japanese patients for schizophrenia with acute agitation

    Directory of Open Access Journals (Sweden)

    Katagiri Hideaki

    2013-01-01

    Full Text Available Abstract Background Olanzapine rapid-acting intramuscular (IM injection is an atypical antipsychotic drug already used overseas and recently approved in Japan. The objective of this study was to confirm the efficacy of rapid-acting IM olanzapine 10 mg was greater than IM placebo in patients with exacerbation of schizophrenia with acute psychotic agitation by comparing changes from baseline to 2 hours after the first IM injection, as measured by the Positive and Negative Syndrome Scale-Excited Component (PANSS-EC total score. Methods We conducted a placebo-controlled, randomized, double-blind, parallel-group study in Japanese patients diagnosed with schizophrenia according to the diagnostic criteria specified in the DSM-IV-TR. Patients were randomized to 2 treatment groups: IM olanzapine (10 mg or IM placebo. The primary efficacy outcome was the change in PANSS-EC from baseline to 2 hours after the first IM injection. Treatment groups were compared with an analysis of variance model which included treatment and site as factors. During the 24-hour treatment period, safety was assessed by clinical examination and laboratory investigations, electrocardiograms, extrapyramidal symptoms scales, and recording spontaneously reported adverse events. Results Of the 91 randomized patients, 90 patients (45 IM olanzapine-group; 45 IM placebo-group were in the full analysis set. The mean change of PANSS-EC total score from baseline to 2 hours after the first IM injection (mean±standard deviation was −9.2±4.5 for the IM olanzapine group and −2.8±5.6 for the IM placebo group. The difference between treatment groups was statistically significant (p Conclusion The efficacy of IM olanzapine 10 mg in patients with exacerbation of schizophrenia with acute psychotic agitation was greater than IM placebo in the primary efficacy measure, PANSS-EC. Intramuscular olanzapine 10 mg was shown to be generally safe and tolerable, and could be a new option for treatment

  6. Evaluation of the efficacy and safety of olanzapine as an adjunctive treatment for anorexia nervosa in adolescent females: a randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Moher David

    2008-01-01

    Full Text Available Abstract Background Anorexia Nervosa (AN is a serious, debilitating condition that causes significant physical, emotional, and functional impairment. The condition is characterized by destructive weight loss behaviours and a refusal to maintain body weight at or above a minimally normal weight for age and height. AN often develops in adolescence and is a predominantly female disorder. Treatment for AN typically involves medical, nutritional and psychological interventions. Pharmacotherapy is also often used; however, the literature on the effectiveness of these drugs in a pediatric population is very limited. Olanzapine, which is an 'atypical' antipsychotic, is becoming more widespread in the treatment of AN. Olanzapine is hypothesized to facilitate weight gain, while decreasing levels of agitation and decreasing resistance to treatment in young women with AN. This randomized, double-blind placebo-controlled trial seeks to examine the effectiveness and safety of olanzapine in female youth with AN. Methods/Design Adolescent females between the ages of 12 and 17 diagnosed with AN (either restricting or binge/purge type or Eating Disorder Not Otherwise Specified with a Body Mass Index of less than or equal to 17.5, will be offered inclusion in the study. Patients will be randomly assigned to receive either olanzapine or placebo. Patients assigned to receive olanzapine will start at a low dose of 1.25 mg/day for three days, followed by 2.5 mg/day for four days, 5 mg/day for one week, then 7.5 mg/day (the target dose chosen for 10 weeks. After 10 weeks at 7.5 mg the medication will be tapered and discontinued over a period of two weeks. The effectiveness of olanzapine versus placebo will be determined by investigating the change from baseline on measures of eating attitudes and behaviors, depression and anxiety, and change in Body Mass Index at week 12, and after a follow-up period at week 40. It is anticipated that 67 participants will be recruited

  7. Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial.

    Directory of Open Access Journals (Sweden)

    Ali Mostafavi

    2014-10-01

    Full Text Available Olanzapine is the frequently prescribed drug in children and adolescents with bipolar disorder, but unfortunately it has metabolic side-effects. On the other hand, in a number of melatonin studies on sleep cycle, regulation of metabolic abnormalities has been reported. Therefore, we aimed to study effects of melatonin in reducing metabolic side-effects of olanzapine in 11-17 year-old patients with bipolar disorder. Seventy-seven 11-17 year-old outpatients entered into the study after their initial diagnosis of bipolar mood disorder by a psychiatrist. After assessing inclusion and exclusion criteria, 48 patients consented to participate in the study. Of this number, 24 patients were allocated to olanzapine, lithium carbonate, and melatonin and 24 patients were allocated to olanzapine, lithium carbonate, and placebo. Young mania rating scale was performed at baseline. Before treatment initiation and at sixth and twelfth weeks after treatment, Lipid profile, Fasting Blood Sugar (FBS, Systolic Blood Pressure (SBP and Diastolic Blood Pressure (DBP were measured. ANOVA with repeated measure and independent sample t-test were used for data analysis. Nineteen patients in each group completed the study and yielded data for analysis.  ANOVA with repeated measure showed that FBS and Triglyceride (TG (especially in boys demonstrated greater increase in the placebo group compared to the melatonin group but the differences were not statistically significant. Melatonin significantly inhibited the rise in Total Cholesterol levels compared to placebo (P=0.032. Mean SBP rose more slowly in the melatonin group (1.05mmHg compared to placebo (6.36 mmHg (P=0.023. The trends in DBP did not show any significant pattern. Administration of melatonin along with olanzapine and lithium carbonate could significantly inhibit the rise in cholesterol level and SBP compared to placebo. The effect of melatonin on TG was more obvious in boys. Melatonin was more effective in

  8. Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial.

    Science.gov (United States)

    Mostafavi, Ali; Solhi, Mahmoud; Mohammadi, Mohammad-Reza; Hamedi, Mehdi; Keshavarzi, Maryam; Akhondzadeh, Shahin

    2014-01-01

    Olanzapine is the frequently prescribed drug in children and adolescents with bipolar disorder, but unfortunately it has metabolic side-effects. On the other hand, in a number of melatonin studies on sleep cycle, regulation of metabolic abnormalities has been reported. Therefore, we aimed to study effects of melatonin in reducing metabolic side-effects of olanzapine in 11-17 year-old patients with bipolar disorder. Seventy-seven 11-17 year-old outpatients entered into the study after their initial diagnosis of bipolar mood disorder by a psychiatrist. After assessing inclusion and exclusion criteria, 48 patients consented to participate in the study. Of this number, 24 patients were allocated to olanzapine, lithium carbonate, and melatonin and 24 patients were allocated to olanzapine, lithium carbonate, and placebo. Young mania rating scale was performed at baseline. Before treatment initiation and at sixth and twelfth weeks after treatment, Lipid profile, Fasting Blood Sugar (FBS), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) were measured. ANOVA with repeated measure and independent sample t-test were used for data analysis. Nineteen patients in each group completed the study and yielded data for analysis.  ANOVA with repeated measure showed that FBS and Triglyceride (TG) (especially in boys) demonstrated greater increase in the placebo group compared to the melatonin group but the differences were not statistically significant. Melatonin significantly inhibited the rise in Total Cholesterol levels compared to placebo (P=0.032). Mean SBP rose more slowly in the melatonin group (1.05mmHg) compared to placebo (6.36 mmHg) (P=0.023). The trends in DBP did not show any significant pattern. Administration of melatonin along with olanzapine and lithium carbonate could significantly inhibit the rise in cholesterol level and SBP compared to placebo. The effect of melatonin on TG was more obvious in boys. Melatonin was more effective in prevention of

  9. Schizophrenia symptoms and functioning in patients receiving long-term treatment with olanzapine long-acting injection formulation

    DEFF Research Database (Denmark)

    Peuskens, Joseph; Porsdal, Vibeke; Pecenak, Jan;

    2012-01-01

    ABSTRACT: BACKGROUND: This analysis of pooled data evaluates maintenance treatment outcomes of patients with schizophrenia receiving maintenance treatment with olanzapine long-acting injection (OLAI) by means of a categorical approach addressing the symptomatic and functional status of patients...... at different times. METHODS: Patients were grouped into 5 categories at baseline, 6 months, and 12 months. Shifts between categories were assessed for individual patients and factors associated with improvement were analyzed. 1182 patients from 3 clinical trials were included in the current analysis. RESULTS......: At baseline, 434 (36.8%) patients had minimal Positive and Negative Syndrome Scale (PANSS) symptoms but seriously impaired Heinrich Carpenter's Quality of Life Scale (QLS) functioning; 303 (25.6%) had moderate to severe symptoms and seriously impaired function; 208 (17.6%) had mild to moderate symptoms...

  10. Involvement of oxidative stress and mitochondrial/lysosomal cross-talk in olanzapine cytotoxicity in freshly isolated rat hepatocytes.

    Science.gov (United States)

    Eftekhari, Aziz; Azarmi, Yadollah; Parvizpur, Alireza; Eghbal, Mohammad Ali

    2016-01-01

    1. Olanzapine (OLZ) is a widely used atypical antipsychotic agent for the treatment of schizophrenia and other disorders. Serious hepatotoxicity and elevated liver enzymes have been reported in patients receiving OLZ. However, the cellular and molecular mechanisms of the OLZ hepatotoxicity are unknown. 2. In this study, the cytotoxic effect of OLZ on freshly isolated rat hepatocytes was assessed. Our results showed that the cytotoxicity of OLZ in hepatocytes is mediated by overproduction of reactive oxygen species (ROS), mitochondrial potential collapse, lysosomal membrane leakiness, GSH depletion and lipid peroxidation preceding cell lysis. All the aforementioned OLZ-induced cellular events were significantly (p lysosomal involvement following the initiation of oxidative stress in hepatocytes.

  11. Atypical antipsychotics olanzapine, quetiapine, and risperidone and risk of acute major cardiovascular events in young and middle-aged adults

    DEFF Research Database (Denmark)

    Pasternak, Björn; Svanström, Henrik; Ranthe, Mattis F

    2014-01-01

    risperidone (n = 14,134). The primary outcome was any major cardiovascular event (composite of cardiovascular mortality, acute coronary syndrome, or ischemic stroke) within 1 year following treatment initiation. Cox regression was used to estimate hazard ratios (HRs) while on current antipsychotic monotherapy......BACKGROUND: A number of serious cardiovascular safety concerns related to the use of atypical antipsychotics, compared with no use, have emerged, but nearly all reports are from studies of older patients. We aimed to compare the risk of cardiovascular events between the three most commonly used...... in the outpatient setting, adjusting for an outcome-specific disease risk score. RESULTS: The crude rate of any major cardiovascular event was 5.3 per 1,000 person-years among olanzapine users, 3.4 in quetiapine users, and 5.2 in risperidone users. Compared with risperidone, the risk of any major cardiovascular...

  12. Frequency of sexual dysfunction and other reproductive side-effects in patients with schizophrenia treated with risperidone, olanzapine, quetiapine, or haloperidol: the results of the EIRE study.

    Science.gov (United States)

    Bobes, J; Garc A-Portilla, M P; Rejas, J; Hern Ndez, G; Garcia-Garcia, M; Rico-Villademoros, F; Porras, A

    2003-01-01

    Atypical antipsychotics seem to differ mainly in their tolerability profile. The aim of this cross-sectional study, the Estudio de Investigaci n de Resultados en Esquizofrenia (Outcomes Research Study in Schizophrenia; EIRE study), was to assess in a clinical setting the frequency of several side-effects related to haloperidol, risperidone, olanzapine, and quetiapine. This article addresses sexual dysfunction and other reproductive side-effects (gynecomastia, menorrhage, amenorrhea, and galactorrhea). We recruited outpatients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) criteria and who had received a single antipsychotic (risperidone, olanzapine, quetiapine, or haloperidol) for at least 4 weeks. During a single visit, we collected data, including demographic and clinical characteristics, current antipsychotic and concomitant treatment, and adverse effects listed in a modified version of the UKU Scale. We used a Chi-squared test to determine pairs comparisons of the frequency of adverse reactions between treatments. To estimate risk of a given adverse reaction with a given treatment, we used a logistic regression method. We assessed 636 evaluable patients out of 669 recruited. Frequency of sexual dysfunction was high with haloperidol (38.1%) and also with olanzapine (35.3%), quetiapine (18.2%), and risperidone (43.2%). We found the frequency of other reproductive side-effects to be relatively low with all four drugs: haloperidol (6.9%), olanzapine (6.4%), quetiapine (2.7%), and risperidone (11.7%). Sexual dysfunction appeared to be dose-related with haloperidol, risperidone, and olanzapine. Risperidone and olanzapine showed a higher risk of sexual dysfunction and other reproductive sideeffects than haloperidol. Quetiapine showed a lower risk of sexual dysfunction during short-term treatment ( 12 weeks) are lacking. Our results suggest that none of the atypical

  13. Clinical outcomes with olanzapine long-acting injection: impact of the 3-hour observation period on patient satisfaction and well-being

    Directory of Open Access Journals (Sweden)

    Anand E

    2016-10-01

    Full Text Available Ernie Anand,1 Lovisa Berggren,2 John Landry,3 Ágoston Tóth,4 Holland C Detke5 1Neuroscience Medical Affairs, Eli Lilly & Company Ltd, Windlesham, UK; 2Global Statistical Sciences, Lilly Deutschland GmbH, Bad Homburg, Germany; 3Global Statistical Sciences, Eli Lilly Canada Inc., Toronto, ON, Canada; 4Neuroscience, Lilly Hungary, Budapest, Hungary; 5Psychiatry and Pain Disorders, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA Background: The objective of the present analysis is to determine the impact of the 3-hour observation period for olanzapine long-acting injection (LAI on patient satisfaction and well-being by comparing data collected before and after its implementation. Methods: This is a post hoc analysis of patients treated with olanzapine LAI in 1 a 6-month fixed-dose randomized controlled trial and/or 2 a 6-year open-label safety study. This analysis was limited to patients with schizophrenia who were treated with olanzapine LAI consistent with the approved indication and dosing recommendations of the European Union Summary of Product Characteristics (N=966. Of the 966 patients, the analysis further focused only on those patients who received both 1 at least one injection before the implementation of the 3-hour observation period and 2 at least one injection after implementation of the 3-hour observation period (N=487. Patient satisfaction was assessed with the three-item Patient Satisfaction with Medication Questionnaire-Modified. Responses were averaged across all postbaseline visits occurring before (ie, without the implementation of the 3-hour observation period and across all postbaseline visits occurring after (ie, with the implementation of the 3-hour observation period. In addition, the rate of postinjection delirium/sedation syndrome events was calculated. Results: There was no meaningful change after implementation of the 3-hour observation period in satisfaction (before: mean [SD] =4.0 [1.02] and

  14. Anthropometric parameters as indicators of metabolic derangements in schizophrenia patients stabilized on olanzapine in an Indian rural population

    Directory of Open Access Journals (Sweden)

    Jayanta Kumar Rout

    2012-01-01

    Full Text Available Context: For any given body mass, Asian Indians have higher central obesity than Europeans. A periodic measurement of body mass index (BMI and waist hip ratio (WHR is practically more feasible than other parameters of metabolic syndrome by repeated blood collection. However, few studies are available on the relative importance of BMI and WHR as markers of dyslipidemia and insulin resistance in schizophrenia patients stabilized on second generation antipsychotics in Indian population. Aim: We conducted the present study on such patients to examine whether BMI or WHR can better predict dyslipidemia and insulin resistance in these patients in a rural area. Settings and Design: The study was a hospital based case control study under rural settings on 38 schizophrenia patients stabilized on olanzapine and 30 matched controls. Materials and Methods: Fasting concentrations of blood glucose, lipid parameters and serum insulin were assessed. Data for Homeostatic model for assessment of insulin resistance (HOMA-IR, BMI, and WHR were obtained to assess the insulin resistance, overall body fat distribution and abdominal fat dispensation respectively. Statistical analysis used: ′t′ test was performed to assay any difference in corresponding mean values between cases and controls. Dependence of HOMA-IR on key parameters was assessed by analysis of co-variance (ANCOVA study. Results: Cases exhibited significantly higher values for HOMA-IR, serum triglyceride and low density lipoprotein cholesterol (LDLc with a significantly lower high density lipoprotein cholesterol (HDLc level. ANCOVA study reflected that irrespective of age and sex, HOMA-IR was dependent on serum triglyceride level and WHR (F=8.3 and 5.7 respectively, P<0.05, but not on BMI (F<0.001, P=0.997. Conclusions: Central obesity could be more closely associated with the pathogenesis of prediabetic state in our case group. So, WHR is a better anthropometric parameter than BMI for an early

  15. Effect of Liraglutide Treatment on Prediabetes and Overweight or Obesity in Clozapine- or Olanzapine-Treated Patients With Schizophrenia Spectrum Disorder

    DEFF Research Database (Denmark)

    Larsen, Julie R; Vedtofte, Louise; Jakobsen, Mathilde S L

    2017-01-01

    Importance: Compared with the general population, patients with schizophrenia have a 2- to 3-fold higher mortality rate primarily caused by cardiovascular disease. Previous interventions designed to counteract antipsychotic-induced weight gain and cardiometabolic disturbances reported limited...... effects. Objectives: To determine the effects of the glucagon-like peptide-1 receptor agonist liraglutide added to clozapine or olanzapine treatment of schizophrenia spectrum disorders. Design, Setting, and Participants: This randomized clinical double-blind trial enrolled participants at 2 clinical sites...... in Denmark. Of 214 eligible participants with a schizophrenia spectrum disorder, 103 were randomized to liraglutide or placebo. Participants received stable treatment with clozapine or olanzapine, were overweight or obese, and had prediabetes. Data were collected from May 1, 2013, through February 25, 2016...

  16. Downregulation of 5-HT7 Serotonin Receptors by the Atypical Antipsychotics Clozapine and Olanzapine. Role of Motifs in the C-Terminal Domain and Interaction with GASP-1.

    Science.gov (United States)

    Manfra, Ornella; Van Craenenbroeck, Kathleen; Skieterska, Kamila; Frimurer, Thomas; Schwartz, Thue W; Levy, Finn Olav; Andressen, Kjetil Wessel

    2015-07-15

    The human 5-HT7 serotonin receptor, a G-protein-coupled receptor (GPCR), activates adenylyl cyclase constitutively and upon agonist activation. Biased ligands differentially activate 5-HT7 serotonin receptor desensitization, internalization and degradation in addition to G protein activation. We have previously found that the atypical antipsychotics clozapine and olanzapine inhibited G protein activation and, surprisingly, induced both internalization and lysosomal degradation of 5-HT7 receptors. Here, we aimed to determine the mechanism of clozapine- and olanzapine-mediated degradation of 5-HT7 receptors. In the C-terminus of the 5-HT7 receptor, we identified two YXXΦ motifs, LR residues, and a palmitoylated cysteine anchor as potential sites involved in receptor trafficking to lysosomes followed by receptor degradation. Mutating either of these sites inhibited clozapine- and olanzapine-mediated degradation of 5-HT7 receptors and also interfered with G protein activation. In addition, we tested whether receptor degradation was mediated by the GPCR-associated sorting protein-1 (GASP-1). We show that GASP-1 binds the 5-HT7 receptor and regulates the clozapine-mediated degradation. Mutations of the identified motifs and residues, located in or close to Helix-VIII of the 5-HT7 receptor, modified antipsychotic-stimulated binding of proteins (such as GASP-1), possibly by altering the flexibility of Helix-VIII, and also interfered with G protein activation. Taken together, our data demonstrate that binding of clozapine or olanzapine to the 5-HT7 receptor leads to antagonist-mediated lysosomal degradation by exposing key residues in the C-terminal tail that interact with GASP-1.

  17. Tolerability and efficacy of paliperidone ER compared to olanzapine in the treatment of schizophrenia: A randomized, double-blind, multicentric trial

    Directory of Open Access Journals (Sweden)

    Sandip Shah

    2011-01-01

    Full Text Available Background: Paliperidone is an active metabolite of risperidone and actss through a combination of central dopamine Type 2 (D2 and serotonin Type 2 (5HT2A receptor antagonism. Aim: The present randomized, double-blind, multicentric trial was designed to determine the safety and efficacy of paliperidone extended release (ER compared to olanzapine in the treatment of acute schizophrenia. Materials and Methods: A total of 214 patients with diagnosis of schizophrenia were randomized to paliperidone ER (n=109 and olanzapine (n=106 treatment groups. Totally 206 patients were evaluated for efficacy parameters using Positive and negative syndrome scale (PANSS score and Clinical Global Impression-severity of illness (CGI-S and Clinical Global Impression-improvement of illness (CGI-I scales. Safety was assessed by treatment-emergent adverse events and movement disorders. Results: All patients showed significant reduction in PANSS scores at the end of treatment. However, the results were comparable and there was no significant difference at the end of the trial between paliperidone ER group and olanzapine group. Both the treatment groups showed decrease in the severity of illness and improvement in symptomatology. The most common adverse events reported in paliperidone ER versus olanzapine group were Extra Pyramidal Syndrome (EPS (13.7% vs. 15.6%, headache (12.7% vs. 8.9%, increased appetite (8.8% vs. 10.0% and drowsiness (4.9% vs. 303%. There was no clinically relevant difference in change from baseline to the end of the trial in abnormal involuntary movement scale (AIMS and barnes akathisia rating scale (BARS total scores between both the groups. Conclusion: Paliperidone ER is effective in controlling schizophrenic symptoms as well as exhibits comparable tolerability profile. Thus, paliperidone ER has the potential to be a useful new treatment option for patients with schizophrenia.

  18. The Effects of Eight-Week Treatment with High Dose Vitamin E on Serum Cholesterol and Triglyceride Level of Patients with Schizophrenia on Olanzapine: A Placebo Controlled Study

    Directory of Open Access Journals (Sweden)

    Firoozeh Raisi

    2008-01-01

    Full Text Available "n  "n Objective: To study the effects of a high dose alpha-tocopherol on serum total cholesterol (TC, triglyceride (TG, and the high density lipoprotein (HDL levels of patients with schizophrenia receiving olanzapine. "nMethod: Thirty six adults diagnosed with schizophrenia based on DSM-IV who were taking olanzapine for a minimum of thirty days entered this eight-week, double blind, placebo-controlled study. Patients were randomized to receive alpha-tocopherol 400IU or placebo capsules twice a day for 2 weeks, then three times a day for 6 more weeks. Fasting total cholesterol (TC, triglyceride(TG,and HDL levels were measured at the baseline and weeks 4 and 8. "nResults: "nTC, TG and HDL levels did not change significantly during this study. There were no significant differences in TC, TG and HDL levels between the two groups at the baseline and weeks 4 and 8. "nConclusion: High-dose vitamin may not improve triglyceride and cholesterol levels in patients who are already on olanzapine. Further studies with greater number of patients and for a longer duration are needed.

  19. Expression Changes of Serotonin Receptor Gene Subtype 5HT3a in Peripheral Blood Mononuclear Cells from Schizophrenic Patients Treated with Haloperidol and Olanzapin

    Directory of Open Access Journals (Sweden)

    Gholam Reza Shariati

    2009-09-01

    Full Text Available Serotonin receptors are involved in pathophysiology of schizophrenia and may mediate other neurotransmitter effects. We investigated serotonin receptors gene expression in peripheral blood mononuclear cells (PBMC of naïve schizophrenic patients, before and after treatment. Also serotonin receptor gene expression was compared in two treatment groups including Haloperidol and Olanzapine. The PBMC was separated from whole blood by Ficoll-hypaque. The total cellular RNA was extracted and the cDNA was synthesized. This process was followed by real-time PCR using primer pairs specific for 5HT3a serotonin receptor mRNA and beta-actin as internal control. The results showed the presence of subtype of serotonin receptor in lymphocytes. Serotonin gene expression showed significant changes in Olanzapine treatment group which correlated with Clinical Global Impression (CGI score improvement. In conclusion, the present study has shown that human PBMC express serotonin receptors 5HT3a. Moreover, clinical symptom improvement of Olanzapin may be demonstrated by a change in serotonin receptor gene expression.

  20. The effect of betahistine, a histamine H1 receptor agonist/H3 antagonist, on olanzapine-induced weight gain in first-episode schizophrenia patients.

    Science.gov (United States)

    Poyurovsky, Michael; Pashinian, Artashes; Levi, Aya; Weizman, Ronit; Weizman, Abraham

    2005-03-01

    Histamine antagonism has been implicated in antipsychotic drug-induced weight gain. Betahistine, a histamine enhancer with H1 agonistic/H3 antagonistic properties (48 mg t.i.d.), was coadministered with olanzapine (10 mg/day) in three first-episode schizophrenia patients for 6 weeks. Body weight was measured at baseline and weekly thereafter. Clinical rating scales were completed at baseline and at week 6. All participants gained weight (mean weight gain 3.1+/-0.9 kg) and a similar pattern of weight gain was observed: an increase during the first 2 weeks and no additional weight gain (two patients) or minor weight loss (one patient) from weeks 3 to 6. None gained 7% of baseline weight, which is the cut-off for clinically significant weight gain. Betahistine was safe and well tolerated and did not interfere with the antipsychotic effect of olanzapine. Our findings justify a placebo-controlled evaluation of the putative weight-attenuating effect of betahistine in olanzapine-induced weight gain.

  1. Physicochemical characterization and in vitro dissolution behavior of olanzapine-mannitol solid dispersions

    Directory of Open Access Journals (Sweden)

    Venkateskumar Krishnamoorthy

    2012-06-01

    Full Text Available The objective of the present work is to study the dissolution behavior of olanzapine from its solid dispersions with mannitol. Solid dispersions were prepared by melt dispersion method and characterized by phase solubility studies, drug content and in vitro dissolution studies. The best releasing dispersions were selected from release data, dissolution parameters and their release profiles. Solid state characterization techniques like Fourier transform infrared (FT-IR spectroscopy, X-ray diffractometry, differential scanning calorimetry, near-infrared and Raman spectroscopy were used to characterize the drug in selected dispersions. The dispersions were also evaluated by wettability studies and permeation studies. The results of phase solubility studies and the thermodynamic parameters indicated the spontaneity and solubilization effect of the carrier. The release study results showed greater improvement of drug release from solid dispersions compared to pure drug, and the release was found to increase with an increase in carrier content. The possible mechanism for increased release rate from dispersions may be attributed to solubilization effect of the carrier, change in crystal quality, phase transition from crystalline to amorphous state, prevention of agglomeration or aggregation of drug particles, change in surface hydrophobicity of the drug, and increased wettability and dispersability of the drug in dissolution medium. The suggested reasons for increased release rate from dispersions were found to be well supported by results of solid state characterization, wettability and permeation studies. The absence of any interaction between the drug and the carrier was also proved by FT-IR analysis.O objetivo do presente trabalho é estudar o comportamento de dissolução da olanzapina a partir de suas dispersões sólidas de manitol. As dispersões sólidas foram preparadas por dispersão por fusão e caracterizadas por estudos de solubilidade de

  2. Effects of switching from olanzapine to aripiprazole on the metabolic profiles of patients with schizophrenia and metabolic syndrome: a double-blind, randomized, open-label study

    Directory of Open Access Journals (Sweden)

    Wani RA

    2015-03-01

    Full Text Available Rayees Ahmad Wani, Mansoor Ahmad Dar, Rajesh Kumar Chandel, Yasir Hassan Rather, Inaamul Haq, Arshad Hussain, Altaf Ahmad MallaDepartment of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, IndiaBackground: Patients with schizophrenia suffer high rates of metabolic derangements on some antipsychotic medications that predispose them to cardiovascular diseases. Keeping this fact in mind, we planned this open-label study to see the effect on various metabolic parameters after switching stable schizophrenia subjects, who had developed metabolic syndrome on olanzapine, to aripiprazole.Methods: Sixty-two patients with schizophrenia who were stable on olanzapine and were fulfilling modified National Cholesterol Education Program (NCEP Adult Treatment Panel III (ATP-III criteria for the presence of metabolic syndrome were enrolled on the study. Patients were randomly assigned either to switch to aripiprazole or to stay on olanzapine, on a 1:1 basis. Cross-tapering over a period of 1 month was done while switching patients to aripiprazole. Laboratory assessment for metabolic parameters was done at baseline, 8 weeks, and 24 weeks after enrollment; efficacy assessment was done using the Positive and Negative Syndrome Scale (PANSS at baseline and 24 weeks, the Clinical Global Impressions severity subscale (CGI-S at baseline, and the Clinical Global Impressions improvement subscale (CGI-I at 24 weeks.Results: All parameters of metabolic syndrome (waist circumference, blood pressure, triglyceride level, fasting blood glucose, and high-density lipoprotein cholesterol kept deteriorating in the stay group, compared with a continuous improvement in the switch group over time. At the end of the study, 26 patients (100% from the stay group and 15 patients (42.8% from switch group met the modified NCEP ATP-III criteria for presence of metabolic syndrome (P<0.001. There were no statistically significant differences between groups in

  3. Quality of life in children and adolescents with bipolar I depression treated with olanzapine/fluoxetine combination.

    Science.gov (United States)

    Walker, Daniel J; DelBello, Melissa P; Landry, John; D'Souza, Deborah N; Detke, Holland C

    2017-01-01

    We examined the efficacy of olanzapine/fluoxetine combination (OFC) in improving health-related quality of life (QoL) in the treatment of bipolar depression in children and adolescents. Patients aged 10-17 years with bipolar I disorder, depressed episode, baseline children's depression rating scale-revised (CDRS-R) total score ≥40, Young Mania Rating Scale (YMRS) total score ≤15, and YMRS-item 1 ≤ 2 were randomized to OFC (6/25-12/50 mg/day olanzapine/fluoxetine; n = 170) or placebo (n = 85) for up to 8 weeks of double-blind treatment. Patients and parents completed the revised KINDL questionnaire for measuring health-related QoL in children and adolescents (KINDL-R) at baseline and endpoint. The mean change in CDRS-R total and item scores were used to compare improvement in symptomatology in patients taking OFC and placebo. Tests were 2-sided using a Type I error cutoff of 0.05, and no adjustments for multiple comparisons were made. Baseline QoL as measured by the KINDL-R was substantially impaired relative to published norms for a healthy school-based sample. OFC-treated patients demonstrated an improvement over placebo at endpoint with respect to mean change from baseline in the patient-rated KINDL-R Self-esteem subscale score (p = 0.028), and in the parent KINDL-R ratings of emotional well-being (p = 0.020), Self-esteem (p = 0.030), and Family (p = 0.006). At endpoint, OFC-treated patients still had a lower QoL compared to the normative population. OFC showed significant improvement (p ≤ 0.05) versus placebo on the CDRS-R total score and on 7 of the 17 CDRS-R items. Patients aged 10-17 years with an acute episode of bipolar depression and their parents reported greater improvements (parents noticed improvements in more areas than did their offspring) on some aspects of QoL when treated with OFC compared with placebo. However, after 8 weeks of treatment, KINDL-R endpoint scores remained lower than those of the, presumably healthy

  4. Haloperidol induces higher Homer1a expression than risperidone, olanzapine and sulpiride in striatal sub-regions.

    Science.gov (United States)

    Iasevoli, Felice; Fiore, Germano; Cicale, Maria; Muscettola, Giovanni; de Bartolomeis, Andrea

    2010-05-15

    Homer1a and Yotiao are two post-synaptic density proteins at the crossroad of dopamine-glutamate neurotransmission. Homer1a has been implicated in the pathophysiology of schizophrenia and is differentially induced by typical and atypical antipsychotics, perhaps according to their dopaminergic profile. Yotiao has been involved in glutamate and dopamine post-synaptic signalling. Here, we seek to determine whether Homer1a and Yotiao might be implicated in post-synaptic response to antipsychotics with affinity to different dopamine D(2) receptors: haloperidol (0.8mg kg(-1)), risperidone (3mg kg(-1)), olanzapine (2.5mg kg(-1)) and (-)-sulpiride (50mg kg(-1)). Homer1a expression was significantly induced by haloperidol compared to vehicle and to atypical antipsychotics in almost all striatal sub-regions. Atypical antipsychotics induced the gene in the lateral putamen and in the core of the accumbens only. All antipsychotics, with the exclusion of sulpiride, elicited a dorsolateral-to-ventromedial distribution pattern of Homer1a expression. No significant induction was detected for Yotiao. These results suggest that the quantitative and topographical pattern of Homer1a expression may putatively be related to antipsychotics affinity and/or occupancy at dopamine D(2) receptors.

  5. Adolescent olanzapine sensitization is correlated with hippocampal stem cell proliferation in a maternal immune activation rat model of schizophrenia.

    Science.gov (United States)

    Chou, Shinnyi; Jones, Sean; Li, Ming

    2015-08-27

    Previous work established that repeated olanzapine (OLZ) administration in normal adolescent rats induces a sensitization effect (i.e. increased behavioral responsiveness to drug re-exposure) in the conditioned avoidance response (CAR) model. However, it is unclear whether the same phenomenon can be detected in animal models of schizophrenia. The present study explored the generalizability of OLZ sensitization from healthy animals to a preclinical neuroinflammatory model of schizophrenia in the CAR. Maternal immune activation (MIA) was induced via polyinosinic:polycytidylic acid (PolyI:C) administration into pregnant dams. Behavioral assessments of offspring first identified decreased maternal separation-induced pup ultrasonic vocalizations and increased amphetamine-induced hyperlocomotion in animals prenatally exposed to PolyI:C. In addition, repeated adolescent OLZ administration confirmed the generalizability of the sensitization phenomenon. Using the CAR test, adolescent MIA animals displayed a similar increase in behavioral responsiveness after repeated OLZ exposure during both the repeated drug test days as well as a subsequent challenge test. Neurobiologically, few studies examining the relationship between hippocampal cell proliferation and survival and either antipsychotic exposure or MIA have incorporated concurrent behavioral changes. Thus, the current study also sought to reveal the correlation between OLZ behavioral sensitization in the CAR and hippocampal cell proliferation and survival. 5'-bromodeoxyuridine immunohistochemistry identified a positive correlation between the magnitude of OLZ sensitization (i.e. change in avoidance suppression induced by OLZ across days) and hippocampal cell proliferation. The implications of the relationship between behavioral and neurobiological results are discussed.

  6. LC–MS/MS assay for olanzapine in human plasma and its application to a bioequivalence study

    Directory of Open Access Journals (Sweden)

    Dinesh S. Patel

    2012-10-01

    Full Text Available This paper describes a selective and sensitive assay for the determination of olanzapine (OLZ in human plasma based on liquid chromatography–tandem mass spectrometry (LC–MS/MS. The analyte and quetiapine as internal standard (IS were extracted from 200 μL plasma via solid phase extraction on Waters Oasis HLB cartridges. Chromatographic separation was achieved on an ACE 5C18-300 column (100 mm×4.6 mm, 5 μm under isocratic conditions in a run time of 3.5 min. Mass spectrometric detection involved electrospray ionization in the positive ion mode followed by multiple reaction monitoring (MRM of the transitions at m/z 313/256 for OLZ and m/z 384/253 for the IS. The assay was linear in the range 0.10–40.0 ng/mL with a lower limit of quantitation and limit of detection of 0.10 and 0.012 ng/mL, respectively. Intra- and inter-day precision (as coefficient of variation and relative recovery were 90%, respectively. The method was successfully applied to a bioequivalence study of 5 and 10 mg OLZ disintegrating tablets in 40 healthy Indian males with reproducibility by incurred sample reanalysis in the range −7.43 to 8.07%.

  7. The effect of federal and state off-label marketing investigations on drug prescribing: The case of olanzapine.

    Science.gov (United States)

    Wang, Bo; Studdert, David M; Sarpatwari, Ameet; Franklin, Jessica M; Landon, Joan; Kesselheim, Aaron S

    2017-01-01

    In the past decade, the federal government has frequently investigated and prosecuted pharmaceutical manufacturers for illegal promotion of drugs for indications not approved by the Food and Drug Administration (FDA) ("off-label" uses). State governments can choose to coordinate with the federal investigation, or pursue their own independent state investigations. One of the largest-ever off-label prosecutions relates to the atypical antipsychotic drug olanzapine (Zyprexa). In a series of settlements between 2008 and 2010, Eli Lilly paid $1.4 billion to the federal government and over $290 million to state governments. We examined the effect of these settlements on off-label prescribing of this medication, taking advantage of geographical differences in states' involvement in the investigations and the timing of the settlements. However, we did not find a reduction in off-label prescribing; rather, there were no prescribing changes among states that joined the federal investigation, those that pursued independent state investigations, and states that pursued no investigations at all. Since the settlements of state investigations of off-label prescribing do not appear to significantly impact prescribing rates, policymakers should consider alternate ways of reducing the prevalence of non-evidence-based off-label use to complement their ongoing investigations.

  8. A Pilot Study of the Usefulness of a Single Olanzapine Plasma Concentration as an Indicator of Early Drug Effect in a Small Sample of First-Episode Psychosis Patients

    Science.gov (United States)

    Zabala, Arantzazu; Bustillo, Mariana; Querejeta, Imanol; Alonso, Marta; Mentxaka, Oiane; González-Pinto, Ana; Ugarte, Amaia; Meana, J. Javier; Gutiérrez, Miguel; Segarra, Rafael

    2017-01-01

    Abstract Purpose/Background Studies analyzing concentration-effect relationships in second-generation antipsychotics have reported contradictory results in chronic schizophrenia. No data are available for the early stages of the disease. The present study aims to evaluate the association between a single olanzapine plasma concentration, clinical response, and severity of adverse effects in first-episode psychosis (FEP); to test the utility of various plasma breakpoints as markers of early response to treatment; and to identify variables affecting olanzapine concentrations. Methods Data from 23 compliant FEP patients receiving olanzapine monotherapy (5–30 mg/d) were evaluated 2 months after beginning treatment. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale and the Montgomery-Åsberg Depression Rating Scale. Adverse effects were rated using the Udvalg for Kliniske Undersøgelser scale. Plasma samples were drawn at 11 (SD, 1) hours after dosing and analyzed with high-performance liquid chromatography/tandem mass spectrometry. Findings Consistent with findings on chronic disease, dose, age, sex, weight, and cigarettes/day accounted for some of the variability in olanzapine concentrations. While no relationship was found between olanzapine concentrations and adverse effects or improvement of depressive symptoms, response of psychotic symptoms was associated with concentrations between 22.56 and 77.92 ng/mL. Plasma breakpoints did not show sufficiently high specificity, resulting in a large number of false-positive results. Implications Although olanzapine concentrations do not seem to be reliable indicators of early drug effect in FEP, they may still prove useful for detecting noncompliance, as well as pharmacokinetically relevant comorbidities or genetic particularities in drug metabolism. PMID:28796022

  9. Highly sensitive voltammetric sensor based on immobilization of bisphosphoramidate-derivative and quantum dots onto multi-walled carbon nanotubes modified gold electrode for the electrocatalytic determination of olanzapine

    Energy Technology Data Exchange (ETDEWEB)

    Mohammadi-Behzad, Leila [Department of Analytical Chemistry, Faculty of Chemistry, Razi University, Kermanshah (Iran, Islamic Republic of); Gholivand, Mohammad Bagher, E-mail: mbgholivand@yahoo.com [Department of Analytical Chemistry, Faculty of Chemistry, Razi University, Kermanshah (Iran, Islamic Republic of); Shamsipur, Mojtaba [Department of Analytical Chemistry, Faculty of Chemistry, Razi University, Kermanshah (Iran, Islamic Republic of); Gholivand, Khodayar [Department of Chemistry, Tarbiat Modares University, Tehran (Iran, Islamic Republic of); Barati, Ali [Department of Analytical Chemistry, Faculty of Chemistry, Razi University, Kermanshah (Iran, Islamic Republic of); Gholami, Akram [Department of Chemistry, Tarbiat Modares University, Tehran (Iran, Islamic Republic of)

    2016-03-01

    In the present paper, a new bisphosphoramidate derivative compound, 1, 4-bis(N-methyl)-benzene-bis(N-phenyl, N-benzoylphosphoramidate) (BMBPBP), was synthesized and used as a mediator for the electrocatalytic oxidation of olanzapine. The electro-oxidation of olanzapine at the surface of the BMBPBP/CdS-quantum dots/multi-walled carbon nanotubes (BMBPBP/CdS-QDs/MWCNTs) modified gold electrode was studied using cyclic voltammetry, chronoamperometry and electrochemical impedance spectroscopy. This sensor showed an excellent electrocatalytic oxidation activity toward olanzapine at less positive potential, pronounced current response, and good sensitivity. The diffusion coefficient and kinetic parameters (such as electron transfer coefficient and the heterogeneous rate constant) were determined for olanzapine oxidation, using the electrochemical approaches. Surface morphology and electrochemical properties of the prepared modified electrode were investigated by scanning electron microscopy (SEM), cyclic voltammetry and electrochemical impedance spectroscopy techniques. The hydrodynamic amperometry at rotating modified electrode at constant potential versus reference electrode was used for detection of olanzapine. Under optimized conditions, the calibration plot was linear in the concentration range of 20 nM to 100 μM and detection limit was found to be 6 nM. The proposed method was successfully applied to the determination of olanzapine in pharmaceuticals and human serum samples. - Highlights: • A highly sensitive sensor for OLZ determination was developed. • The sensor constructed based on immobilization of BMBPBP on CdS-QDs/MWCNTs Au electrode • The morphology of the modified electrode was examined by SEM. • The prepared sensor shows stable electrochemical behavior at a wide pH range. • The proposed sensor is used for trace determination of OLZ in real samples.

  10. A Comparative Study of Clozapine Versus Olanzapine in Side Effect on Treatment Patients with Schizophrenia%氯氮平和奥氮平治疗36例精神分裂症副反应比较

    Institute of Scientific and Technical Information of China (English)

    姜伟宏

    2011-01-01

    Objective:To evaluate the effect and side effect of clozapine versus olanzapine for patients with schizophrenia Methods:72 cases with schizophrenia from October 2009 to December 2010 were randomly divided into clozapine group and olanzapine group. Clozapine group was treated by clozapine, and olanzapine group was treated by olanzapine. And then, the effect and side effect of two groups was observed and compared.Results:After 8 weeks treated, clozapine group's total effective ersirates was 83.34% and olanzapine group's total effective rates was 86.11%, they are not significant difference between two groups (P>0.05). The side effect of clozapine group's are fewer than those in olanzapine group's, and they are significant difference between two groups (P<0.05). Conclusion:Clozapine and olanzapine are all ideal drugs for patients with schizophrenia on effect.Olanzapine for treating patients with schizophrenia have high efficacy, litter side effect. It's worth to spread clinical.%目的:比较氯氮平奥氮平治疗精神分裂症患者的临床疗效及副反应.方法:将2009年10月~2010年12月收治于我院的72例精神分裂症患者分为两组,分别采用氯氮平和奥氮平对其进行治疗,观察并比较两组患者的疗效及副反应情况.结果:经过治疗,氯氮平组治疗总有效率为83.34%,奥氮平组治疗总有效率为86.11%,两组比较无显著性差异(P>0.05).奥氮平组患者的副反应少于氯氮平组,经比较差异均有统计学意义(P<0.05).结论:氯氮平和奥氮平治疗精神分裂症患者的临床疗效均较理想.其中,奥氮平治疗精神分裂症具有疗效好,副反应小等特点,值得临床推广应用.

  11. The antipsychotics clozapine and olanzapine increase plasma glucose and corticosterone levels in rats: comparison with aripiprazole, ziprasidone, bifeprunox and F15063.

    Science.gov (United States)

    Assié, Marie-Bernadette; Carilla-Durand, Elisabeth; Bardin, Laurent; Maraval, Mireille; Aliaga, Monique; Malfètes, Nathalie; Barbara, Michèle; Newman-Tancredi, Adrian

    2008-09-11

    Several novel antipsychotics activate serotonin 5-HT1A receptors as well as antagonising dopamine D2/3 receptors. Such a pharmacological profile is associated with a lowered liability to produce extrapyramidal side effects and enhanced efficacy in treating negative and cognitive symptoms of schizophrenia. However, 5-HT1A receptor agonists increase plasma corticosterone and many antipsychotics disturb the regulation of glucose. Here, we compared the influence on plasma glucose and corticosterone of acute treatments with 'new generation' antipsychotics which target dopamine D2/3 receptors and 5-HT1A receptors, with that of atypical antipsychotics, and with haloperidol. Olanzapine and clozapine, antipsychotics that are known to produce weight gain and diabetes in humans, both at 10 mg/kg p.o., substantially increased plasma glucose (from 0.8 to 1.7 g/l) at 1 h after administration, an effect that returned to control levels after 4 h. In comparison, F15063 (40 mg/kg p.o.) was without effect at any time point. Olanzapine and clozapine dose-dependently increased plasma glucose concentrations as did SLV313 and SSR181507. Haloperidol and risperidone had modest effects whereas aripiprazole, ziprasidone and bifeprunox, antipsychotics that are not associated with metabolic dysfunction in humans, and F15063 had little or no influence on plasma glucose. The same general pattern of response was found for plasma corticosterone levels. The present data provide the first comparative study of conventional, atypical and 'new generation' antipsychotics on glucose and corticosterone levels in rats. A variety of mechanisms likely underlie the hyperglycemia and corticosterone release observed with clozapine and olanzapine, whilst the balance of dopamine D2/3/5-HT1A interaction may contribute to the less favourable impact of SLV313 and SSR181507 compared with that of bifeprunox and F15063.

  12. Economic consequences of the adverse reactions related with antipsychotics: an economic model comparing tolerability of ziprasidone, olanzapine, risperidone, and haloperidol in Spain.

    Science.gov (United States)

    Bobes, Julio; Cañas, Fernando; Rejas, Javier; Mackell, Joan

    2004-12-01

    Frequency of adverse reactions (ARs) related with antipsychotics usage is high. Along with clinical implications, economic impact might be important. The purpose of this study was to model the economic consequences of ARs related with ziprasidone, olanzapine, risperidone, and haloperidol in Spain, by means of a cost-effectiveness model developed using a Markov modeling approach. The model simulated treatment of a cohort of 1000 schizophrenics for 12 months, initiating treatment with one of four antipsychotic drugs; haloperidol, risperidone, olanzapine and ziprasidone. Conditional probabilities of developing any of four adverse events were calculated. Treatment was modified (decrease dose, switch medication) according to incidence of ARs and physician judgments, obtained from a local cross-sectional study and clinical trials previously published. The analysis was conducted in year 2002 from a third party payer perspective. Results are shown as annual cost per month with psychotic symptoms controlled and included univariate sensitivity analysis. The therapeutic strategy starting with ziprasidone showed the lower costs and the greater number of months with symptoms controlled in most scenarios evaluated versus the other options considered, although the differences were weak: 9.6, 9.3, 9.5 and 9.5 controlled months per patient in base scenario, with annual cost per patient per month with symptoms controlled of 1035 Euros, 1084 Euros, 1087 Euros and 1090 Euros for ziprasidone, haloperidol, risperidone and olanzapine, respectively. Results were robust to one-way sensitivity analysis. Despite the unlike drug prices of antipsychotics, a considerable economic impact due to adverse reactions was seen in our setting. These results should be taken into account by health decision makers and clinicians in the management of patients with schizophrenia.

  13. Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis

    Directory of Open Access Journals (Sweden)

    Heinloth Alexandra N

    2009-03-01

    Full Text Available Abstract Background This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions. Methods Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI ≥ 25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n = 68, sibutramine (n = 42, or amantadine (n = 48. Individual patients were analyzed for categorical weight loss ≥ 2 kg and weight gain ≥ 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale. Results Predictors/correlates of weight loss ≥ 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain ≥ 1 kg. Conclusion The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy. Trial Registration This analysis was not

  14. A 52-Week Study of Olanzapine with a Randomized Behavioral Weight Counseling Intervention in Adolescents with Schizophrenia or Bipolar I Disorder.

    Science.gov (United States)

    Detke, Holland C; DelBello, Melissa P; Landry, John; Hoffmann, Vicki Poole; Heinloth, Alexandra; Dittmann, Ralf W

    2016-12-01

    To evaluate the 52-week safety/tolerability of oral olanzapine for adolescents with schizophrenia or bipolar mania and compare effectiveness of a standard versus intense behavioral weight intervention in mitigating risk of weight gain. Patients 13-17 years old with schizophrenia (Brief Psychiatric Rating Scale for Children [BPRS-C] total score >30; item score ≥3 for hallucinations, delusions, or peculiar fantasies) or bipolar I disorder (manic or mixed episode; Young Mania Rating Scale [YMRS] total score ≥15) received open-label olanzapine (2.5-20 mg/day) and were randomized to standard (n = 102; a single weight counseling session) or intense (n = 101; weight counseling at each study visit) weight intervention. The primary outcome measure was mean change in body mass index (BMI) from baseline to 52 weeks using mixed-model repeated measures. Symptomatology was also assessed. No statistically significant differences between groups were observed in mean baseline-to-52-week change in BMI (standard: +3.6 kg/m(2); intense: +2.8 kg/m(2); p = 0.150) or weight (standard: +12.1 kg; intense: +9.6 kg; p = 0.148). Percentage of patients at endpoint who had gained ≥15% of their baseline weight was 40% for the standard group and 31% for the intense group (p = 0.187). Safety/tolerability results were generally consistent with those of previous olanzapine studies in adolescents, with the most notable exception being the finding of a mean decrease in prolactin. On symptomatology measures, patients with schizophrenia had a mean baseline-to-52-week change in BPRS-C of -32.5 (standard deviation [SD] = 10.8), and patients with bipolar disorder had a mean change in YMRS of -16.7 (SD = 8.9), with clinically and statistically significant improvement starting at 3-4 days for each. Long-term weight gain was high in both groups, with no statistically significant differences between the standard or intense behavioral weight interventions in BMI or

  15. Incidence of tardive dyskinesia with risperidone or olanzapine in the elderly: results from a 2-year, prospective study in antipsychotic-naïve patients.

    Science.gov (United States)

    Woerner, Margaret G; Correll, Christoph U; Alvir, Jose Ma J; Greenwald, Blaine; Delman, Howard; Kane, John M

    2011-07-01

    Tardive dyskinesia (TD) rates with second-generation antipsychotics (SGAs) are considered to be low relative to first-generation antipsychotics (FGAs), even in the particularly vulnerable elderly population. However, risk estimates are unavailable for patients naïve to FGAs. Therefore, we aimed to determine the TD incidence in particularly vulnerable, antipsychotic-naïve elderly patients treated with the SGA risperidone or olanzapine. The present work describes a prospective inception cohort study of antipsychotic-naïve elderly patients aged 55 years identified at New York Metropolitan area in-patient and out-patient geriatric psychiatry facilities and nursing homes at the time of risperidone or olanzapine initiation. At baseline, 4 weeks, and at quarterly periods, patients underwent assessments of medical and medication history, abnormal involuntary movements, and extra-pyramidal signs. TD was classified using Schooler-Kane criteria. Included in the analyses were 207 subjects (age: 79.8 years, 70.0% female, 86.5% White), predominantly diagnosed with dementia (58.9%) or a major mood disorder (30.9%), although the principal treatment target was psychosis (78.7%), with (59.4%) or without (19.3%) agitation. With risperidone (n=159) the cumulative TD rate was 5.3% (95% confidence interval (CI): 0.7, 9.9%) after 1 year (mean dose: 1.0±0.76 mg/day) and 7.2% (CI: 1.4, 12.9%) after 2 years. With olanzapine (n=48) the cumulative TD rate was 6.7% (CI: 0, 15.6%) after 1 year (mean dose: 4.3±1.9 mg/day) and 11.1% (CI: 0, 23.1%) after 2 years. TD risk was higher in females, African Americans, and patients without past antidepressant treatment or with FGA co-treatment. The TD rates for geriatric patients treated with risperidone and olanzapine were comparable and substantially lower than previously reported for similar patients in direct observation studies using FGAs. This information is relevant for all patients receiving antipsychotics, not just the especially

  16. Associations between MDR1 gene polymorphisms and schizophrenia and therapeutic response to olanzapine in female schizophrenic patients.

    Science.gov (United States)

    Bozina, Nada; Kuzman, Martina Rojnic; Medved, Vesna; Jovanovic, Nikolina; Sertic, Jadranka; Hotujac, Ljubomir

    2008-01-01

    Multidrug resistant protein (MDR1) gene, which codes for P-glycoprotein and functions as an efflux transporter in different cells, is widely localized in normal tissues including the gastrointestinal tract, blood cells, biliary tract, kidney and brain and plays a major role in absorption, distribution and elimination of various xenobiotics. Therefore, MDR1 gene variants were proposed as potential susceptibility factors for diseases and as determinants of treatment response to various drugs. We investigated the relationships between exon 21 G2677T and exon 26 C3435T genetic variants of MDR1 gene with susceptibility and treatment response in female schizophrenic patients. The study was conducted in two steps. We first compared allele, genotype and haplotype distributions between 117 female schizophrenic patients and 123 control female subjects. Afterwards, we studied treatment response to olanzapine, in 87 out of 117 previously unmedicated female patients. Overall, we found lower representation of G2677/C3435 haplotype in schizophrenic female patients compared to controls. Test result for linkage disequilibrium between loci was found to be significant. Furthermore, we found significant associations between MDR1 exon 21 G2677T genotypes and treatment response measured with positive PANSS percentage changes, with T allele and TT genotype being associated with significantly better treatment response. A borderline, non-significant statistical association was found between MDR1 exon 26 C3435T genotypes and treatment response, with TT genotype being associated with better treatment response. Our data support functional importance of the MDR1 mutations for the susceptibility and treatment response in female schizophrenic patients.

  17. Berberine Alleviates Olanzapine-Induced Adipogenesis via the AMPKα-SREBP Pathway in 3T3-L1 Cells.

    Science.gov (United States)

    Li, Yanjie; Zhao, Xiaomin; Feng, Xiyu; Liu, Xuemei; Deng, Chao; Hu, Chang-Hua

    2016-11-09

    The aim of this study was to investigate the mechanisms underlying the inhibitory effects of berberine (BBR) on olanzapine (OLZ)-induced adipogenesis in a well-replicated 3T3-L1 cell model. Oil-Red-O (ORO) staining showed that BBR significantly decreased OLZ-induced adipogenesis. Co-treatment with OLZ and BBR decreased the accumulation of triglyceride (TG) and total cholesterol (TC) by 55.58% ± 3.65% and 49.84% ± 8.31%, respectively, in 3T3-L1 adipocytes accompanied by reduced expression of Sterol regulatory element binding proteins 1 (SREBP1), fatty acid synthase (FAS), peroxisome proliferator activated receptor-γ (PPARγ), SREBP2, low-density lipoprotein receptor (LDLR), and hydroxymethylglutaryl-coenzyme A reductase (HMGR) genes compared with OLZ alone. Consistently, the co-treatment downregulated protein levels of SREBP1, SREBP2, and LDLR by 57.71% ± 9.42%, 73.05% ± 11.82%, and 59.46% ± 9.91%, respectively. In addition, co-treatment reversed the phosphorylation level of AMP-activated protein kinase-α (AMPKα), which was reduced by OLZ, determined via the ratio of pAMPKα:AMPKα (94.1%) compared with OLZ alone. The results showed that BBR may prevent lipid metabolism disorders caused by OLZ by reversing the degree of SREBP pathway upregulated and the phosphorylation of AMPKα downregulated. Collectively, these results indicated that BBR could be used as a potential adjuvant to prevent dyslipidemia and obesity caused by the use of second-generation antipsychotic medication.

  18. Berberine Alleviates Olanzapine-Induced Adipogenesis via the AMPKα–SREBP Pathway in 3T3-L1 Cells

    Science.gov (United States)

    Li, Yanjie; Zhao, Xiaomin; Feng, Xiyu; Liu, Xuemei; Deng, Chao; Hu, Chang-Hua

    2016-01-01

    The aim of this study was to investigate the mechanisms underlying the inhibitory effects of berberine (BBR) on olanzapine (OLZ)-induced adipogenesis in a well-replicated 3T3-L1 cell model. Oil-Red-O (ORO) staining showed that BBR significantly decreased OLZ-induced adipogenesis. Co-treatment with OLZ and BBR decreased the accumulation of triglyceride (TG) and total cholesterol (TC) by 55.58% ± 3.65% and 49.84% ± 8.31%, respectively, in 3T3-L1 adipocytes accompanied by reduced expression of Sterol regulatory element binding proteins 1 (SREBP1), fatty acid synthase (FAS), peroxisome proliferator activated receptor-γ (PPARγ), SREBP2, low-density lipoprotein receptor (LDLR), and hydroxymethylglutaryl-coenzyme A reductase (HMGR) genes compared with OLZ alone. Consistently, the co-treatment downregulated protein levels of SREBP1, SREBP2, and LDLR by 57.71% ± 9.42%, 73.05% ± 11.82%, and 59.46% ± 9.91%, respectively. In addition, co-treatment reversed the phosphorylation level of AMP-activated protein kinase-α (AMPKα), which was reduced by OLZ, determined via the ratio of pAMPKα:AMPKα (94.1%) compared with OLZ alone. The results showed that BBR may prevent lipid metabolism disorders caused by OLZ by reversing the degree of SREBP pathway upregulated and the phosphorylation of AMPKα downregulated. Collectively, these results indicated that BBR could be used as a potential adjuvant to prevent dyslipidemia and obesity caused by the use of second-generation antipsychotic medication. PMID:27834848

  19. Berberine Alleviates Olanzapine-Induced Adipogenesis via the AMPKα–SREBP Pathway in 3T3-L1 Cells

    Directory of Open Access Journals (Sweden)

    Yanjie Li

    2016-11-01

    Full Text Available The aim of this study was to investigate the mechanisms underlying the inhibitory effects of berberine (BBR on olanzapine (OLZ-induced adipogenesis in a well-replicated 3T3-L1 cell model. Oil-Red-O (ORO staining showed that BBR significantly decreased OLZ-induced adipogenesis. Co-treatment with OLZ and BBR decreased the accumulation of triglyceride (TG and total cholesterol (TC by 55.58% ± 3.65% and 49.84% ± 8.31%, respectively, in 3T3-L1 adipocytes accompanied by reduced expression of Sterol regulatory element binding proteins 1 (SREBP1, fatty acid synthase (FAS, peroxisome proliferator activated receptor-γ (PPARγ, SREBP2, low-density lipoprotein receptor (LDLR, and hydroxymethylglutaryl-coenzyme A reductase (HMGR genes compared with OLZ alone. Consistently, the co-treatment downregulated protein levels of SREBP1, SREBP2, and LDLR by 57.71% ± 9.42%, 73.05% ± 11.82%, and 59.46% ± 9.91%, respectively. In addition, co-treatment reversed the phosphorylation level of AMP-activated protein kinase-α (AMPKα, which was reduced by OLZ, determined via the ratio of pAMPKα:AMPKα (94.1% compared with OLZ alone. The results showed that BBR may prevent lipid metabolism disorders caused by OLZ by reversing the degree of SREBP pathway upregulated and the phosphorylation of AMPKα downregulated. Collectively, these results indicated that BBR could be used as a potential adjuvant to prevent dyslipidemia and obesity caused by the use of second-generation antipsychotic medication.

  20. Prior haloperidol, but not olanzapine, exposure augments the pursuit of reward cues: implications for substance abuse in schizophrenia.

    Science.gov (United States)

    Bédard, Anne-Marie; Maheux, Jérôme; Lévesque, Daniel; Samaha, Anne-Noël

    2013-05-01

    Drug abuse and addiction are excessively common in schizophrenia. Chronic antipsychotic treatment might contribute to this comorbidity by inducing supersensitivity within the brain's dopamine system. Dopamine supersensitivity can enhance the incentive motivational properties of reward cues, and reward cues contribute to the maintenance and severity of drug addiction. We have shown previously that rats withdrawn from continuous haloperidol (HAL) treatment (via subcutaneous minipump) develop dopamine supersensitivity and pursue reward cues more vigorously than HAL-naive rats following an amphetamine (AMPH) challenge. Atypical antipsychotic drugs are thought to be less likely than typicals to produce dopamine supersensitivity. Thus, we compared the effects of HAL and the atypical antipsychotic olanzapine (OLZ) on the pursuit of reward cues. Rats were trained to associate a light-tone cue with water then treated with HAL or OLZ. Following antipsychotic withdrawal, we assessed AMPH-induced enhancement of lever pressing for the cue. Withdrawal from HAL, but not from OLZ, enhanced this effect. HAL, but not OLZ, also enhanced AMPH-induced psychomotor activation and c-fos mRNA expression in the caudate-putamen. Thus, prior HAL, but not OLZ, enhanced conditioned reward following an AMPH challenge, and this was potentially linked to enhanced behavioral sensitivity to AMPH and AMPH-induced engagement of the caudate-putamen. These findings suggest that HAL, but not an atypical like OLZ, modifies reward circuitry in ways that increase responsiveness to reward cues. Because enhanced responsiveness to reward cues can promote drug-seeking behavior, it should be investigated whether atypical antipsychotics might be a preferential option in schizophrenic patients at risk for drug abuse or addiction.

  1. A low TSH profile predicts olanzapine-induced weight gain and relief by adjunctive topiramate in healthy male volunteers.

    Science.gov (United States)

    Evers, Simon S; van Vliet, André; van Vugt, Barbara; Scheurink, Anton J W; van Dijk, Gertjan

    2016-04-01

    Second generation antipsychotics, like olanzapine (OLZ), have become the first line drug treatment for patients with schizophrenia. However, OLZ treatment is often associated with body weight (BW) gain and metabolic derangements. Therefore, the search for prospective markers for OLZ's negative side effects as well as adjunctive treatments to inhibit these has been of major interest. The aim of this study was to investigate in healthy male volunteers (age: 36 ± 11 years; BW: 84 ± 12 kg; BMI=25.5 ± 2.5) whether adjunctive topiramate (TPM) administration opposes OLZ-induced weight gain over the course of 14 days treatment. In addition, we investigated behavioral, endocrine and metabolic characteristics as underlying and potentially predictive factors for weight regulation and/or metabolic derangements associated with OLZ and TPM treatment. While adjunctive TPM indeed reduced OLZ-induced weight gain (PTPM. Using multiple regression analysis, BW gain was the key factor explaining metabolic disturbances (e.g., plasma insulin- LDL interaction: PTPM treatment, nor its circulating levels, contributed to variation observed in ΔBW. In a second multiple regression analysis, we observed that a low baseline thyrotropin profile (TSHAUC) before the start of drug treatment was associated with an increase in ΔBW over the course of drug treatment (PTPM treatment did attenuate OLZ induced BW gain (PTPM treatment blocking OLZ-induced ΔBW gain. Others have shown that OLZ-induced BW gain is associated with improvement in brief psychiatric rating scores (BPRS); adjunctive TPM treatment may be a solution specifically for those subjects susceptible to OLZ-induced rapid weight gain who-on a therapeutic level-benefit most of OLZ treatment.

  2. Probing of possible olanzapine binding site on human serum albumin: Combination of spectroscopic methods and molecular dynamics simulation

    Energy Technology Data Exchange (ETDEWEB)

    Shahlaei, Mohsen, E-mail: mohsenshahlaei@yahoo.com [Nano drug delivery research Center, Research Center, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Department of Medicinal Chemistry, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Rahimi, Behnoosh [Department of Medicinal Chemistry, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Student research committee, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Ashrafi-Kooshk, Mohammad Reza [Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Sadrjavadi, Komail [Department of Medicinal Chemistry, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Department of Pharmacognosy and Biotechnology, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Khodarahmi, Reza, E-mail: rkhodarahmi@mbrc.ac.ir [Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of); Department of Pharmacognosy and Biotechnology, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah (Iran, Islamic Republic of)

    2015-02-15

    Human serum albumin (HSA)-drug binding affinity is one of the major factors that determine the pharmacokinetics, halftime and bioavailability of drugs in various tissues. In the present study, the interaction of olanzapine (OLZ), a thienobenzodiazepine drug, administered for the treatment of schizophrenia and bipolar disorder, with HSA has been studied using spectroscopic methods such as ultraviolet absorbance, fluorescence and FTIR combined with computational procedures. Analyzing of the Stern–Volmer quenching data showed only one primary binding site on HSA with a binding constant of 4.12×10{sup 4} M{sup −1} at 298 K. Thermodynamic analyses showed enthalpy change (ΔH°) and entropy change (ΔS°) were 28.03±3.42 kJ mol{sup −1} and −25.52±11.52 J mol{sup −1} K{sup −1}, respectively. Molecular docking results suggested the hydrophobic residues such as Val{sub 216}, Leu{sub 327}, Ala{sub 350} and polar residues such as Glu{sub 354} play an important role in the drug binding. Decrement in α-helix content of the protein upon OLZ binding was also confirmed by evidences provided by molecular dynamics simulation as well as FTIR spectroscopy. - Highlights: • Leu{sub 327}, Ala{sub 350} as well as hydrophilic residues of HSA play an important role in the binding reaction. • The drug has only one primary binding site on HSA with a binding constant of 4.12×10{sup 4} M{sup −1} at 298 K. • The drug binds near to site I.

  3. A comparison between augmentation with olanzapine and increased risperidone dose in acute schizophrenia patients showing early non-response to risperidone.

    Science.gov (United States)

    Hatta, Kotaro; Otachi, Taro; Sudo, Yasuhiko; Kuga, Hironori; Takebayashi, Hiroshi; Hayashi, Hideaki; Ishii, Ryusuke; Kasuya, Masataka; Hayakawa, Tatsuro; Morikawa, Fumiyoshi; Hata, Kazuya; Nakamura, Mitsuru; Usui, Chie; Nakamura, Hiroyuki; Hirata, Toyoaki; Sawa, Yutaka

    2012-07-30

    We examined whether augmentation with olanzapine would be superior to increased risperidone dose among acute schizophrenia patients showing early non-response to risperidone. We performed a rater-blinded, randomized controlled trial at psychiatric emergency sites. Eligible patients were newly admitted patients with acute schizophrenia. Early response was defined as Clinical Global Impressions-Improvement Scale score ≤3 following 2 weeks of treatment. Early non-responders were allocated to receive either augmentation with olanzapine (RIS+OLZ group) or increased risperidone dose (RIS+RIS group). The 78 patients who completed 2 weeks of treatment were divided into 52 early responders to risperidone and 26 early non-responders to risperidone (RIS+OLZ group, n=13; RIS+RIS group, n=13). No difference in the achievement of ≥50% improvement in Positive and Negative Syndrome Scale total score was observed between RIS+OLZ and RIS+RIS groups. Although time to treatment discontinuation for any cause was significantly shorter in the RIS+RIS group (6.8 weeks [95% confidence interval, 5.2-8.4]) than in early responders to risperidone (8.6 weeks [7.9-9.3]; P=0.018), there was no significant difference between the RIS+OLZ group (7.9 weeks [6.3-9.5]) and early responders to risperidone. Secondary outcomes justify the inclusion of augmentation arms in additional, larger studies comparing strategies for early non-responders.

  4. Analysis of clinical symptomatology, extrapyramidal symptoms and neurocognitive dysfunction following dehydroepiandrosterone (DHEA) administration in olanzapine treated schizophrenia patients: a randomized, double-blind placebo controlled trial.

    Science.gov (United States)

    Strous, Rael D; Stryjer, Rafael; Maayan, Rachel; Gal, Gilad; Viglin, Dina; Katz, Elena; Eisner, Dana; Weizman, Abraham

    2007-02-01

    Several studies have demonstrated the effective use of dehydroepiandrosterone (DHEA) in the management of mood, however studies of its use in psychosis remain limited. The aim of this study was to investigate for the first time efficacy of DHEA augmentation with standardized antipsychotic medication (olanzapine) and to explore effects of DHEA augmentation on side-effect profiles including weight gain, glucose tolerance, aggression, quality of life and neurocognitive function. Finally, we aimed to analyze any relationship between plasma levels and clinical response to DHEA administration. Forty patients with chronic schizophrenia stabilized on olanzapine were randomized in double-blind fashion to receive either DHEA (titrated up to 150mg) or placebo augmentation for a period of 12-weeks. Blood samples were collected at baseline, mid-study and study completion. Results indicated improvement of negative symptoms (SANS scale) even when baseline scores were controlled as a covariate. Some improvement in Parkinsonism and akathisia compared to baseline was seen in patients receiving DHEA. No change in psychosis as reflected by the PANSS was noted. Patients receiving DHEA appeared to demonstrate relatively stable glucose levels compared to controls at the end of the study. An improvement in cognitive performance (most notably memory), which did not reach significance due to low sample number, was observed following DHEA administration. Results further suggest preliminary evidence of involvement of the neurosteroid system in schizophrenia pathophysiology, and confirm initial "cautious" findings identifying an agent capable of improving negative symptoms and certain features of extrapyramidal side effects.

  5. Development and validation of a HPLC-UV method for the simultaneous determination of the antipsychotics clozapine, olanzapine and quetiapine, several beta-blockers and their metabolites.

    Science.gov (United States)

    Gracia, Margarete Silva; Köppl, Alexandra; Unholzer, Sandra; Haen, Ekkehard

    2017-03-07

    A simple, accurate and selective column-switching high performance liquid chromatography (HPLC) method was developed and validated for simultaneous quantification of six beta-blockers (metoprolol MET, timolol TIM, bisoprolol BIS, propranolol PRO, carvedilol CAR and nebivolol NEB), three of their metabolites (α-hydroxy metoprolol α-HMET, N-desisopropyl propranolol DIPRO and 4'-hydroxy carvedilol 4-HCAR), three antipsychotics (olanzapine OLA, clozapine CLO and quetiapine QUE) and three of their metabolites (N-desmethyl olanzapine DMOLA, N-desmethyl clozapine DMCLO and N-desalkyl quetiapine DAQUE) in human serum. After pretreatment on a Merck LiChrospher RP-4 ADS column (25 μm) drugs were separated on a Phenomenex Gemini Phenyl Hexyl 110 A column (250 mm x 4.6 mm, 5 μm) using a gradient mixture of acetonitrile and potassium dihydrogen phosphate buffer pH 3.1 (containing 10 % methanol) as a mobile phase at a flow rate of 1ml/min. The total analysis time was 40 min. For detection of the analytes, four different UV wavelengths were used: 215 nm, 226 nm, 242 nm and 299 nm. The method was validated according to the guidelines of the Society of Toxicology and Forensic Chemistry (GTFCh) in terms of selectivity, linearity, accuracy, precision and stability and successfully applied for the analysis of the 15 described analytes in human serum.

  6. Olanzapine-induced weight gain is associated with the -759C/T and -697G/C polymorphisms of the HTR2C gene.

    Science.gov (United States)

    Godlewska, B R; Olajossy-Hilkesberger, L; Ciwoniuk, M; Olajossy, M; Marmurowska-Michałowska, H; Limon, J; Landowski, J

    2009-08-01

    Weight gain, a serious problem associated with some antipsychotic drugs, notably olanzapine and clozapine, was suggested to be associated with -759C/T polymorphism of the 5-HT2C receptor gene. This study aimed to examine a potential association of two functional polymorphisms of the promoter region of this gene: -759C/T (rs3813929) and -697G/C (rs518147), with weight gain after 6 weeks of olanzapine monotherapy. It included 107 patients with schizophrenia; among them 36 are first-episode drug-naive patients. Analysis was carried out by PCR-restriction fragment length polymorphism. A protective effect of -759T and -697C alleles was found: significantly less patients with -697C (3/51) and no patient with -759T (0/28) alleles experienced body mass index increase >or=10% (P=0.0006 and 0.002, respectively). The same was true for drug-naive patients possessing any of the variant alleles. There was a significant association of haplotypes with a >or=10% body mass index increase (P=0.001). On the basis of the additional statistical analysis, the more important role of -697C allele was suggested.

  7. Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the worldwide schizophrenia outpatients health outcomes (W-SOHO study

    Directory of Open Access Journals (Sweden)

    Hong Jihyung

    2012-12-01

    Full Text Available Abstract Background With many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting. Methods W-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162 and vice versa (n=136. Clinical status was assessed at the visit when the first switch was made (i.e. before switching and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization. Results 48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019. Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26, extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89 and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13. No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who

  8. In vivo pharmacological evaluations of novel olanzapine analogues in rats: a potential new avenue for the treatment of schizophrenia.

    Science.gov (United States)

    Jafari, Somayeh; Huang, Xu-Feng; Andrews, Jessica L; Fernandez-Enright, Francesca

    2013-01-01

    Olanzapine (Olz) is one of the most effective antipsychotic drugs commonly used for treating schizophrenia. Unfortunately, Olz administration is associated with severe weight gain and metabolic disturbances. Both patients and clinicians are highly interested in the development of new antipsychotics which are as effective as atypical antipsychotics but which have a lower propensity to induce metabolic side effects. In the present study, we examined two new derivatives of Olz; OlzEt (2-ethyl-4-(4'-methylpiperazin-1'-yl)-10Hbenzo[b]thieno[2,3-e][1,4]diazepine), and OlzHomo (2-ethyl-4-(4'-methyl-1',4'-diazepan-1'-yl)-10H-benzo[b]thieno[2,3-e] [1,4]diazepine), for their tendency to induce weight gain in rats. Weight gain and metabolic changes were measured in female Sprague Dawley rats. Animals were treated orally with Olz, OlzEt, OlzHomo (3 or 6 mg/kg/day), or vehicle (n = 8), three times daily at eight-hour intervals for 5 weeks. Furthermore, a phencyclidine (PCP)-treated rat model was used to examine the prevention of PCP-induced hyperlocomotor activity relevant for schizophrenia therapy. Male Sprague Dawley rats were pre-treated with a single dose (3 mg/kg/day) of Olz, OlzEt, OlzHomo, or vehicle (n = 12), for 2 weeks. Locomotor activity was recorded following a subcutaneous injection with either saline or PCP (10 mg/kg). Olz was found to induce weight gain, hyperphagia, visceral fat accumulation, and metabolic changes associated with reduced histamatergic H1 receptor density in the hypothalamus of treated rats. In contrast, OlzEt and OlzHomo presented promising antipsychotic effects, which did not induce weight gain or fat deposition in the treated animals. Behavioural analysis showed OlzEt to attenuate PCP-induced hyperactivity to a level similar to that of Olz; however, OlzHomo showed a lower propensity to inhibit these stereotyped behaviours. Our data suggest that the therapeutic effectiveness of OlzHomo may be delivered at a higher dose than that of Olz

  9. Effect of olanzapine or fluoxetine and combined olanzapine with fluoxetine on citrate synthase activity in rat brain%奥氮平与氟西汀单独或联合给药对大鼠脑内柠檬酸合成酶活性的影响

    Institute of Scientific and Technical Information of China (English)

    张普; 孔丽敏

    2016-01-01

    目的:研究奥氮平与氟西汀单独或两药联合给药对大鼠脑内柠檬酸合成酶活性短期和长期的影响。方法135只Wistar大鼠随机分为对照组与实验组。对照组腹腔注射生理盐水,实验组再分为几个亚组。2个剂量奥氮平组(3,6 mg· kg-1),2个剂量氟西汀组(12.5,25.0 mg· kg-1),联合用药组:A组(3 mg· kg-1奥氮平+12.5 mg · kg-1氟西汀)、B 组(3 mg · kg-1奥氮平+25.0 mg· kg-1氟西汀)、C组(6 mg· kg-1奥氮平+12.5 mg · kg -1氟西汀)、D组(6 mg· kg-1奥氮平+25.0 mg· kg-1氟西汀),连续给药28 d。用分光光度法测定并比较第1次给药后2 h、末次给药后2,24 h的大鼠前额叶皮层、海马区和纹状体柠檬酸合成酶的活性。结果与对照组相比,在给药第1次后2 h,2个剂量奥氮平组、大剂量氟西汀组、联合A组的大鼠海马区柠檬酸合成酶活性明显增加( P<0.05)。结论短程小剂量奥氮平联合氟西汀可显著增加大鼠脑内柠檬酸合成酶活性。%Objective To evaluated the effect of acute and chronic ad-ministration of fluoxetine , olanzapine and the combination of fluoxetine/olanzapine on citrate synthase activity in rat brain.Methods One hun-dred and thirty-five Wistar rats were randomly divided into control group and experimental group.The rats of the control group received injections of saline.The rats of the experimental group were divided into 8 sub groups by the ways of treament:low and high dose of olanzapine groups (3,6 mg· kg -1 ),the low and high dose of fluoxetine groups (12.5,25.0 mg· kg-1 ), the two -drug combination:A group(3 mg· kg -1 olanza-pine +12.5 mg· kg -1 fluoxetine), B group(3 mg· kg -1 olanzapine +25 mg · kg -1 fluoxetine ) , C group ( 6 mg · kg -1 olanzapine +12.5 mg· kg-1 fluoxetine), D group(6 mg· kg -1 olanzapine +25 mg· kg -1 fluoxetine ).Saline or medications were given once a day , which lasted

  10. In vivo effects of olanzapine on striatal dopamine D{sub 2}/D{sub 3} receptor binding in schizophrenic patients: an iodine-123 iodobenzamide single-photon emission tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Dresel, S.; Rossmueller, B.; Hahn, K.; Tatsch, K. [Department of Nuclear Medicine, University of Munich (Germany); Mager, T.; Meisenzahl, E.; Moeller, H.J. [Department of Psychiatry, University of Munich (Germany)

    1999-08-01

    Olanzapine is a new atypical antipsychotic agent that belongs to the same chemical class as clozapine. The pharmacological efficacy of olanzapine (in contrast to that of risperidone) has been shown to be comparable to that of clozapine, but olanzapine has the advantage of producing a less pronounced bone marrow depressing effect than clozapine. The specific aims of this study were (a) to assess dopamine D{sub 2}/D{sub 3} receptor availability in patients treated with olanzapine by means of iodine-123 iodobenzamide [{sup 123}I]IBZM single-photon emission tomography (SPET), (b) to compare the results with findings of [{sup 123}I]IBZM SPET in patients under treatment with risperidone and (c) to correlate the results with the occurrance of extrapyramidal side-effects (EPMS). Brain SPET scans were performed in 20 schizophrenic patients (DSM III R) at 2 h after i.v. administration of 185 MBq [{sup 123}I]IBZM. Images were acquired using a triple-head gamma camera (Picker Prism 3000 XP). For semiquantitative evaluation of D{sub 2}/D{sub 3} receptor binding, transverse slices corrected for attenuation were used to calculate specific uptake values [STR-BKG]/BKG (STR=striatum; BKG=background). The mean daily dose of olanzapine ranged from 0.05 to 0.6 mg/kg body weight. The dopamine D{sub 2}/D{sub 3} receptor binding was reduced in all patients treated with olanzapine. Specific IBZM binding [STR-BKG]/BKG ranged from 0.13 to 0.61 (normal controls >0.95). The decreased D{sub 2}/D{sub 3} receptor availability revealed an exponential dose-response relationship (r=-0.85, P<0.001). The slope of the curve was similar to that of risperidone and considerably higher than that of clozapine as compared with the results of a previously published study. EPMS were observed in only one patient, presenting with the lowest D{sub 2}/D{sub 3} availability. The frequency of EPMS induced by olanzapine (5%) was considerably lower than the frequency under risperidone treatment (40%). Our findings

  11. In vivo effects of olanzapine on striatal dopamine D[sub 2]/D[sub 3] receptor binding in schizophrenic patients: an iodine-123 iodobenzamide single-photon emission tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Dresel, S.; Rossmueller, B.; Hahn, K.; Tatsch, K. (Department of Nuclear Medicine, University of Munich (Germany)); Mager, T.; Meisenzahl, E.; Moeller, H.J. (Department of Psychiatry, University of Munich (Germany))

    1999-08-01

    Olanzapine is a new atypical antipsychotic agent that belongs to the same chemical class as clozapine. The pharmacological efficacy of olanzapine (in contrast to that of risperidone) has been shown to be comparable to that of clozapine, but olanzapine has the advantage of producing a less pronounced bone marrow depressing effect than clozapine. The specific aims of this study were (a) to assess dopamine D[sub 2]/D[sub 3] receptor availability in patients treated with olanzapine by means of iodine-123 iodobenzamide [[sup 123]I]IBZM single-photon emission tomography (SPET), (b) to compare the results with findings of [[sup 123]I]IBZM SPET in patients under treatment with risperidone and (c) to correlate the results with the occurrance of extrapyramidal side-effects (EPMS). Brain SPET scans were performed in 20 schizophrenic patients (DSM III R) at 2 h after i.v. administration of 185 MBq [[sup 123]I]IBZM. Images were acquired using a triple-head gamma camera (Picker Prism 3000 XP). For semiquantitative evaluation of D[sub 2]/D[sub 3] receptor binding, transverse slices corrected for attenuation were used to calculate specific uptake values [STR-BKG]/BKG (STR=striatum; BKG=background). The mean daily dose of olanzapine ranged from 0.05 to 0.6 mg/kg body weight. The dopamine D[sub 2]/D[sub 3] receptor binding was reduced in all patients treated with olanzapine. Specific IBZM binding [STR-BKG]/BKG ranged from 0.13 to 0.61 (normal controls >0.95). The decreased D[sub 2]/D[sub 3] receptor availability revealed an exponential dose-response relationship (r=-0.85, P<0.001). The slope of the curve was similar to that of risperidone and considerably higher than that of clozapine as compared with the results of a previously published study. EPMS were observed in only one patient, presenting with the lowest D[sub 2]/D[sub 3] availability. The frequency of EPMS induced by olanzapine (5%) was considerably lower than the frequency under risperidone treatment (40%). Our findings

  12. Downregulation of 5-HT7 Serotonin Receptors by the Atypical Antipsychotics Clozapine and Olanzapine. Role of Motifs in the C-Terminal Domain and Interaction with GASP-1

    DEFF Research Database (Denmark)

    Manfra, Ornella; Van Craenenbroeck, Kathleen; Skieterska, Kamila

    2015-01-01

    -mediated degradation of 5-HT7 receptors and also interfered with G protein activation. In addition, we tested whether receptor degradation was mediated by the GPCR-associated sorting protein-1 (GASP-1). We show that GASP-1 binds the 5-HT7 receptor and regulates the clozapine-mediated degradation. Mutations...... of the identified motifs and residues, located in or close to Helix-VIII of the 5-HT7 receptor, modified antipsychotic-stimulated binding of proteins (such as GASP-1), possibly by altering the flexibility of Helix-VIII, and also interfered with G protein activation. Taken together, our data demonstrate that binding...... of clozapine or olanzapine to the 5-HT7 receptor leads to antagonist-mediated lysosomal degradation by exposing key residues in the C-terminal tail that interact with GASP-1....

  13. A control study of olanzapine and risperidone in the treatment of senile delirium%奥氮平与利培酮治疗老年期谵妄患者的对照研究

    Institute of Scientific and Technical Information of China (English)

    冼易平; 王英

    2011-01-01

    Objective; To compare the efficacy and safety of olanzapine and risperidone in the treatment of senile delirium. Method: Fifty patients with senile delirium were randomly divided into olanzapine treatment group (n = 25 ) and risperidone treatment group ( n = 25). They were prospectively observed and assessed with the Chinese revision of confusion assessment method (CAM-CR) .clinical global impression severity scale (CGI-SI) and treatment emergent symptom scales (TESS). Results:The effective rate of olanzapine treatment group and risperidone treatment group were 64. 0% and 68. 0% respectively (P > 0. 05). CGI-SI total scores of olanzapine treatmeng group and that of risperidone treatmen group were both reduced significantly after treatment (t=5. 19,6. 95 ;P 0.05 ). The total incidence rate of side effects in the risperidone group was significantly higher than that in olanzapine group ( χ2 = 5. 88, P < 0. 05). Conclusion; Olanzapine and risperidone have similar effects in treating senile delirium,ahd has fewer side effects.%目的:比较奥氮平和利培酮治疗老年期谵妄的疗效和安全性. 方法:将50例老年期谵妄患者随机分成奥氮平治疗组(n=25),利培酮治疗组(n=25),疗程2周.治疗前后以谵妄评定方法中文修订版(CAM-CR)及临床疗效总评量表-病情严重程度(CGI-SI)评定疗效;以治疗中出现的症状量表(TESS)评定药物不良反应. 结果:奥氮平组和利培酮组显效率分别为64.0%和68.0% (P >0.05).两组CGI-SI总分治疗后均较治疗前明显降低(t=5.19、6.95,P均<0.01);两组间比较,差异无统计学意义(P>0.05).利培酮组不良反应明显高于奥氮平组(x2=5.88,P<0.05). 结论:奥氮平和利培酮治疗老年期谵妄疗效相当,不良反应轻.

  14. A single-blind, randomized comparison of olanzapine at a starting dose of 5 mg versus 20 mg in acute schizophrenia.

    Science.gov (United States)

    Mauri, Massimo Carlo; Colasanti, Alessandro; Rossattini, Matteo; Moliterno, Donatella; Baldi, Marialuisa L; Papa, Pietro

    2006-01-01

    Acute psychotic episodes represent critical situations during the course of schizophrenia. Olanzapine (OLZ), a second-generation antipsychotic, is efficacious in acute settings at dosages of 5 to 20 mg/d, and it can be considered a first-line treatment for patients with an acute episode of schizophrenia. The aim of this study was to evaluate the efficacy and tolerability of OLZ at a starting dose of 5 mg versus 20 mg in acute schizophrenic patients and to compare titration versus nontitration.Fifty-one schizophrenic inpatients were randomly assigned to receive OLZ at 5 mg/d (26 patients, group 1) or 20 mg/d (25 patients, group 2) as a starting dosage during an exacerbation phase. In group 1, the OLZ dosage was increased to a mean dosage of 10.55 (+/- 4.00) mg/d. Group 2 received OLZ at a fixed dose of 20 mg throughout the hospitalization period. Olanzapine was significantly and clinically effective on Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale, PANSS positive symptoms, and Hamilton Rating Scale for Depression in both groups. There were no significant differences between groups 1 and 2 in the percent improvement in BPRS, Positive and Negative Syndrome Scale, PANSS positive symptoms, PANSS negative symptoms, or Hamilton Rating Scale for Depression; but group 2 was significantly superior in the mean percent improvement in the BPRS items of anxiety (P < 0.001) and suspiciousness (P < 0.05). In conclusion, the higher doses evidence more efficacy on anxiety and suspiciousness, so it seems to be useful to begin therapy with a full dose of the drug to obtain the maximum effect without any significant side effects.

  15. Olanzapine/Fluoxetine combination in children and adolescents with bipolar I depression: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Detke, Holland C; DelBello, Melissa P; Landry, John; Usher, Roland W

    2015-03-01

    To assess the efficacy and safety of olanzapine/fluoxetine combination (OFC) for the acute treatment of bipolar depression in children and adolescents. Patients 10 to 17 years of age with bipolar I disorder (BP-I), depressed episode, baseline Children's Depression Rating Scale-Revised (CDRS-R) total score ≥40, Young Mania Rating Scale (YMRS) total score ≤15, and YMRS-item 1 ≤2 were randomized to OFC (6/25-12/50 mg/day olanzapine/fluoxetine; n = 170) or placebo (n = 85) for up to 8 weeks of double-blind treatment. The primary efficacy measure was mean change in CDRS-R using mixed-model repeated-measures methodology. Baseline-to-week-8 least-squares mean change in CDRS-R total score was greater for OFC-treated patients than for placebo-treated patients (-28.4 versus -23.4, p = .003; effect size = .46), with between-group differences statistically significant at week 1 (p = .02) and all subsequent visits (all p bipolar I depression in patients 10 to 17 years of age. Benefits should be weighed against the risk of adverse events, particularly weight gain and hyperlipidemia. Clinical trial registration information-A Study for Assessing Treatment of Patients Ages 10-17 with Bipolar Depression; http://clinicaltrials.gov; NCT00844857. Copyright © 2015 American Academy of Child & Adolescent Psychaitry. Published by Elsevier Inc. All rights reserved.

  16. Functional and motor response to low dose olanzapine in huntington's disease: case report Resposta funcional e motora a doses baixas de olanzapina na doença de Huntington: relato de caso

    Directory of Open Access Journals (Sweden)

    Jerson Laks

    2004-12-01

    Full Text Available Previous reports on the use of olanzapine in Huntington's disease (HD used doses ranging from 10-30 mg. We report a case of HD with marked delusions and behavioral impairment assessed by the Unified Huntington's Disease Rating Scale at baseline and four months later treated with a low dose of olanzapine. The patient improved in motor, psychiatric and activity of daily living symptoms after four months of treatment. The response to a low dose of olanzapine in HD may be an indicator of efficacy in similar cases. Further randomized controlled trials can properly assess these findings.Relatos de casos sobre o uso de olanzapina na doença de Huntington (DH usaram doses variando de 10-30 mg. Este é um relato de caso de DH avaliado pela Unified Huntington Rating Scale no início e quatro meses depois com uma dose baixa de olanzapina. A paciente melhorou dos sintomas motores, psiquiátricos e nas atividades de vida diária após os quatro meses de tratamento. A resposta a baixas doses de olanzapina na DH pode ser um indicador de eficácia em casos similares. Mais estudos controlados randomizados podem avaliar apropriadamente esses achados.

  17. Control Study of Sulpiride Combined Olanzapine in the Treatment of Refractory Schizophrenia%舒必利合并奥氮平治疗难治性精神分裂症对照研究

    Institute of Scientific and Technical Information of China (English)

    杨立身; 马洪亮; 李渊兴; 段加艳; 周树南

    2012-01-01

    Objective: To compare olanzapine combined sulpiride treatment of refractory schizophrenia and safety. Methods: 45 patients with refractory schizophrenia were randomly divided into two groups: sulpiride combined olanzapine for the study group (n = 22) and the olanzapine for the control group (n=23), before treatment and after treatment (1,2,4,8,12) weekend, used positive and negative symptom scale (PANSS) and treatment emergent symptoms scale (TESS) to evaluate the efficacy and side effects. Results: The second week of the treatment group the total score, positive and negative symptoms, general pathology before treatment was significantly lower than in the control group at 4 weeks before onset, and the Study Group score, negative symptoms and the use of olanzapine dose was significantly lower than the control group.Conclusion: sulpiride combined olanzapine for refractory schizophrenia has a rapid onset, good efficacy and few side effects, reduce the cost burden on patients and increase medication compliance.%目的 比较舒必利合并奥氮平治疗难治性精神分裂症的疗效及安全性.方法 对45 例难治性精神分裂症患者随机分为两组:舒必利合并奥氮平为研究组(n=22) 和奥氮平对照组(n=23),于治疗前和治疗后(1 、2、4、8、12) 周末进行阳性和阴性症状量表(PANSS) 及不良反应症状量表(TESS) 评价疗效及副反应.结果 于治疗第二周末研究组总分、阳性及阴性症状,一般病理分比治疗前明显降低,而对照组于第4周才起效,且研究组的总分,阴性症状分及所用奥氮平剂量明显低于对照组.结论 舒必利合并奥氮平对难治性精神分裂症具有起效快,疗效好,并少有副反应,降低病人费用负担,增加长期服药依从性.

  18. Olanzapine vs Sulpiride in Treating Delusional Syndrome after Acute Cerebral Vascular Disease%奥氮平与舒必利治疗急性脑血管疾病后妄想综合征比较

    Institute of Scientific and Technical Information of China (English)

    唐斌

    2013-01-01

    目的观察奥氮平治疗急性脑血管疾病后妄想综合征的疗效。方法 急性脑血管疾病后妄想综合征病人100例,分为2组奥氮平组50例,男性28例,女性22例,年龄(60±S11)岁,给予奥氮平2.5mg/d逐渐加至5~10mg/d、PO×4周;舒必利组50例,男性26例,女性24例,年龄(62±S13)岁,给予舒必利0.3g/d逐渐加至0.4~0.6g/d、PO×4周。结果奥氮平组和舒必利组经过4WK的治疗后总有效率分别为88%和83%(P>0.05)、两组在2周末有效率分别为78%和26%(P<0.05)。结论 奥氮平治疗急性脑血管疾病后妄想综合征与舒必利对比显效早、药物不良反应少且轻。%Objective:To observe the effects of olanzapine for curing delusions syndrome after acute cerebral vascular disease(ACVD).Method:One hundred patients with ACVD were divided into two groups; olanzapine group (50 patients) male28, female22, age(60±12)a. were given olanzapine 2.5mg/d with gradual increase dosage of 5~10>mg/d, po× 4wk;Sulpiride group of 50 patients, M26, F24, age(62±13)a, sulpiride 0.3g/d also with gradual increase of dosage into 0.4~0.6g/d, po for 4weeks. Result: After 4weeks, the general effective rates of olanzapine group and sulpivide group were 88% and 80%, respectively(P>0.05), those of two group by the end of 2weeks were 78% and 26%, respectively(P<0.05). Conclusion: Delusional syndrome disappearing after ACVD with olanzapine is earlier than sulpiride with more effective results and less adverse reactions.

  19. 奥氮平与奋乃静治疗阿尔茨海默病精神症状的对照%Contrasting of olanzapine and perphenazine treating psychiatric symptoms of Alzheimer' s disease

    Institute of Scientific and Technical Information of China (English)

    宋春联; 王红伟; 孙小华

    2011-01-01

    Objective To compare the curative effect between olanzapine and perphenzine in the treatment of Alzheimer' s disease with psychiatric symptoms. Methods To evaluate the brief psychiatric rating scale(BPRS) ,treatment emergent symptom scale(TESS) in 0,2nd,4th and 6th week in 25 case of Alzheimer' s disease with psychiatric symptoms being treated by olanzapine and in 24 cases treated by perphenzine. Results The BPRS score were lower than that before treatment in both groups in the 2nd week. There were no significant difference in BPRS between two groups( all P > 0. 05 ). But the TESS score of the olanzapine group was significantly lower than that of perphenzine group in the 2nd,4th and 6th week( all P < 0. 05 ). Conclusions Olanzapine and perphenzine have similar therapeutic effect in the treatment of psychiatric symptoms of Alzheimer' s disease. The side effect of olanzapine was lower than that of perphenzine.%目的 对比奥氮平和奋乃静治疗阿尔茨海默病中精神症状的疗效与不良反应.方法 对25例奥氮平和24例奋乃静治疗的存在精神症状的阿尔茨海默病患者,在治疗的0、2、4、6周分别评定简明精神病评定量表(BPRS)、治疗中出现的症状量表(TESS)对比两组阳J疗效和不良反应的差别.结果 两周时两组BPRS评分均较治疗前有显著性降低(P均0.05).2、4、6周奥氮平组的TESS评分明显低于奋乃静组,两组间差异有显著性(P<0.05).结论 奥氮平和奋乃静对治疗阿尔茨海默病精神症状的疗效相似,奥氮平的不良反应低于奋乃静.

  20. 奥氮平治疗阿尔茨海默病精神行为症状对照研究%Comparative study of olanzapine in treatment of behavioral and psychological symptoms of Alzheimer's disease

    Institute of Scientific and Technical Information of China (English)

    吴忠海; 王洪娟

    2015-01-01

    Objective To compare the effect and adverse reaction of olanzapine and risperidone in the treatment of behavioral and psychological symptoms of Alzheimer's disease.Methods 70 cases with Alzheimer's disease were randomly divided into 2 groups, being treated with olanzapine and risperidone seperately for 8 weeks.The Alzheimer's disease pathology behavioral assessment scale ( BEHAVE-AD) and Treatment Emergent Symptom Scale ( TESS) were used to assess the efficacy and adverse reactions.Results Scores of BEHAV-AD decreased significantly after treatment (P0.05).The incidence of extrapyramidal system reaction ( EPS) and insomnia in risperidone group was higher than that of olanzapine group (P <0.05).Conclusions Olanzapine and risperidone had considerable effect in the treatment of behavioral and psychological symptoms of Alzheimer's disease, but olanzapine had better safety.%目的:探讨奥氮平与利培酮治疗老年期痴呆患者的精神行为症状的疗效及不良反应。方法对70例老年痴呆患者随机分为奥氮平组和利培酮组进行治疗,疗程8周。采用阿尔茨海默病病理行为评定表( BEHAVE-AD )及不良反应症状量表( TESS )评定疗效和不良反应。结果治疗后两组BEHAV-AD评分均显著下降(P<0.05或P<0.01);4周时以奥氮平组BEHAV-AD总分及行为紊乱、抑郁、焦虑评分降低明显(P<0.05);奥氮平组有效率91.43%,利培酮组有效率88.57%(P>0.05);在锥体外系反应(EPS)、失眠的发生率利培酮组高于奥氮平组(P<0.05)。结论奥氮平和利培酮用于治疗阿尔茨海默病精神行为症状的临床疗效相当,但奥氮平的安全性更好。

  1. Neurobehavioral and metabolic long-term consequences of neonatal maternal deprivation stress and adolescent olanzapine treatment in male and female rats.

    Science.gov (United States)

    Llorente-Berzal, Alvaro; Mela, Virginia; Borcel, Erika; Valero, Manuel; López-Gallardo, Meritxell; Viveros, Maria-Paz; Marco, Eva M

    2012-03-01

    Early maternal deprivation (MD), 24h of dam-litter separation on postnatal day (PND) 9, has been proposed as a suitable animal model to investigate some neuropsychiatric disorders with a base in neurodevelopment that also compromises metabolic and endocrine homeostasis. Atypical antipsychotics are frequently prescribed to children and adolescents as first-line treatment for several mental disorders despite the adverse metabolic effects frequently reported. However, persistent long-term effects after adolescent drug therapy have been scarcely investigated. In the present study we aimed to investigate the long-lasting metabolic and behavioral effects of MD in combination with the administration of an atypical antipsychotic, i.e. olanzapine, during adolescence. For that purpose, male and female Wistar rats not exposed (control group, Co) and exposed to the MD protocol were administered with oral olanzapine (Olan, 7.5mg/kg/day) or vehicle (Vh, 1mM acetic acid) in drinking water from PND 28 to PND 49. Body weight gain, glycaemia and plasma triglyceride (TG) levels were evaluated as relevant metabolic parameters. MD significantly diminished body weight gain, while Olan administration only induced a subtle decrease in body weight gain among female animals in the long-term. Olan discontinuation decreased plasma TG levels in adult rats, an effect that was counteracted by neonatal exposure to the MD protocol. Both MD and Olan treatment impaired cognitive function in the novel object recognition test, although no interaction between treatments was observed. Neither MD nor Olan administration affected psychotic-related symptoms evaluated in the prepulse inhibition task, although animals treated with Olan showed an increased reactivity to the first acoustic stimulus. MD diminished the corticosterone stress-induced response among females, and reduced the expression of CB1 receptors in the hippocampus of both male and female rats. Notably, Olan administration tended to

  2. Prediction of long-term metabolic effects of olanzapine and risperidone treatment from baseline body mass index in schizophrenia and bipolar disorder.

    Science.gov (United States)

    Bobo, William Victor; Bonaccorso, Stefania; Jayathilake, Karuna; Meltzer, Herbert Yale

    2011-09-30

    Baseline body mass index (BMI), baseline BMI status (normal, overweight, obese) and early (1 month) BMI increases were tested as predictors of 6- and 12-month increases in glucose and lipid measures in 82 olanzapine (OLZ)- and 78 risperidone (RIS)-treated patients with schizophrenia, schizoaffective disorder, or bipolar disorder who participated in a 12-month randomized, prospective metabolic effects study. Baseline BMI predicted greater fasting glucose and HgbA1c levels at 12 months for both treatments. Early BMI change predicted fasting glucose levels at 6 months, but not HgbA1c or BMI, at either time point. For patients who received no concomitant mood stabilizers, early BMI change predicted 12 month HgbA1c values in the OLZ group, and 6- (but not 12-) month fasting glucose and HgbA1c values in the RIS group. Neither baseline BMI nor early BMI change consistently predicted increases in lipids with either drug. OLZ-treated patients with normal baseline BMI had greater increases in total cholesterol, triglycerides, and non-HDL-cholesterol than those who were overweight or obese. In conclusion, higher baseline BMI predicted adverse glycemic changes after 12 months with OLZ and RIS. Individuals with normal baseline BMI may be most susceptible to OLZ-induced hyperlipidosis. Frequency of metabolic screening should be independent of baseline BMI or rapid increases in BMI.

  3. Tianeptine, olanzapine and fluoxetine show similar restoring effects on stress induced molecular changes in mice brain: An FT-IR study

    Science.gov (United States)

    Türker-Kaya, Sevgi; Mutlu, Oğuz; Çelikyurt, İpek K.; Akar, Furuzan; Ulak, Güner

    2016-05-01

    Chronic stress which can cause a variety of disorders and illness ranging from metabolic and cardiovascular to mental leads to alterations in content, structure and dynamics of biomolecules in brain. The determination of stress-induced changes along with the effects of antidepressant treatment on these parameters might bring about more effective therapeutic strategies. In the present study, we investigated unpredictable chronic mild stress (UCMS)-induced changes in biomolecules in mouse brain and the restoring effects of tianeptine (TIA), olanzapine (OLZ) and fluoxetine (FLX) on these variations, by Fourier transform infrared (FT-IR) spectroscopy. The results revealed that chronic stress causes different membrane packing and an increase in lipid peroxidation, membrane fluidity. A significant increment for lipid/protein, Cdbnd O/lipid, CH3/lipid, CH2/lipid, PO-2/lipid, COO-/lipid and RNA/protein ratios but a significant decrease for lipid/protein ratios were also obtained. Additionally, altered protein secondary structure components were estimated, such as increment in random coils and beta structures. The administration of TIA, OLZ and FLX drugs restored these stress-induced variations except for alterations in protein structure and RNA/protein ratio. This may suggest that these drugs have similar restoring effects on the consequences of stress activity in brain, in spite of the differences in their action mechanisms. All findings might have importance in understanding molecular mechanisms underlying chronic stress and contribute to studies aimed for drug development.

  4. Concurrent determination of olanzapine, risperidone and 9-hydroxyrisperidone in human plasma by ultra performance liquid chromatography with diode array detection method: application to pharmacokinetic study.

    Science.gov (United States)

    Siva Selva Kumar, M; Ramanathan, M

    2016-02-01

    A simple and sensitive ultra-performance liquid chromatography (UPLC) method has been developed and validated for simultaneous estimation of olanzapine (OLZ), risperidone (RIS) and 9-hydroxyrisperidone (9-OHRIS) in human plasma in vitro. The sample preparation was performed by simple liquid-liquid extraction technique. The analytes were chromatographed on a Waters Acquity H class UPLC system using isocratic mobile phase conditions at a flow rate of 0.3 mL/min and Acquity UPLC BEH shield RP18 column maintained at 40°C. Quantification was performed on a photodiode array detector set at 277 nm and clozapine was used as internal standard (IS). OLZ, RIS, 9-OHRIS and IS retention times were found to be 0.9, 1.4, .1.8 and 3.1 min, respectively, and the total run time was 4 min. The method was validated for selectivity, specificity, recovery, linearity, accuracy, precision and sample stability. The calibration curve was linear over the concentration range 1-100 ng/mL for OLZ, RIS and 9-OHRIS. Intra- and inter-day precisions for OLZ, RIS and 9-OHRIS were found to be good with the coefficient of variation <6.96%, and the accuracy ranging from 97.55 to 105.41%, in human plasma. The validated UPLC method was successfully applied to the pharmacokinetic study of RIS and 9-OHRIS in human plasma.

  5. The influence of drug physical state on the dissolution enhancement of solid dispersions prepared via hot-melt extrusion: a case study using olanzapine.

    Science.gov (United States)

    Pina, Maria Fátima; Zhao, Min; Pinto, João F; Sousa, João J; Craig, Duncan Q M

    2014-04-01

    In this study, we examine the relationship between the physical structure and dissolution behavior of olanzapine (OLZ) prepared via hot-melt extrusion in three polymers [polyvinylpyrrolidone (PVP) K30, polyvinylpyrrolidone-co-vinyl acetate (PVPVA) 6:4, and Soluplus® (SLP)]. In particular, we examine whether full amorphicity is necessary to achieve a favorable dissolution profile. Drug–polymer miscibility was estimated using melting point depression and Hansen solubility parameters. Solid dispersions were characterized using differential scanning calorimetry, X-ray powder diffraction, and scanning electron microscopy. All the polymers were found to be miscible with OLZ in a decreasing order of PVP>PVPVA>SLP. At a lower extrusion temperature (160°C), PVP generated fully amorphous dispersions with OLZ, whereas the formulations with PVPVA and SLP contained 14%-16% crystalline OLZ. Increasing the extrusion temperature to 180°C allowed the preparation of fully amorphous systems with PVPVA and SLP. Despite these differences, the dissolution rates of these preparations were comparable, with PVP showing a lower release rate despite being fully amorphous. These findings suggested that, at least in the particular case of OLZ, the absence of crystalline material may not be critical to the dissolution performance. We suggest alternative key factors determining dissolution, particularly the dissolution behavior of the polymers themselves.

  6. Peroxisome proliferator-activated receptor gamma (PPARG) Pro12Ala: lack of association with weight gain in psychiatric inpatients treated with olanzapine or clozapine.

    Science.gov (United States)

    Staeker, Julia; Leucht, Stefan; Steimer, Werner

    2012-04-01

    Weight gain is a common problem of treatment with atypical antipsychotics. However, the dimension of body weight change differs interindividually, and various genetic factors are considered to be associated with this effect. Peroxisome proliferator-activated receptor gamma (PPARG) Pro12Ala polymorphism and its reported relationship to type 2 diabetes susceptibility and body mass accumulation prompted us to investigate the impact of this single nucleotide polymorphism (SNP) on antipsychotic-induced changes of body weight and body mass index (BMI) in a naturalistic study design. Included were 138 olanzapine- and 32 clozapine-treated psychiatric inpatients whose demographic data, medical anamnesis, and drug treatment were assessed at admission to hospital and 4 weeks thereafter. The PPARG Pro12Ala SNP was determined with a validated real-time PCR assay. In contrast to previous investigations, we did not detect significant variations of weight gain among the different PPARG Pro12Ala genotypes. Our results suggest that the examined polymorphism appears to play a minor or no role in clinical practice concerning antipsychotic drug-induced weight gain.

  7. Comparative Study of Olanzapine Combined with Xiaoyao Pill in the Treatment of Anorexia Nervosa%奥氮平联合逍遥丸治疗女性神经性厌食症对照研究

    Institute of Scientific and Technical Information of China (English)

    戴春晓; 张海生; 谢健

    2012-01-01

    目的:观察奥氮平联合逍遥丸治疗神经性厌食症的疗效.方法:将46例神经性厌食症住院患者随机分为研究组(奥氮平联合逍遥丸)和对照组(单用奥氮平),每组23例,总疗程12周,疗程结束后随访6月.分别于治疗前及治疗后第2、6、12周及治疗结束后6月记录体重、月经恢复时间评定疗效,同时采用治疗副反应量表(Treatment Emergent Symptom Scale,TESS)评定不良反应.结果:研究组治疗2周体重较治疗前已有显著性增加(P<0.05) ;治疗6周时两组体重增加有显著性差异(P<0.05).研究组的患者平均月经恢复时间较对照组短,差异具有统计学意义(P<0.05).研究组的不良反应发生率较对照组低,差异具有统计学意义(P<0.05),TESS评分在治疗2周、6周两组间比较有显著性差异(P <0.01,P<0.05).结论:奥氮平合并逍遥丸比单独使用奥氮平起效快,并且药物不良反小.%Objective: To study the effects of Olanzapine combined with Xiaoyao pill in anorexia nervosa . Methods: 46 inpatients were randomly divided into the treatment (Olanzapine combined with Xiaoyao pill) group (n =23) and control ( Olanzapine only) group ( n = 23). Patients of the treatment and control groups were given Olanzapine combined with Xiaoyao pill and Olanzapine only respectively. The clinical efficacy was evaluated with weight gain, the time of menses resumption and the safety of drugs was evaluated by using TESS at 1st,2nd,6th, 12th weekend and 6 months after treatment termination. Results: There was a significant weight gain in the treatment group at 2nd weekend,but not in the control group (P < 0. 05) , and the difference of weight gain at 6th weekend between the two groups was significant (P < 0. 05). The time of menses resumption in the treatment group was significantly earlier than that in the control group (P < 0. 05). The incidence of adverse reactions was significantly lower in the treatment group than that in the control

  8. 奥氮平治疗首发精神分裂症的随访对照研究%A compartive Study of Olanzapine in the treatment of first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    谭余龙

    2011-01-01

    Objective To investigate the olanzapine and risperidone in treatm ent of first-episode schizophrenia curative effect and the security.M ethods 148 patients w ith first-episode schizophrenia patients w ere random ly divided into study group (olanzapine group) in 75 cases and the control group (73 cases,risperidone group) respectively taking olanzapine,risperidone treatm ent.T o evaluate clinicalefficacy,positive and negative sym ptom s scale (P A N SS) form s have been used before the treatm ent and afte the treatm ent at the the end of the second,the forth,the eighth and tw elveth m onth,asw ell as using the social dysfunction screening scale (SD SS ) form to assess the social function.R esults the olanzapine and risperidone groups in cure rate,significant efficiency,P A N SS score and SD SS score difference does not have statistical significance (P>0.05),the olanzapine group in extrapyram idal reactions,endocrine disorders,less than risperidone group,the increase in the body w eight than risperidone group,the difference w as statistically significant (P<0.05).C onclusion B oth O lanzapine and risperidone in the treatm ent of first-episode schizophrenia curative effect are good;but olanzapine less adverse reaction,high safety,high com pliance.%目的 探讨奥氮平与利培酮治疗首发精神分裂症的疗效及安全性.方法 将148例首发精神分裂症患者随机分为研究组(奥氮平组)75例和对照组(利培酮组)73例,分别服用奥氮平、利培酮治疗.于治疗前及治疗第2月、4月、8月及12个月末采用阳性症状与阴性症状量表(PANsS)评定临床疗效,同时以社会功能缺陷筛选表(SDSS)评定社会功能;以副反应量表(TESS)评定不良反应.结果 奥氮平组与利培酮组在痊愈率、显效率、PANSS评分与SDSS评分差异无统计学意义(P>0.05),奥氮平组在锥体外系反应、内分泌失调等方面少于利培酮组,在体质量增加方面多于利培酮组,差异具有统计学意

  9. Efficacy of olanzapine in the treatment of patients with acute psychosis%奥氮平治疗急性期精神病患者的疗效观察

    Institute of Scientific and Technical Information of China (English)

    弓剑

    2015-01-01

    Objective:To investigate the efficacy of olanzapine in the treatment of acute psychotic patients.Methods:39 acute psychosis patients were selected.They were treated with olanzapine.According to the PANSS scale,we evaluated the therapeutic effect,and we recorded the adverse reactions.Results:Compared with before the treatment,the PANSS scores of the patients were significantly decreased.There were in 4 cases of lethargy,3 cases of insomnia,1 cases of myotonia,tremor in 1 cases,10 cases of weight gain,4 cases of tachycardia,3 cases of dry mouth and nausea in 4 cases.Conclusion:Olanzapine as the drug therapy in patients with acute psychosis has significant effect.%目的:探讨奥氮平治疗急性期精神病患者的疗效。方法:收治急性期精神病患者39例,给予奥氮平治疗,根据PANSS量表评定治疗效果,记录不良反映。结果:与治疗前相比,患者PANSS量表评分明显降低。出现嗜睡4例、失眠3例、肌强直1例、震颤1例、体重增加10例、心动过速4例、口干3例和恶心4例。结论:奥氮平作为急性期精神病患者的治疗药物,有非常明显的效果。

  10. 奥氮平联合多奈哌齐治疗脑器质性精神障碍疗效观察%Efficacy of olanzapine plus donepezil in the treatment of brain organic psychosis

    Institute of Scientific and Technical Information of China (English)

    潘振山; 魏冬

    2014-01-01

    Objective To explore the efficacy of olanzapine plus donepezil in the treatment of brain organic psychosis (BOP) .Methods Eighty-two BOP patients were randomly divided into 2 groups ,both groups received conventional therapy for brain organic disease and took orally olanzapine ,on this basis research group was plus donepezil .Efficacies and adverse reac-tions were assessed with the Brief Psychiatric Rating Scale (BPRS) ,Positive and Negative Syndrome Scale (PANSS) and Activities of Daily Living (ADL) before and after treatment .Results After treatment all scales scores lowered more significantly compared with pretreatment (P0 .05) .Conclusion Olanzapine plus donepezil has an evident effect and higher safety compared with single olanzapine in the treatment of brain organic psychosis .%目的:探讨奥氮平联合多奈哌齐治疗脑器质性精神障碍的临床疗效和安全性。方法将82例脑器质性精神障碍患者随机分为两组,均接受脑器质性疾病常规治疗及口服奥氮平治疗,研究组在此基础上联合多奈哌齐治疗。于治疗前后采用简明精神病量表、阳性与阴性症状量表、日常生活能力量表评定临床疗效及不良反应。结果治疗后两组各量表评分均较治疗前显著降低(P<0.01),研究组显著低于对照组(P<0.01);两组不良反应发生率比较差异无显著性(P>0.05)。结论奥氮平联合多奈哌齐治疗脑器质性精神障碍临床疗效显著,安全性高,优于单用奥氮平治疗。

  11. CONTROL STUDY BETWEEN RISPERIDONE ORAL SOLUTION AND OLANZAPINE FOR ALCOHOL -INDUCED MENTAL DISORDER%利培酮口服液与奥氮平治疗酒精所致精神障碍对照研究

    Institute of Scientific and Technical Information of China (English)

    王丽莉; 吕浩; 杨建立

    2012-01-01

    目的:探讨利培酮口服液与奥氮平治疗酒精所致精神障碍的疗效和安全性.方法:将68例男性酒精所致精神障碍患者随机分为利培酮口服液治疗组和奥氮平治疗组.采用阳性与阴性症状量表( PANSS)评定临床疗效;采用治疗副反应量表( TESS)评定药物不良反应.结果:利培酮口服液与奥氮平两组疗效差异无显著性.利培酮口服液主要不良反应为锥外系反应,奥氮平为体重增加.结论:利培酮口服液与奥氮平治疗酒精所致精神障碍疗效及耐受性均好,可根据用药对象对不良反应的耐受等情况进行选择.%Objective: To compare the efficacy and safety of risperidone oral solution and olanzapine in the treatment of alcohol - induced mental disorder. Methods: Sixty - eight male patients with alcohol - induced mental disorder were randomly divided into risperidone oral solution group and olanzapine group. Clinical effect was evaluated by Positive and Negative Syndrome Scale (PANSS) ,and the adverse drug reactions were assessed with Treatment Emergent Symptom Scale ( TESS) . Results: No significant differences were observed in the clinical effect of the two groups. The main side effect experienced by the olanzapine group was body weight gain, while the resperidone oral solution group showed extrapyramidal responses. Conclusion: Both olanzapine and risperidone oral solution are safe and effective for the treatment of alcohol - induced mental disorder,and can be clinically selected according to patients' tolerance of the side effects.

  12. 艾司西酞普兰合并奥氮平治疗难治性抑郁症疗效观察%A comparative study of escitalopram augmented with olanzapine in the treatment of refractory depression.

    Institute of Scientific and Technical Information of China (English)

    孟祥军; 李玉焕; 姜玉艳; 陈修哲

    2011-01-01

    Objective To investigate the efficacy of escitalopram combined with olanzapine in the treatment of refractory depression.Methods A total of 55 patients were randomly divided into study group treated with escitalopram combined with olanzapine and control group treated with olanzapine for 12 weeks.The efficacy and side effects were evaluated with Hamilton Depression Rating Scale (HAMD) and Treatment Emergent Symptom Scale (TESS).Results Scores of HAMD in two groups both decreased significantly (P < 0.05 ) after the treatment.Scores of HAMD in study group were significantly lower than that in control group at the 8th and 12th weekend (P <0.05).Side effects in the two groups were mild, but the frequency of weigh gain and hypersomnia in study group were significantly higher than those in control study ( P < 0.05 ).Conclusion Escitalopram augmented with olanzapine has better effect than escitalopram monotherapy in the treatment of refractory depression with satisfactory tolerability.%目的 探讨艾司西酞普兰合并奥氮平对难治性抑郁症的临床疗效.方法 将55例难治性抑郁症患者随机分为研究组(艾司西酞普兰合并奥氮平)和对照组(单用艾司西酞普兰),疗程为12周,采用汉密尔顿抑郁量表(HAMD)评定临床疗效,副反应量表(TESS)评定不良反应.结果 治疗结束后,两组HAMD评分较治疗前均有显著性降低(P<0.05).治疗后第8、12周末,研究组的HAMD评分显著低于对照组,且差异有显著性意义(P<0.05).两组副作用均较小,研究组仅在体重增加、嗜睡方面较对照组高,差异有显著性意义(P<0.05).结论 艾司西酞普兰合并奥氮平治疗难治性抑郁症能明显提高疗效,安全可靠.

  13. 奥氮平所致难治性迟发性肌张力障碍1例%Case report of refractory tardive dystonia induced by olanzapine

    Institute of Scientific and Technical Information of China (English)

    孙振晓; 王相立

    2014-01-01

    Tardive dystonia (TDt), a cluster of extrapyramidal symptoms that are caused by long-term use of antipsychotic medication, is characterized by difficulty in autonomic movements of skeletal (voluntary) muscles and consequent deformations of the body. TDt is rarely seen among patients taking olanzapine, but olanzapine was the precipitating antipsychotic medication in this 22-year old male patient with schizophrenia who developed lip puckering, persistent involuntary torticollis, muscular pain, axial dystonia and unstable gait after taking a standard dose of olanzapine regularly for about one year. His symptoms did not resolve after his olanzapine was stopped. Four months of treatment with clozapine combined with magnesium valproate, vitamin E, tiapride, and lorazepam did not lead to any improvement in the dystonia.%迟发性肌张力障碍是长期使用抗精神病药物所致的一系列锥体外系症状,主要特征包括骨骼肌肉(随意肌)自主运动困难和随后的躯体变形。迟发性肌张力障碍在服用奥氮平患者中罕见,但本文报道中奥氮平正是这名22岁男性精神分裂症患者的促发抗精神病药物,他坚持服用标准剂量的奥氮平大约1年后出现撅嘴、持续不自主斜颈、肌肉疼痛、轴向肌张力障碍和步态不稳的症状。停用奥氮平后,他的症状没有缓解。氯氮平合并丙戊酸镁、维生素E、硫必利和劳拉西泮治疗四个月也没有让肌张力障碍得到任何改善。

  14. 奥氮平联合氯氮平治疗难治性精神分裂症患者的疗效观察%The effect of olanzapine combined with clozapine in the treatment of refractory schizophrenia

    Institute of Scientific and Technical Information of China (English)

    刘旭; 严宏力; 郑华

    2011-01-01

    目的:观察奥氮平联合氯氮平治疗难治性精神分裂症的疗效和不良反应. 方法:50例难治性精神分裂症患者随机分为合用药组和单用药组各25例.合用药组给予奥氮平合并小剂量氯氮平治疗,单用药组仅给予奥氮平治疗.疗程12周.采用阳性与阴性症状量表(PANSS)及治疗中出现的症状量表(TESS)于治疗前及治疗4、8、12周分别评定疗效和不良反应. 结果:治疗后两组PANSS总分、阳性症状及阴性症状分均较治疗前明显降低(P<0.05或P<0.01),以合用药组显著低于单用药组(P<0.05).两组不良反应比较差异无统计学意义(P>0.05). 结论:奥氮平联合氯氮平治疗难治性精神分裂症疗效好,不良反应少且依从性好.%Objective:To investigate the efficacy and adverse reactions of olanzapine combined with clozapine in the treatment of refractory schizophrenia. Method:The SO patients of refractory schizophrenia were randomly divided into combined drug group and single-use drug group,25 cases each. Combination group were given a small dose of olanzapine combined with clozapine,single group were given olanzapine,treatment lasted 12 weeks. Positive and negative syndrome scale (PANSS) and treatment emergent symptom scale(TESS) were used to evaluate the efficacy and adverse drug reactions,before treatment and 4,8,12 weeks after starting treatment were assessed respectively. Results: The scores of total PANSS and positive and negative factor scores were decreased in both groups (P 0.05 ). Conclusion:Olanzapine combined with clozapine treatment of refractory schizophrenia,can significantly improve the positive and negative symptoms,better efficacy,fewer side effects and better compliance.

  15. Effect of quetiapine and olanzapine on cognitive function in patients with chronic schizophrenia%喹硫平和奥氮平对慢性精神分裂症患者认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    王美玲

    2014-01-01

    目的:比较喹硫平和奥氮平对慢性精神分裂症患者认知功能的影响。方法:80例慢性精神分裂症患者随机分配接受喹硫平、奥氮平治疗。分别在入组时、12周、24周末测定PANSS、WCST、言语流畅性测验、成人言语学习测验、CPT、WMS、WAIS、连线试验测定、手指叩击试验。结果:喹硫平组患者在言语流畅性、CPT和执行功能方面优于奥氮平组,有统计学差异(P<0.05);认知功能的改善与PANSS量表总分、阴性症状的改善之间有显著的相关性(r=-0.33, P<0.05)。结论:喹硫平、奥氮平均可不同程度改善慢性精神分裂症患者的认知功能,喹硫平在某些方面优于奥氮平。%Objective:To compare effects of quetiapine and olanzapine on cognitive function in patients with chronic schizo-phrenia. Methods:A total of 80 patients with chronic schizophrenia were randomly divided into quetiapine group and olanzapine group. The cognitive function was assessed at baseline,12th weekend and 24th weekend with positive and negative syndrome scale (PANSS), Wisconsin card sorting test (WCST), verbal fluency test, adult verbal learning test, continuous performance test (CPT), Wechsler memory scale ( WMS) , Wechsler adult intelligence scale ( WAIS) , trail marking test ( TMT) and finger tapping test ( FIT) . Results:Quetiapine had more significant improvement on executive function, CPT and verbal fluency than olanzapine (P<0. 05). The cognitive function change was related to change of total score and negative symptoms score in PANSS (r=-0. 33, P<0. 05). Conclusions:Que-tiapine and olanzapine could improve the cognitive function for the patients with chronic schizophrenia, and the former is better in some aspects.

  16. Schizophrenia symptoms and functioning in patients receiving long-term treatment with olanzapine long-acting injection formulation: a pooled analysis

    Directory of Open Access Journals (Sweden)

    Peuskens Joseph

    2012-08-01

    Full Text Available Abstract Background This analysis of pooled data evaluates treatment outcomes of patients with schizophrenia receiving maintenance treatment with olanzapine long-acting injection (OLAI by means of a categorical approach addressing the symptomatic and functional status of patients at different times. Methods Patients were grouped into 5 categories at baseline, 6 months, and 12 months. Shifts between categories were assessed for individual patients and factors associated with improvement were analyzed. 1182 patients from 3 clinical trials were included in the current analysis. Results At baseline, 434 (36.8% patients had minimal Positive and Negative Syndrome Scale (PANSS symptoms but seriously impaired Heinrich Carpenter’s Quality of Life Scale (QLS functioning; 303 (25.6% had moderate to severe symptoms and seriously impaired function; 208 (17.6% had mild to moderate symptoms but good functioning, and 162 (13.7% had minimal symptoms and good functioning. Baseline category was significantly associated with Clinical Global Impression – Severity (CGI-S, extrapyramidal symptoms, working status, age, and number of previous episodes. The majority of all patients starting OLAI treatment maintained or improved (62% at 6 months and 52% at 12 months their symptom and functioning levels on OLAI maintenance treatment. Less than 8% of the patients showed worsening of symptoms or functioning. An improvement in category was associated with high PANSS positive and low CGI-S scores at baseline. Conclusions We present evidence that a composite assessment of schizophrenic patients including symptom severity and functioning is helpful in the evaluation of maintenance treatment outcomes. This approach could also be useful for the assessment of treatment options in clinical practice. The trials from which data are reported here were registered on clinicaltrials.gov as NCT00088491, NCT00088465, and NCT00320489.

  17. 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.

    Science.gov (United States)

    Sacristán, J A; Gómez, J C; Montejo, A L; Vieta, E; Gregor, K J

    2000-05-01

    The objectives of this study were to determine the doses of olanzapine (OLZ), risperidone (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. 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 > or = 2 points on the CGI, with a final CGI score or = 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). 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.

  18. Cost effectiveness of paliperidone palmitate versus risperidone long-acting injectable and olanzapine pamoate for the treatment of patients with schizophrenia in Sweden.

    Science.gov (United States)

    Mehnert, Angelika; Nicholl, Deborah; Pudas, Hanna; Martin, Monique; McGuire, Alistair

    2012-01-01

    To model the cost effectiveness of paliperidone palmitate (paliperidone long-acting injectable; PLAI), a new once-monthly long-acting antipsychotic therapy, compared with risperidone long-acting injectable (RLAI) and olanzapine pamoate (OLAI), in multi-episode patients (two or more relapses) with schizophrenia in Sweden. A Markov decision analytic model was developed to simulate the history of a cohort of multi-episode patients transitioning through different health states on a monthly basis over a 5-year time horizon from the perspective of the Swedish healthcare system. Therapeutic strategies consisted of starting treatment with RLAI (mean dose 37.5 mg every 2 weeks), PLAI (mean dose 75 mg equivalent (eq.) every month) or OLAI (150 mg every 2 weeks or 300 mg every 4 weeks). Probability of relapse, level of adherence, side-effects (extrapyramidal symptoms, tardive dyskinesia, weight gain and diabetes) and treatment discontinuation (switch) were derived from long-term observational data when feasible. Incremental cost-effectiveness outcomes, discounted at 3% annually, included cost per quality-adjusted life-year (QALY) and cost per relapse avoided (expressed in 2009 Swedish Krona SEK). Relative to RLAI and OLAI, PLAI is economically dominant: more effective (additional QALYs, less relapses) and less costly treatment option over a 5-year time horizon. The results were robust when tested in sensitivity analysis. The impact of once-monthly treatment on adherence levels is not yet known, and not all variables that could impact on real-world outcomes and costs were included in this model. PLAI was cost saving from a Swedish payer perspective compared with RLAI and OLAI in the long-term treatment of multi-episode (two or more relapses) schizophrenia patients.

  19. 奥氮平对美国王鸽生产性能的影响及机制研究%Effect of olanzapine on laying performance of Americal king pigeons and approach to the mechanisms

    Institute of Scientific and Technical Information of China (English)

    赵文静; 顾林英; 邹晓庭; 张敏; 刘进国

    2011-01-01

    This trial was conducted to investigate the effects and mechanism of olanzapine (a antagonist of DA and 5-HT) on laying performance of Americal king pigeons. One hundred and twenty couples of 720-day laying pigeons were randomly allocated to four groups (one control and three treatment groups), supplied with 0,0. 25, 0. 75 and 1.25 mg. kg-1 olanzapine, respectively. The experiment period was sixty days. Results indicated that: 1) supplement of 0. 75 and 1.25 mg. kg-1 olanzapine in diet increased the laying rate by 20. 24%(P<0. 05) and 23. 41% (P<0. 05), decreased the laying interval by 29. 83% (P<0. 05) and 37. 46% (P<0. 05), respectively; and the serum concentrations of total protein were significantly increased by 7. 33% (P<0. 05) and 11.59% (P<0. 05) and blood urea nitrogen level significantly decreased by 32. 6% (P<0. 05) and 47. 8% (P<0. 05) in the 0. 75 and 1.25 mg. kg-1 olanzapine groups, respectively; 2) different levels of olanzapine had no effect on fecundation and incubation rate of the eggs; compared with the control group, 0. 75 and 1.25 mg·kg-1 olanzapine groups decreased prolactin concentrations by 21.90% (P<0. 05) and 34. 53%(P<0. 05), increased the follicle-stimulating hormone concentrations by 24. 0% (P<0.05) and 28. 5% (P<0. 05), and increased the progestin concentrations by 33. 7% (P<0. 05) and 42.0% (P<0. 05), respectively.It is indicated that olanzapine, as an antagonist of DA and 5-HT, can promote the laying performance of king pigeon by decreasing the prolactin concentration.%采用多巴胺(dopamine,DA)和5-羟色胺(5-hydroxy tryptamine,5-HT)的拮抗剂奥氮平(olanzapine,Ola)作为调控物,研究奥氮平对美国王鸽产蛋性能的影响并探讨其作用机制.选720日龄美国王鸽120对,随机分成4组;对照组饲喂基础日粮,试验组分别添加0.25、0.75和1.25 mg·kg-1臭氮平,试验期60 d.试验结果显示:1)与对照组相比,0.75和1.25 mg·kg-1奥氮平

  20. 阿立哌唑与奥氮平治疗酒精所致精神障碍对照研究%A control study of aripiprazole vs .olanzapine in the treatment of mental disorders due to alcohol

    Institute of Scientific and Technical Information of China (English)

    刘娟; 高营

    2014-01-01

    目的:探讨阿立哌唑与奥氮平治疗酒精所致精神障碍的临床疗效和安全性。方法将66例酒精所致精神障碍患者随机分为两组,分别口服阿立哌唑与奥氮平治疗,观察8周。治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗8周末阿立哌唑组显效率87.5%,总有效率96.9%,奥氮平组分别为88.2%、97.0%,两组显效率、总有效率比较差异无显著性(χ2=0.19、0.00,P>0.05)。两组不良反应较轻微,阿立哌唑组主要表现为头痛、失眠等;奥氮平组主要表现为嗜睡、体质量增加等。结论阿立哌唑与奥氮平均能快速改善酒精所致精神障碍的精神症状,总体疗效相当,安全性高,但不良反应表现形式有所不同,临床上可根据不同患者选用不同的药物治疗。%Objective To explore the efficacy and safety of aripiprazole vs .olanzapine in the treatment of mental disorders due to alcohol (MDA) .Methods Sixty-six MDA patients were randomly divided into two groups taking orally aripiprazole or olanzapine respectively for 8 weeks .Efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS) before and after treatment and adverse reactions with the Treatment Emergent Syndrome Scale (TESS) .Results At the end of the 8th week ,obvious and total ef-fective rate were respectively 87 .5% and 96 .9% in aripiprazole and 88 .2% and 97 .0% in olanzapine group ,which showed no significant differences (χ2 =0 .19 ,0 .00 ;P>0 .05) .Adverse reactions of both groups were mild ,mainly headache ,insomnia etc .in aripiprazole and hypersomnia and weight gain etc .in olanzapine group .Conclusion Both aripiprazole and olanzapine could improve mental symptoms of MDA quickly ,their total efficacy are equivalent ,both have higher safety ,but manifestations of adverse reactions are somew hat different ,so different pharmacotherapies

  1. Disease Burden Research of Quetiapine and Olanzapine in the treatment of Schizophrenia%喹硫平与奥氮平治疗精神分裂症患者的疾病负担研究

    Institute of Scientific and Technical Information of China (English)

    路亚洲; 白羽霞; 李虹耀; 韩晟

    2016-01-01

    Objective Based on real world data, this study explores disease burden of schizophrenia and evaluates the impacts of quetiapine and olanzapine on economic burden.Methods Included data were extracted from urban basic medical insurance database.Then statistical analyses were used to analyze the data.Results Study included 26 patients with schizophrenia hospitalized patients,the average hospitalization time (116±56)d,average hospital- lization expenses for (8899±11,748) yuan.Quetiapine group patients hospitalization time was significantly lower than that in the olanzapine group,average hospitalization expenses and average daily hospitalization expenses were significantly lower than those of olanzapine group,average and daily drug cost,drug accounted for were significantly lower than the olanzapine group,differences were statisticaly significant(P<0.05).Conclusion Our mental division patients in hospital for a long time,burden of disease.Compared to the olanzapine,quetiapine can save medical resources and quetiapine economy better.%目的:基于真实世界数据,对中国精神分裂症进行疾病负担研究,并以奥氮平和喹硫平为例探讨该疾病的经济负担情况。方法提取2011年中国医疗保险研究会《全国城镇基本医疗保险参保患者药品医疗器械和诊疗项目利用情况调查》数据库中精神分裂症住院患者的相关数据,进行统计分析。结果研究纳入了2600例精神分裂症住院患者,平均住院时间为(116±56)d,次均住院费用为(8899±11748)元;喹硫平组患者的次均住院时间显著低于奥氮平组,次均住院费用和日均住院费用均显著低于奥氮平组,次均及日均药品费用、药占比均显著低于奥氮平组,差异均有统计学意义(均P<0.05)。结论我国精神分裂症患者住院时间长,疾病负担重;相比于奥氮平,使用喹硫平能节约医疗服务资源,且经济性更佳。

  2. Comparative Study of Amisulpride vs . Olanzapine for the Treatment of Schizophrenia%氨磺必利与奥氮平治疗精神分裂症的对照研究

    Institute of Scientific and Technical Information of China (English)

    杨栋; 陈晋东; 谌益华; 彭红莉

    2014-01-01

    [Objective]To explore clinical efficacy and safety of amisulpride in the treatment of schizophre-nia .[Methods] Totally 121 patients with schizophrenia were randomly assigned to amisulpride group ( n=61) and olanzapine group( n=60) .Two groups were treated with amisulpride and olanzapine respectively for 12 weeks .The efficacy and side reactions were evaluated with positive and negative syndrome scale (PANSS) and treatment emergent symptom scale (TESS ) .[Results] After 12 weeks of treatment , the effective rate of amisulpride and olanzapine were 83 .6% and 86 .7% respectively ,but there was no significant difference be-tween two groups( P > 0 .05) .Compared with before treatment ,the total scores of PANSS in amisulpride group and olanzapine group after treatment were significantly decreased [(41 .79 ± 9 .66) vs .(91 .76 ± 13 .06) , (46 .56 ± 9 .88) vs .(94 .83 ± 15 .67)]( P 0 .05) .[Conclusion]The total efficacy of amisulpride is similar to olanzapine ,. Amisulpride can better improve negative symptoms ,and has mild side reaction and high safety .%【目的】探讨氨磺必利治疗精神分裂症的临床疗效与安全性。【方法】121例精神分裂症患者随机分为氨磺必利组(N=61)与奥氮平组(N=60)两组,分别予以氨磺必利与奥氮平治疗,疗程12周。采用阳性和阴性症状量表(PANSS)、副反应量表(TESS)评定疗效和不良反应。【结果】治疗12周后,氨磺必利组的有效率为83.6%,奥氮平组的有效率为86.7%,两组的差异无统计学意义( P >0.05);氨磺必利组与奥氮平组患者PANSS总分治疗后(41.79±9.66,46.56±9.88)均较治疗前(91.76±13.06,94.83±15.67)有显著下降( P <0.01);氨磺必利组患者在治疗12周后 PANSS阴性症状分值为(9.61±3.86)分,降低较奥氮平组(12.56±6.15)更为显著( P <0.05)。两组不良反应发生率

  3. 60例脑血管疾病所致精神障碍奥氮平与利培酮治疗效果对比%Effect of olanzapine and risperidone in the treatment of 60 cases of mental disorder caused by cerebrovascular disease comparison

    Institute of Scientific and Technical Information of China (English)

    高晨

    2015-01-01

    Objective To observe the effect of mental disorder caused by olanzapine and risperidone in the treatment of cerebral vascular disease. Methods will randomly olanzapine group and risperidone group. According to the grouping of olanzapine in the treatment group received olanzapine treatment of risperidone in treatment group were given risperidone, treatment. Results In the total effective rate of treatment group was 96.66%, treatment with olanzapine, risperidone group 93.33%, two groups are basically the same. However, olanzapine has fewer adverse effects of the treatment group was 16.66%, risperidone in treatment group was 30%, statistically significant difference contrast. Conclusion Olanzapine can significantly reduce the incidence of adverse reaction of patients, more worthy of clinical promotion and practice of strengthening the.%目的:分析奥氮平与利培酮治疗脑血管疾病所致精神障碍的疗效。方法将该院于2013年1月—2013年12月选取的60例患者随机划分为奥氮平治疗组与利培酮治疗组。根据分组对奥氮平治疗组患者予以奥氮平进行治疗,对利培酮治疗组予以利培酮进行治疗。结果在治疗的总有效率方面,奥氮平治疗组为96.66%,利培酮治疗组为93.33%,两组基本一致,对比差异不具有统计学意义。但奥氮平治疗组患者的不良反应更少为16.66%,利培酮治疗组为30%,对比差异具有统计学意义。结论奥氮平治疗脑血管疾病所致精神障碍的效果与利培酮基本一致,但是却能够明显降低患者的不良反应发生率,更加值得加强临床推广与实践。

  4. 氨磺必利替换奥氮平治疗对伴有代谢综合征精神分裂症患者的影响%The effects of amisulpride replacing olanzapine therapy in schizophrenia patients with metabolic syn-drome

    Institute of Scientific and Technical Information of China (English)

    刘立恒; 易军

    2014-01-01

    Objective:To observe the effects of amisulpride replace olanzapine therapy in schizophrenic patients with metabolic syndrome. Method:Ninety-two schizophrenia patients with metabolic syndrome that primarily used olanzapine were randomly divided into amisulpride group(treatment group)and olanzapine group (control group),each group 46 cases. In the treatment group we replaced olanzapine with amisulpride within two weeks;In the control group,the olanzapine treatment unchanged;Observation time 12 weeks. At the time of en-rollment and the 6,12 weekend,blood pressure,waist circumference,body mass index(BMI)and fasting blood sugar(FBS),high density lipoprotein(HDL),triglycerides(TG)levels were measured,respectively. The clinical situation was assessed by positive and negative symptoms rating scale(PANSS)and treatment emergent side-effect scale(TESS). Results:After 12 weeks treatment,waist circumference,systolic blood pressure,BMI, TG,FBS of the treatment group were significantly lower than the control group(P 0. 05),while TESS score of the treatment group was lower than the control group(P 0.05),而 TESS 评分治疗组低于对照组(P <0.05)。结论:氨磺必利替换奥氮平治疗对精神分裂症患者体质量增加及代谢综合征有显著改善作用。

  5. Síndrome neuroléptica maligna de paciente em uso de olanzapina Neuroleptic malignant syndrome in patient using olanzapine

    Directory of Open Access Journals (Sweden)

    Fabrício Lins de Medeiros

    2008-01-01

    Full Text Available A síndrome neuroléptica maligna (SNM é uma reação idiossincrásica rara, extremamente grave e potencialmente fatal ao uso de antipsicóticos, tanto típicos quanto atípicos, bem como drogas de ação dopaminérgica. O diagnóstico fundamenta-se em critérios clínicos e laboratoriais e exclusão de outras condições médicas gerais ou psiquiátricas que melhor expliquem os sintomas. Segundo o DSM-IV, os principais critérios são rigidez muscular grave e temperatura elevada, associadas ao uso de medicação antipsicótica. Foi relatado um caso de paciente com 30 anos manifestando história de transtorno afetivo bipolar, que apresentou sinais e sintomas consistentes com SNM, após três semanas de tratamento com olanzapina. Esse relato visa a discutir o risco da SNM ao uso de antipsicóticos atípicos, bem como a importância de diagnóstico precoce e intervenção imediata.Neuroleptic malignant syndrome (NMS is an idiosyncratic, serious and potentially fatal disorder observed in patients who receive treatment with neuroleptics, typical and atypical, as well as medications with dopaminergic effects. The diagnosis is based on clinical and laboratory criteria and the exclusion of other general medical or psychiatric conditions that could best explain the symptoms. The main criteria according to DSM-IV are severe rigidity and fever associated with the use of antipsychotic medication. We present a case of a 30-year-old female with history of bipolar affective disorder that developed signs and symptoms consistent with NMS after three weeks of treatment with Olanzapine. This case aims to address the risk of NMS associated atypical antipsychotic, as well as the importance of an early diagnosis and immediate intervention.

  6. Neuroleptic malignant syndrome due to concomitant use of olanzapine and fluvoxamine%奥氮平联用氟伏沙明致恶性综合征

    Institute of Scientific and Technical Information of China (English)

    孙振晓; 李景君

    2016-01-01

    1例72岁男性抑郁症患者应用奥氮平(7.5 mg/ d)合并氟伏沙明(125 mg/ d)口服治疗2个月后出现发热、意识障碍、肌强直、多汗、心动过速,WBC 12.3×109/ L,血清 CK 737 U/ L。停用所有口服药物,给予持续吸氧、心电监护、保持呼吸道通畅、物理降温、维持水电解质及酸碱平衡、控制感染等处置,并静脉滴注氯硝西泮1 mg/ d,口服多巴胺受体激动剂吡贝地尔100 mg/ d。3 d 后患者体温恢复正常,意识转清,5 d 后肌张力及血常规各项指标和血清 CK 恢复正常。%A 72-year-old man with depression received oral olanzapine 7. 5 mg/ d and fluvoxamine 125 mg/ d. Two months after the drug administration,the patient developed fever,consciousness,rigidity, sweating,and tachycardia. Blood tests showed that the white blood cell count was 12. 3 × 109 / L and creatine kinase( CK ) level was 737 U/ L. All drugs were stopped and continuous oxygen inhalation, electrocardiographic monitoring and measures for keeping the respiratory tract unobstructed were given. Ice pillows and ice packs were used to lower his temperature. Treatments such as fluid infusion,correction of water-electrolyte balance,infection prevention,intravenous infusion of clonazepam 1 mg once daily,and oral dopamine receptor agonist piribedil 100 mg once daily were also given. Three days later,his temperature returned to normal and his consciousness turned clear. Five days later,his muscle tension,routine blood test,and CK level returned to normal.

  7. Development and evaluation of olanzapine-loaded PLGA nanoparticles for nose-to-brain delivery: in vitro and in vivo studies.

    Science.gov (United States)

    Seju, U; Kumar, A; Sawant, K K

    2011-12-01

    Olanzapine (OZ) is a second-generation or atypical antipsychotic which selectively binds to central dopamine D₂ and serotonin (5-HT(2c)) receptors. It has poor bioavailability due to hepatic first-pass metabolism and low permeability into the brain due to efflux by P-glycoproteins. The present investigation aimed to prepare a nanoparticulate drug delivery system of OZ using poly(lactic-co-glycolic acid) (PLGA) for direct nose-to-brain delivery to provide brain targeting and sustained release. PLGA nanoparticles (NP) were prepared by the nanoprecipitation technique and characterized by entrapment efficiency, particle size, zeta potential, modulated temperature differential scanning calorimetry (MTDSC) and X-ray diffraction (XRD) studies. The NP were evaluated for in vitro release, ex vivo diffusion, toxicity and pharmacokinetic studies. The NP were 91.2±5.2 nm in diameter and had entrapment efficiency 68.91±2.31%. MTDSC studies indicated broadening of the drug peak and a shift in the polymer peak, possibly due to physical interaction or H-bonding between the carbonyl groups of PLGA and the NH groups of OZ, and also due to the plasticization effect of OZ on PLGA. XRD studies indicated a decrease in the crystallinity of OZ or amorphization. In vitro drug release showed a biphasic pattern with initial burst release and, later, sustained release (43.26±0.156% after 120 h), following the Fickian diffusion-based release mechanism. Ex vivo diffusion through sheep nasal mucosa showed 13.21±1.59% of drug diffusion in 210 min from NP. Histopathological study of sheep nasal mucosa showed no significant adverse effect of OZ-loaded NP. In vivo pharmacokinetic studies showed 6.35 and 10.86 times higher uptake of intranasally delivered NP than OZ solution delivered through intravenous (IV) and intranasal (IN) route, respectively. These results proved that OZ could be transported directly to the brain after IN delivery of PLGA NP, enhanced drug concentration in the brain and

  8. 氟哌啶醇与奥氮平治疗精神分裂症的临床疗效对比研究%The effect comparsion of haloperidol and olanzapine in the treatment of schizophrenia

    Institute of Scientific and Technical Information of China (English)

    张建; 常余善; 蒋正伟

    2016-01-01

    Objective To compare clinical efficacy of haloperidol and olanzapine in the treatment of schizophrenia. Methods From March 2014 to March 2015 in Xuzhou Mental Hospital 72 patients with schizophrenia were admitted and ran-domly divided into haloperidol group and olanzapine group,36 cases in each group. Haloperidol group were treated with oral hal-operidol,olanzapine group were treated with oral olanzapine,positive and negative syndrome scale(PANSS)score,serum lip-ids〔triglycerides(TG),total cholesterol(TC),low - density lipoprotein cholesterol(LDL - C),high density lipoprotein cholesterol(HDL - C)〕,mental illness quality of life table(WHOQOL - BREF)score and the incidence of adverse drug reac-tions of two groups were compared. Results Before and after treatment,positive symptoms of schizophrenia,negative symp-toms,general psychopathology score and total score between the two groups showed no statistically significant(P > 0. 05);after treatment,positive symptoms of schizophrenia,negative symptoms two groups of patients,former general psychopathology score and total score of two groups were lower than before treatment(P 0. 05);after treatment TG,TC,LDL - C of haloperidol group were lower than olanzapine group( P 0. 05);after treatment for six months,field physiological,psychological status,social relations and the environment factor score of haloperidol group were higher than olanzapine group(P 0. 05). Conclusion Haloperidol and olanzapine in the treatment of schizophrenia have same effect,can improve the clinical symptoms,but haloperidol has less impact on blood lipid levels of patients,long - term prognosis of patients is better.%目的:比较氟哌啶醇与奥氮平治疗精神分裂症的临床疗效。方法选取2014年3月—2015年3月徐州精神病院收治的精神分裂症患者72例,随机分为氟哌啶醇组与奥氮平组,各36例。氟哌啶醇组患者给予口服氟哌啶醇治疗,奥氮平组给予口服奥氮平治疗,比较两组

  9. 奥氮平与氟哌啶醇治疗老年性谵妄的随机对照观察%Olanzapine and haloperidol for senile delirium: A randomized controlled observation

    Institute of Scientific and Technical Information of China (English)

    胡华; 邓伟; 杨辉; 刘玉

    2006-01-01

    啶醇组次之,对照组起效最慢(P<0.01).结论:奥氮平与氟哌啶醇治疗老年性谵妄疗效相当,但奥氮平起效更快.%BACKGROUND: Delirium is an acute organic brain syndrome caused by various reasons, and it is common in elderly patients. Antipsychotics treatment is an important method to control delirium.OBJECTIVE: To observe the efficacy of new antipsychotic agent of olanzapine and the traditional antipsychotic agent of haloperidol in treating senile delirium.DESIGN: A randomized controlled observation. SETTING: Mental Health Center, the First Affiliated Hospital of Chongqing University of Medical Sciences.PARTICIPANTS: Totally 175 inpatients with senile delirium were selected from the First Affiliated Hospital of Chongqing University of Medical Sciences from September 2001 to September 2003, they were randomly divided into olanzapine treatment group (n=74), haloperidol treatment group (n=72) and a control group(n=29). There were 111 males (63.4%) and 64 females (36.6%). Delirium had occurred for a duration of 30 minutes to 17 days, with an average of (3.02±2.71) days. The enrolled patients were classified according to the etiological factors of delirium: metabolic (n=68), toxic (n=47), structural (n=25) and infectious (n=35).METHODS: Different treatments were used in different groups. Control group (n=29): The patients were only given somatic treatment aiming at delirium, and not any drug for central nervous system was used. Olanzapine group (n=74): Besides the somatic treatment aiming at delirium, the patients were given olanzapine (Zyprexa, produced by Eli Lilly and Company,5 mg/tablet) taken orally or sublingually (fasted patients), the initial dosage was 1.25-2.5 mg per day, and then adjusted to 1.25-20 mg per day. Haloperidol group (n=72): Besides the somatic treatment aiming at delirium, they were treated with intramuscular injection of haloperidol (2.5-10 mg per day). The effects were prospectively observed for 1 week.The scores were observed before enrollment

  10. 奥氮平对精神分裂症患者认知功能的影响%Effect of Olanzapine on the Cognitive Function of Schizophrenia Patients

    Institute of Scientific and Technical Information of China (English)

    贾敏

    2011-01-01

    [Objective]To explore the effect of olanzapine on the cognitive function of schizophrenia patients. [Methods] Fifty two patients with schizophrenia in out hospital were given olanzapine for 8 weeks. The positive and negative syndrome scale(PANSS) , Wechsler memory scale(WMS) and Wisconsin card sorting test(WCST) were used to evaluate before and after treatment. [Results]After 8 weeks of treatment, the score of PANSS was decreased significantly[(43.12±13. 83) vs (77.68±12.14), P<0.01]. The scores of fault answer and un-dura tive fault in WCST decreased significantly( P <0.05). The memory quotient(MQ) and scores of reactive and com prehension in WMS increased significantly ( P <0.05). [Conclusion]Olanzapine can improve the cognitive func tion of schizophrenia patients.%[目的]探讨奥氮平对精神分裂症患者认知功能的影响.[方法]对本院52例精神分裂症患者使用奥氮平治疗8周,于治疗前及治疗后使用阳性和阴性症状量表(Positive and Negative Syndrome Scale, PANSS)、韦氏记忆量表(Wechsler Memory Scale,WMS)和威斯康星卡片分类测验(Wisconsin Card Sorting Test, WCST)进行评估.[结果]治疗8周后,PANSS总分显著降低[(43.12±13.83) vs (77.68±12.14),P<0.01];WCST中错误应答数、非持续性错误的分值显著降低(P<0.05);WMS中记忆商(memory quotient,MQ)、再生和理解的分值显著升高(P<0.05).[结论]奥氮平治疗精神分裂症可改善患者的认知功能.

  11. 氨磺必利与奥氮平治疗女性精神分裂症对照研究%A control study of amisulpride vs olanzapine in the treatment of female schizophrenia

    Institute of Scientific and Technical Information of China (English)

    刘晓红; 金思畅; 李卫军

    2015-01-01

    Objective To explore the clinical efficacy and safety of amisulpride and olanzapine in the treatment of female schizophrenia .Methods Fifty female schizophrenics were randomly assigned to two groups taking orally amisulpride or olanzapine for 6 weeks .Efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scales (TESS) .Results Since the end of the 2nd week the PANSS total and each fac‐tor scores of both groups lowered continuously compared with pretreatment (P0.05) .There were no significant group differences in the incidence of total adverse reactions (P>0.05) ,but manifestations of adverse reactions were somewhat different .Conclusion Amisulpride has an evident effect equivalent to olanzapine ,higher safety and better compliance in female schizophrenia .%目的:探讨氨磺必利与奥氮平治疗女性精神分裂症的临床疗效和安全性。方法将50例女性精神分裂症患者随机分为两组,研究组口服氨磺必利治疗,对照组口服奥氮平治疗,观察6周。于治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗2周末起两组阳性与阴性症状量表总分及各因子分均较治疗前呈持续性下降( P<0.05或0.01),治疗6周末研究组显效率59.1%、有效率81.8%,对照组分别为65.2%、86.9%,两组比较差异无显著性(P>0.05)。两组总体不良反应发生率比较差异无显著性(P>0.05),但不良反应表现形式有所不同。结论氨磺必利治疗女性精神分裂症疗效显著且与奥氮平相当,安全性高,依从性好。

  12. 奥氮平联合舒必利对78例精神分裂症患者的疗效观察%Olanzapine and sulpiride on treatment of schizophrenia patients were observed in 78 cases

    Institute of Scientific and Technical Information of China (English)

    陈丽霞

    2015-01-01

    Objective To observe the curative effect of olanzapine combined with sulpiride for patients with schizophrenia.Methods From April 2013 to April 2015,156 cases of patients with schizophrenia were selected as the research object.All patients were randomly divided into observation group and control group,78 cases in each group.The observation group received olanzapine combined with sulphide in the treatment,the control group was given the olanzapine in the treatment of patients,observed the therapeutic effect of the two groups.Results After treatment,the BPRS score of the observation group was significantly relieved compared to the control group,the difference was statistically significant (P< 0.05).After treatment,the adverse reactions of the two groups were significantly less than those of the control group,the difference was statistically significant (P < 0.05).After treatment,the two groups were treated with 38.46% (30/78),significantly higher than the control group of 23.08% (18/78);the observation group was 2.56% (2/78),significantly lower than the control group 11.54% (9/78),the difference was statistically significant (P < 0.05).Conclusion Olanzapine combined with sulpiride for schizophrenic patients has better clinical curative effect,reduce the probability of the occurrence of adverse reactions.%目的 观察奥氮平联合舒必利对于精神分裂症患者的疗效.方法 2013年4月至2015年4月,选取156例精神分裂症患者作为研究对象.以随机数字法将所有患者分为观察组及对照组,每组78例.观察组患者实施奥氮平联合舒必利治疗,对照组患者实施奥氮平治疗,对比观察两组的治疗效果.结果 两组经过治疗后,观察组的简明精神病评定量表(BPRS)评分相比于对照组得到明显缓解,差异有统计学意义(P<0.05).观察组不良反应相比于对照组明显减少,差异有统计学意义(P<0.05).观察组治愈率38.46%(30/78),明显高于对照组的23.08

  13. Control study of Sulpiride and Olanzapine in the treatment of anorexia nervosa%舒必利与奥氮平治疗神经性厌食症患者的对照研究

    Institute of Scientific and Technical Information of China (English)

    钟智勇; 吴小立; 程敏锋; 张晋碚

    2011-01-01

    AIM: To compare the difference of effect and side effects of Sulpiride with Paroxetine and Olanzapine with Paroxetine in the treatment of anorexia nervosa. METHODS: 57 anorexia vervosa patients were involved in the research, including 25 cases of Sulpiride group,32 cases of Olanzapine group, before and after the treatment, body weight, body mass index (BMI), Hamilton anxiety scale (HAMA),Hamilton depression rating scale (HAMD) and Treatment emergent side-effect scale (TESS) were used to evaluate the curative effect and the adverse drug reactions. RESULTS: After 8 weeks treatment , the indexes of body weight, BMI,HAMA, HAMD were obviously better than those of before treatment (P<0.05). The indexes of body weight and BMI of Olanzapine group were better than those in Sulpiride group after 8 weeks treatment (P<0.05), but there were no difference of HAMA, HAMD and TESS between two groups (P > 0.05) . CONCLUSION: After analysis of the indexes as body weight, BMI,HAMA, HAMD and TESS, the following conclusions are made: the two methods are both effective to the treatment of anorexia noversa, but the Olanzapine with Paroxetine is better than Sulpiride with Paroxetine in improving the body weight and the BMI. The difference of the adverse drug reactions is not found in the two groups.%目的:比较舒必利联合帕罗西汀与奥氮平联合帕罗西汀治疗神经性厌食症的疗效与副反应差别.方法:分析57例(其中使用舒必利组25例,奥氮平组32例)住院神经性厌食症患者治疗8周前后的体重,体重指数,汉密尔顿焦虑量表(HAMA),汉密尔顿抑郁量表(HAMD)及副反应量表(TESS)的结果.结果:两组治疗8周后体重,体重指数及汉密尔顿焦虑量表、汉密尔顿抑郁量表总分均比入院时有明显改善.同时治疗8周后奥氮平组比舒必利组在改善体重及体重指数上要更加明显,两组间比较有统计学差异,而在HAMA、HAMD、TESS的比较上未见统计学差异.结论:舒必利联

  14. Determinação de olanzapina em formulações farmacêuticas por espectrofotometria: desenvolvimento e validação Spectrophotometric olanzapine determination in pharmaceutical formulations: method development and validation

    Directory of Open Access Journals (Sweden)

    Jardes Figuerêdo do Rêgo

    2010-01-01

    Full Text Available Spectrophotometric methods of zero order, first and second derived order had been developed for olanzapine determination in tablets using ethanol and isopropanol as solvent. The two solvents revealed to be adequate. For the three methods the calibration curve coefficient of correlation had been greater than 0.9998 with limit of detection varying from 0.068 to 0.190 mg L-1, in ethanol, and 0.026 to 0.205 mg L-1, in isopropanol. The inter-day precision was inferior to 1.1 and 1.9 mg L-1 for ethanol and isopropanol, respectively. The average recoveries varied from 98 to 101%, in ethanol and 99 to 103% in isopropanol.

  15. Clinical comparison and investigation of curative effects by olanzapine and risperidone in the treatment of behavioral and psychological symptoms of Alzheimer’s disease%奥氮平、利培酮治疗老年痴呆精神行为症状疗效的临床比较探讨

    Institute of Scientific and Technical Information of China (English)

    慕经纬

    2016-01-01

    Objective To compare clinical effects by olanzapine and risperidone in the treatment of behavioral and psychological symptoms of Alzheimer’s disease. Methods A total of 102 patients with Alzheimer’s disease were randomly divided into olanzapine group and risperidone group, with 51 cases in each group. The olanzapine group received olanzapine tablets for treatment, and the risperidone group received risperidone tablets for treatment. Improvements of clinical symptoms were observed in 2, 4, and 8 weeks of treatment. Mini mental state examination (MMSE), dementia pathological behavior score (BE-HAVE) and positive and negative syndrome scale (PANSS) were taken. Condition of adverse drug reactions was evaluated. Results The olanzapine group had total effective rate as 92.2%, and the risperidone group had that as 90.2%. Their difference had no statistical significance (P>0.05). There was no statistically significant difference of scores in hostile suspicion, disturbance of thought, behavior disorders, anxiety-depression, and bigotry between the two groups after 2, 4 and 8 weeks of treatment (P>0.05). The olanzapine group had lower PANSS score in 2 and 4 weeks of treatment than the risperidone group, and the difference had statistical significance (P0.05)。两组治疗后2、4、8周敌对猜疑、思维障碍、行为紊乱、焦虑抑郁、偏执等评分比较差异均无统计学意义(P>0.05)。奥氮平组在治疗2、4周时 PANSS 评分低于利培酮组,差异有统计学意义(P<0.05)。利培酮组发生锥体外系反应和恶心例数多于奥氮平组,差异有统计学意义(P<0.05)。结论奥氮平和利培酮治疗老年痴呆精神行为症状均有较好的疗效,但奥氮平起效更快,不良反应较少,患者耐受性更好。

  16. 加巴喷丁联合奥氮平对老年痴呆夜间谵妄患者睡眠的影响%Effects of gabapentin and olanzapine on the sleep disorders of Alzheimer′s disease patients with delirium

    Institute of Scientific and Technical Information of China (English)

    沈青峰; 李海玲; 孙秀媛; 王恒; 王广法

    2015-01-01

    Objective To observe the therapeutic effects of gabapentin and olanzapine combination on the sleep dis -orders of Alzheimer′s disease patients with delirium .Methods A total of 50 Alzheimer′s disease patients with delirium in our hospital were randomly divided into a treatment group ( n=25 ) and a control group ( n=25 ) .The treatment group was administrated with gabapentin and olanzapine , while the control group received olanzapine alone .Then their sleep patterns were assessed by polysomnography ( PSG) .Results Patients receiving gabapentin and olanzapine therapy pres-ented remarkably improved sleeping process , sleep structure , and REM measurements than those given olanzapine alone (P<0.05).Conclusion The combination of gabapentin and olanzapine can be applied to treat Alzheimer ′s disease pa-tients with delirium , and the mechanism involved required further discussion .%目的:观察加巴喷丁联合奥氮平对老年痴呆夜间谵妄患者睡眠障碍的治疗效果。方法抽取50例住院老年痴呆合并夜间谵妄患者,随机分为实验组(n=25)和对照组(n=25),实验组给予加巴喷丁联合奥氮平治疗,对照组给予奥氮平治疗,以多导睡眠生理仪评定2组患者的睡眠状况。结果实验组患者治疗后睡眠进程、睡眠结构、快动眼睡眠(REM)测量值较对照组改善更为明显,差异具有统计学意义(P<0.05)。结论加巴喷丁联合奥氮平是一种有效治疗老年痴呆合并夜间谵妄患者睡眠障碍的方法,值得临床推广并进一步探讨其机制。

  17. Clozapine regulation of p90RSK and c-Fos signaling via the ErbB1-ERK pathway is distinct from olanzapine and haloperidol in mouse cortex and striatum.

    Science.gov (United States)

    Pereira, Avril; Zhang, Betty; Malcolm, Peter; Sundram, Suresh

    2013-01-10

    Treatment of the positive psychotic symptoms of schizophrenia with standard antipsychotic drugs (APDs) is ineffective in a proportion of cases. For these treatment resistant patients the alternative is the APD clozapine which is superior to other agents but carries serious side effects. Why clozapine is uniquely effective is unknown, but we have previously postulated may involve G-protein coupled receptor (GPCR) and epidermal growth factor (EGF) receptor (ErbB1) transactivation signaling to the mitogen-activated protein kinase-extracellular signal regulated kinase (MAPK-ERK) cascade. This was based upon clozapine induced initial down-regulation and delayed ErbB1 mediated activation of the cortical and striatal ERK response in vivo distinct from other APDs. This study investigated if modulation of the ErbB1-ERK1/2 pathway by clozapine, olanzapine and haloperidol affected expression of the ERK substrates p90RSK and c-Fos, factors that regulate transcription of proteins associated with neuroplasticity and synapse formation in C57Bl/6 mice. In cortex and striatum, acute clozapine treatment induced biphasic p90RSK phosphorylation via MEK that paralleled ERK phosphorylation independent of EGF receptor blockade. By contrast, olanzapine and haloperidol caused p90RSK phosphorylation that was not concomitant with ERK signaling over a 24-hour period. For c-Fos, clozapine elevated expression 24h after administration, a timeframe consistent with ERK activation at 8h. Alternatively, haloperidol stimulation of c-Fos levels limited to the striatum was in accord with direct transcriptional regulation through ERK. The unique spatio-temporal expression of downstream nuclear markers of the ErbB1-ERK pathway invoked by clozapine may contribute to its effectiveness in treatment resistant schizophrenia.

  18. Control study of amisulpride and olanzapine in the treatment of schizophrenia%氨磺必利与奥氮平治疗精神分裂症的对照研究

    Institute of Scientific and Technical Information of China (English)

    何建华

    2015-01-01

    目的:比较氨磺必利与奥氮平治疗精神分裂症的疗效及安全性。方法60例精神分裂症患者随机分为氨磺必利组和奥氮平组,各30例,疗程8周。采用阳性和阴性症状量表(PANSS)及副反应量表(TESS)分别在治疗第8周末评估疗效及副反应。结果氨磺必利组显效率为73.3%,奥氮平组显效率为80.0%,两组有效率均为93.3%,差异无统计学意义(P>0.05);两组治疗前后PANSS总分及各因子分比较差异均无统计学意义(P>0.05)。奥氮平组体重增加、镇静嗜睡的发生率明显高于氨磺必利组,差异有统计学意义(P0.05). There was no statistically significant difference of the total score or factor score of PANSS between the two groups before and after treatment (P>0.05). The olan-zapine group had obviously higher incidences of weight growth and calm drowsiness than the amisulpride group, and the difference was statistically significant (P<0.05). Conclusion Amisulpride is as effective as olanzapine in treating schizophrenia, but it has less side reactions as weight growth and calm drowsiness.

  19. 氨磺必利与奥氮平治疗急性期精神分裂症的疗效分析%The curative effects of amisulpride and olanzapine on acute schizophrenia

    Institute of Scientific and Technical Information of China (English)

    孙霞; 杨建立

    2013-01-01

    Objective To evaluate the curative effects and safety of amisulpride and olanzapine on acute schizophrenia.Methods Seventy four patients with acute schizophrenia were divided into amisulpride group (n=38) and olanzapine group (n=36).Before and after treatment for 6 months,Positive and Negative Syndrome Scale (PANSS) was used to score for all patients,the blood sugar,blood lipid,serum prolactin (PRL) and electrocardiogram (ECG) were examined.Results After treatment for 6 months,the total scores of PANSS in two groups were significantly lower than the baseline levels (P<0.01),but there was no significant difference of total scores between two groups.The effective rates of two groups were 86.8% and 88.9%,respectively,there was no significant difference.After treatment for 6 months,the PRL level of amisulpride group was significantly higher than the baseline level (P<0.05),the blood sugar and blood lipid levels of olanzapine group were significantly higher than the baseline levels (P<0.01).The main adverse effects in amisulpride group were menopause,galactorrhea,EPS,insomnia and leg-pain.The main adverse effects in olanzapine group were weight-gain,low blood pressure and somnolence.Conclusion The curative effect of amisulpride and olanzapine on acute schizophrenia was similar to the curative effect of olanzapine,but amisulpride could impact PRL level and induce less somnolence and metabolic abnormalities..%目的 比较氨磺必利和奥氮平治疗急性精神分裂症的疗效和安全性.方法 74例精神分裂症患者被随机分为氨磺必利组(38例)和奥氮平组(36例).分别于基线和治疗6周后进行阳性与阴性症状量表(PANSS)评分,测定空腹血糖、血脂、血清泌乳素和心电图检查.记录不良反应.结果 治疗6周后,2组患者PANSS总分均较基线时明显降低,差异有统计学意义(t值分别为22.16、22.23,P<0.01);氨磺必利组减分为(32.4±15.8)分,奥氮平组为(35.6±13.9)分;2组

  20. 喹硫平、奥氮平在治疗老年痴呆患者精神行为障碍的效果研究%Study on the Effect of Quetiapine and Olanzapine in the Treatment of Senile Dementia Patients With Behavioral and Psychological Disorders

    Institute of Scientific and Technical Information of China (English)

    赵永明

    2015-01-01

    Objective Observation of quetiapine, olanzapine treatment with mental behavior disorder symptoms of alzheimer's patients clinical effect. Methods Compared with quetiapine lfat and olanzapine group two groups of therapeutic effect. Results Two groups of curative effect and adverse reaction rate was no signiifcant difference (P>0.05). Conclusion Quetiapine and the nitrogen average is safe and effective.%目的:观察喹硫平、奥氮平治疗有精神行为障碍症状的老年痴呆患者的临床效果。方法对比喹硫平组和奥氮平组两组治疗效果。结果两组疗效和不良反应发生率比较无显著差异(P>0.05)。结论喹硫平和奥氮平均安全有效。

  1. A control study on amisulPride and olanzaPine in first ePisode Patients with schizoPhrenia%氨磺必利与奥氮平治疗精神分裂症首次发病患者的对照研究

    Institute of Scientific and Technical Information of China (English)

    李福球; 郑小泳; 冯文锐

    2014-01-01

    目的:比较氨磺必利和奥氮平治疗精神分裂症的临床疗效和安全性。方法:将62例精神分裂症首次发病患者随机分为氨磺必利组和奥氮平组治疗8周。采用阳性与阴性症状量表(PANSS)于治疗前后评定疗效,并观察不良反应。结果:治疗8周两组 PANSS 总分减分及一般病理学减分比较差异无统计学意义;氨磺必利组 PANSS 阴性症状减分明显高于奥氮平组,奥氮平组 PANSS 阳性症状减分显著高于氨磺必利组(P 均﹤0.02)。氨磺必利组和奥氮平组总有效率分别为93.2%和96.8%,差异无统计学意义(P ﹥0.02)。奥氮平组体质量增加、镇静嗜睡和血糖升高发生率明显高于氨磺必利组(P ﹤0.02或 P ﹤0.01)。结论:氨磺必利治疗精神分裂症的疗效与奥氮平相当,但不良反应相对较少。%Objective:To compare the clinical efficacy and safety of amisulpride and olanzapine in first episode patients with schizophrenia. Method:Sixty-two first episode patients with schizophrenia were divided randomly into amisulpride group and olanzapine group,and received amisulpride and olanzapine respectively for 8 weeks. The positive and negative symptoms scale(PANSS)was used before and after treatment to evaluate the efficacy,and the side effects were observed. Results:After 8 weeks of treatment,the reduction of PANSS total score and general pathology score between the two groups were not statistically significant;the reducion of nega-tive symptoms score in amisulpride group was significantly higher than olanzapine group,while the reducion of positive symptoms score in olanzapine group was significantly higher than amisulpride group(all P ﹤ 0. 02). The total efficiency in amisulpride group and olanzapine group were 93. 2% and 96. 8% respectively,and no signifi-cant difference between two groups(P ﹥ 0. 02). The incidence of sedation or somnolence,weight gain and glu-cose enhance in olanzapine group

  2. Clinical Efficacy of Risperidone and Olanzapine in the Treatment of first Episode Schizophrenia%利培酮与奥氮平治疗首发精神分裂症患者的临床疗效与安全性

    Institute of Scientific and Technical Information of China (English)

    任丽

    2015-01-01

    Objective To investigate the effect of risperidone and olanzapine in the treatment of first-episode clinical eficacy and safety in patients with schizophrenia.Methods Methods 68 patients with first episode schizophrenia were randomly divided into risperidone group in 34 cases and 34 cases of olanzapine group, risperidone group were treated with oral risperidone treatment,olanzapine group were treated with oral olanzapine treatment,after 8 weeks of treatment with PANSS reduction rate of curative effect evaluation.Results Risperidone group of patients,the total effective rate was 94.1%(32/34),olanzapine group of patients,the total effective rate was 91.2%(31/34),the difference between the two groups had no statistical significance(P>0.05).Olanzapine group drowsiness,dry mouth and body mass increase adverse effects than risperidone group,risperidone group akathisia, insomnia and headache adverse reactions than olanzapine group(P<0.05).Conclusion Equivalent efficacy of olanzapine and risperidone on schizophrenia,but the adverse reactions of two different,clinicians should take according to the regimen of according to the clinical characteristics of the patients with.%目的:探讨利培酮与奥氮平治疗首发精神分裂症患者的临床疗效与安全性。方法将68例首发精神分裂症患者随机分为利培酮组34例及奥氮平组34例,利培酮组患者给予口服利培酮进行治疗,奥氮平组患者给予口服奥氮平进行治疗,治疗8周后采用阳性和阴性症状量表(PANSS)减分率评估疗效。结果利培酮组患者总有效率为94.1%(32/34),奥氮平组患者总有效率为91.2%(31/34),两组比较差异无统计学意义(P>0.05)。奥氮平组嗜睡、口干和体质量增加不良反应多于利培酮组,利培酮组静坐不能、失眠和头痛不良反应多于奥氮平组(P<0.05)。结论奥氮平与利培酮对首发精神分裂症的疗效相当,但二者不良反应不同,临床

  3. Efficacy and executive function of olanzapine and risperidone in the treatment of elderly patients with schizophrenia%奥氮平与利培酮治疗老年精神分裂症患者疗效及执行功能比较

    Institute of Scientific and Technical Information of China (English)

    杭荣华; 程万良; 王瑞权; 吴明飞

    2012-01-01

    AIM: To explore the difference on efficacy and executive function between olanzapine and risperidone in treatment of elderly patients with schizophrenia. METHODS: 84 eider-ly patients with schizophrenia were randomly divided into olanzapine group (43 cases) and ris-peridon group (41 cases) treated for 8 weeks. The efficacy was assessed with the positive and negative symptoms scale (PANSS) and the executive function was evaluated with Wisconsin Card Sorting Test (WCST) in baseline and after 8 weeks of treatment. RESULTS: After 8 weeks of treatment, the efficacy rate of olanzapine was 90. 6 % . in which 67. 4% was improved markedly. The efficacy rate of risperidon was 92. 6%, in which 68.3% were improved markedly. There were no differences between two groups (P>0. 01). The score of negative symptom of olanzapine group was significantly lower than that of risperidon group(P<0. 05). The score of categories control in risperidon group was significantly lower than that in olanzapine group, persistent errors and response error were higher than that in olanzapine group(P<0. 01). CONCLUSION; Both olanzapine and risperidon can improve the symptom and executive function of elderly patients with schizophrenia. Olanzapine is better than risperidon in improving negative symptom and executive function.%目的:比较奥氮平与利培酮治疗老年精神分裂症的疗效及对执行功能的影响.方法:84例老年精神分裂症患者随机分为奥氮平组(43例)和利培酮组(41例),于治疗前及治疗后第8周末采用阳性与阴性症状量表(PANSS)和威斯康星卡片分类测验( WCST)评定疗效和执行功能,分别比较每组治疗前后及两组间的结果.结果:治疗后奥氮平组的有效率及显效率分别为90.6%和67.4%,利培酮组的有效率及显效率分别为92.6%和68.3%,两者差异无统计学意义(P>0.05).治疗后奥氮平组的阴性症状分低于利培酮组(P<0.01).利培酮组WCST的完成分类数低于奥氮平组,

  4. Efficacy of olanzapine versus methylphenidate treatment for childhood hyperkinetic syndrome%奥氮平与哌醋甲酯治疗儿童多动症效果对照

    Institute of Scientific and Technical Information of China (English)

    郝学儒; 崔文波

    2005-01-01

    BACKGROUND: Attention deficit and hyperkinetic disorder (ADHD) is frequently treated with psychostimulant medications, which had been shown to improve both cognitive and behavioral outcomes for most chil dren. OBJECTIVE: To compare the efficacy and adverse effects of olanzapine vs methylphenidate treatment in childhood hyperkinetic syndrome.DESIGN: Clinical comparative study. SETTING: Department of Psychiatry, Beijing Huilongguan Hospital; De partment of Mental Psychiatry, Shangdong Mouping People's Hospital. PARTICIPANT S: Sixty children with hyperkinetic syndrome from the clinics of the Department of Psychiatry,Beijing Huilongguan Hospital and the Department of Mental Psychiatry of Shandong Mouping People's Hos pital between March 2002 and April 2004 were enrolled into this prospec tive study after obtaining the consents from their guardians.The patients were randomly divided into 2 group: the olanzapine group (n=30) and the methylphenidate group (n=30). METHODS: In the olanzapine group olanzapine 2.5-7.5 mg per day was given as a single dose in every evening.In the methylphenidate group methylphenidate 5-15 mg per day was given in divided dose in every morning and evening.The dosage ofolanzapine and methylphenidate were adjusted according to age, body mass and patient's clinical condi tions. And the period of treatment for either drug was 12 weeks. Conners teachers scale was used before and at the end of the 12 weektreatment (①hyperkinetic index consisted of 10 items②hyperkinetic behavior factor consisted of 7 items. Each item was rated “none=0, a little=1, quite a lot=2, and very much=3 ). Side effect scale was used to evaluate the hy perkinetic symptom and adverse reactions which consisted of behavior toxicity, abnormal laboratory tests , symptoms of the nervous system, au tonomic nervous system, cardiovascular system and skin etc with. 0=none; 1 =suspicious or very mild, 2=mild, 3 =moderate, 4=severe. The highest score was 22,and the lowest was 0 with a

  5. Weight gain management in patients with schizophrenia during treatment with olanzapine in association with nizatidine Manejo do ganho de peso em pacientes portadores de esquizofrenia durante o tratamento com olanzapina em associação com nizatidina

    Directory of Open Access Journals (Sweden)

    Sheila Seleri Marques Assunção

    2006-12-01

    Full Text Available OBJECTIVE: Weight gain is associated with treatment with many psychotropic agents. Nizatidine, H2 receptor antagonist, has been proposed to have weight-reducing effects. This was a 12-week, randomized, double-blind, placebo-controlled trial to evaluate the efficacy of nizatidine in reducing/limiting weight gain in patients with schizophrenia who have been under treatment with olanzapine. METHOD: Patients receiving olanzapine (2 to 6 months and weight gain > 5% of their body weight during olanzapine treatment were randomly assigned to receive nizatidine 600 mg or placebo for up to 12 weeks. Change in psychopathology was assessed using Brief Psychiatric Rating Scale scores from baseline to endpoint. Safety was assessed using the Safety Assessed Software, assessment of glucose and lipid blood levels, and treatment-emergent adverse events. RESULTS: Out of 54 patients enrolled in this analysis, 45 completed the protocol. The mean weight change prior randomization was 7.6 kg and 7.3 kg for those randomized to placebo and nizatidine, respectively (p = 0.828. Patients receiving placebo and nizatidine had a mean weight gain of 12.3% (0.7 kg and 12% (1.1 kg from baseline to endpoint, respectively (p = 0.9. Patients from both groups experienced a statistically significant decrease on the Brief Psychiatric Rating Scale mean score from baseline to endpoint. Treatment-emergent adverse events were reported by 18.5% and 25.9% on the placebo and nizatidine group, respectively. There were no statistically significant differences in glucose and lipid blood levels from baseline to endpoint and between groups. CONCLUSIONS: The concomitant use of olanzapine with nizatidine was not effective in controlling weight gain in patients who had previously gained weight during treatment with olanzapine when compared to placebo.OBJETIVO: Ganho de peso está associado ao tratamento com inúmeros psicotrópicos. O uso de nizatidina, um antagonista H2, pode estar associado

  6. Effect analysis of olanzapine in cancer-related depression and anxiety%奥氮平治疗肿瘤相关性抑郁与焦虑的效果分析

    Institute of Scientific and Technical Information of China (English)

    翟西菊; 李瑞卿

    2014-01-01

    目的:探讨奥氮平在肿瘤相关性抑郁与焦虑中的疗效及毒副反应。方法将本院2013年4月至2013年7月收治的179例伴肿瘤相关性抑郁、焦虑的患者随机分为对照组(89例)和观察组(90例),对照组采用安慰、鼓励、帮助、同情及换位思考等心理支持治疗,而观察组给予奥氮平(放疗时5mg/d,连用2周,化疗时5mg/d,连用2周,化疗间歇期不服用)。分析两组的治疗完成情况并记录奥氮平使用期间的毒副反应,分别于治疗前、化疗2、4、6个周期后和放疗后采用Zung抑郁自评量表( SDS)和焦虑自评量表( SAS)评价焦虑、抑郁标准分变化及治疗有效率。结果观察组4、6个化疗周期的完成率高于对照组( P<0�05)。观察组化疗中的SAS评分均低于对照组,化疗4、6个周期的SDS评分均低于对照组( P<0�05)。观察组治疗后SAS和SDS治疗有效率均高于对照,差异有统计学意义( P<0�05)。观察组使用奥氮平后的毒副反应为嗜睡、体重增加、头晕、乏力、口干、便秘和外周水肿。结论奥氮平能够改善肿瘤相关性焦虑与抑郁,临床应用方便,毒副作用小,患者可耐受。%Objective To explore the effect of olanzapine in cancer-related depression and anxiety and the adverse reaction. Methods One hundred and seventy-nine patients with cancer-related depression and anxiety from April 2013 to July 2013 were ran-domly assigned into control group(n=89) and observation group(n=90). The control group was given psychological support therapy including encouragement, help, compassion and empathy. While only the observation group received olanzapine:5mg/day oral during radiotherapy or chemotherapy for two weeks. The treatment completion status and toxic side effects of olanzapine during use were recor-ded. The Zung self-rating depression scale( SDS) and self-rating anxiety scale( SAS) were employed to

  7. Clinical control ed study of clozapine and olanzapine in the treatment of psychiatric symptoms of Alzheimer's disease%氯氮平与奥氮平治疗阿尔茨海默病精神症状的临床对照研究

    Institute of Scientific and Technical Information of China (English)

    孔荣见; 余琼芳

    2014-01-01

    objective: to compare the clozapine and olanzapine in the treatment of alzheimer's disease to mental symptom curative effect and adverse reactions to observe. Methods:23 cases of 23 cases of clozapine and olanzapine in treatment of psychotic symptoms of alzheimer's patients, in the treatment of 0, 2, 4, 8 weeks, respectively, with the brief psychiatric rating scale (BPRS), treatment with symptoms scale (TESS), compared two groups of curative effect and adverse reaction of observation. Results: two weeks, two groups of patients with BPRS scores were significantly lower than before treatment (P < 0.05), two groups of BPRS score there was no significant difference in different treatment time (P < 0.05). At 2, 4, 8 weeks TESS scores of olanzapine group was obviously lower than clozapine group, significant differences in the two groups (P < 0.05). Conclusion: clozapine and olanzapine in the treatment of alzheimer's disease is similar mental symptoms curative effect, adverse reaction of olanzapine significantly lower than clozapine.%目的:对比氯氮平与奥氮平在治疗阿尔茨海默病中对精神症状的疗效与不良反应观察。方法:对23例氯氮平与23例奥氮平治疗有精神病性症状的阿尔茨海默病患者,在治疗0、2、4、8周分别用简明精神病评定量表(BPRS)评定,治疗中用症状量表(TESS)评定,对比两组疗效及不良反应观察。结果:治疗2周时,两组患者BPRS评分均较治疗前显著降低(P均<0.05),两组的BPRS评分在不同的治疗时间差异无显著性(P<0.05)。2、4、8周时奥氮平组的TESS评分明显低于氯氮平组,两组存在显著差异(P<0.05)。结论:氯氮平与奥氮平在治疗阿尔茨海默病的精神症状疗效基本相似,但奥氮平的不良反应明显低于氯氮平。

  8. T he Effects of Olanzapine and Clozapine on Glucose M etabolism and Lipid M etabolism%精神分裂症患者口服奥氮平和氯氮平对糖及脂代谢的影响

    Institute of Scientific and Technical Information of China (English)

    苗淑芳

    2015-01-01

    Objective We study the side-effect of olanzapine and clozapine on theglucose metabolism and lipid metabolism in schizophrenic patients .Method 7 1 cases of hospitalized patients with schizophrenia(2 0 1 0 .3-2 0 1 0 .1 1 ) ,randomly divided into two groups were given clozapine and olanzapine treatment .Determination of Cholesterol ,triglyceride ,fasting glucose ,insulin and C peptides by Roche Modular P8 0 0 .Measured the height and weight to calculate body mass index .Determination of olanzapine ,clozapine and N -demethyl clozapine in plasma .Results Clozapine and olanzapine treatment for body mass index ,triglycerides ,insulin and c-peptide the influence of the difference was statistically significant(P0 .0 5 ) .Conclusion Clozapine and olanzapine have effect on glucose metabolism , lipid metabolism and body mass index ,but the influence of clozapine .We should pay attention to the changes of blood sugar and blood fat w hen using atypical psychotropic drugs in clinical practices .%目的:探讨精神分裂症患者服用奥氮平和氯氮平后对体重指数、糖代谢和脂代谢指标变化的影响。方法选取我院2010年3~11月71例住院精神分裂症患者,随机分成两组,分别给予氯氮平和奥氮平治疗。采用罗氏全自动生化分析仪检测患者的糖代谢和脂代谢指标以及测量患者身高、体重,计算体重指数。结果氯氮平和奥氮平治疗后对体重指数、甘油三脂、胰岛素和C肽的影响差异有统计学意义(P<0.05),对血糖的影响差异无统计学意义(P>0.05)。结论氯氮平与奥氮平对糖代谢、脂代谢和体重指数都有影响,但氯氮平影响相对较大,临床治疗过程中应注意监测糖脂代谢的变化。

  9. Clinical analysis of treating somatoform disorders by duloxetine combined with olanzapine%度洛西汀联合奥氮平治疗躯体形式障碍患者的临床分析

    Institute of Scientific and Technical Information of China (English)

    杨泗学; 吴江; 秦榛; 曹栋

    2014-01-01

    Objective:To explore the efficacy and safety of duloxetine combined with low dose olanzapine in the treatment of somatoform disorders. Method:A total of 120 patients with somatoform disorders were randomly divided into study group with duloxetine combined with small dosage of olanzapine and control group with duloxetine for the treatment of somatoform disorders for 6 weeks. They were assessed using Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),Athens insomnia scale(AIS),clinical global impression (CGI)to evaluate the efficacy and treatment emergent side effect scale( TESS)to evaluate the safety. Results:In the 2nd weekend,the scores of HAMA and CGI-GI in study group were significantly lower than those in control group(all P < 0. 01). In the 1st and 6th weekend,the dropout rate of control group was significantly larger than that of study group(all P < 0. 05). In the 1st weekend,the incidence rate of nausea and vomiting in control group was significantly larger than that in study group. Conclusion:Duloxetine combined with small dosage of olanzapine in the treatment of somatoform disorder takes effects faster than single duloxetine and has lower dropout rate.%目的:探讨度洛西汀联合小剂量奥氮平治疗躯体形式障碍患者的疗效和安全性。方法:120例躯体形式障碍患者随机分为研究组即度洛西汀联合小剂量奥氮平组和对照组即单用度洛西汀组,各60例疗程6周。治疗前后以汉密尔顿焦虑量表(HAMA)、密尔顿抑郁量表(HAMD)的疑病条目、阿森斯失眠量表(AIS),临床疗效总评量表(CGI)进行疗效评估,以治疗时出现的症状量表(TESS)评估用药的安全性。结果:治疗第2周,研究组 HAMA 和 CGI-GI 评分显著低于对照组(P 均<0.01)。治疗第6周,两组显效率基本接近,对照组的疑病观念的残留率高于研究组(P <0.05)。两组第2、4、6周的 HAMA 评分均显著低于治疗前(P <0.01

  10. 老年性痴呆精神行为症状实施奥氮平治疗的有效性分析%Effectiveness of behavioral and psychological symptoms of senile dementia implementation of olanzapine treatment

    Institute of Scientific and Technical Information of China (English)

    何炳接

    2014-01-01

    目的:对奥氮平治疗老年性痴呆精神行为症状的有效性实施分析。方法随机选取我院2012年1月-2013年12月实施治疗的120例老年性痴呆精神行为症状患者,并将其平均分成对照组和观察组两组,每组60例患者,其中对照组患者采用利培酮实施治疗,观察组患者则采用奥氮平实施治疗。对比分析两组患者的临床治疗效果和不良反应发生率。结果其中观察组患者的治疗总有效率为90.0%,对照组患者仅为76.7%,两组之间差异显著,对比具有统计学意义(P<0.05);观察组患者的各项不良反应发生率也均明显的低于对照组,两组之间差异显著,对比具有统计学意义(P<0.05)。结论在老年性痴呆精神行为症状中,采用奥氮平进行治疗,其不但有助于对其临床治疗效果进行提高,同时还可以有效降低患者的不良反应发生率,因此可以说其值得推广应用。%Purpose: The effectiveness of the implementation of olanzapine treatment of senile dementia behavioral and psychological symptoms of analysis. Method: I randomly selected hospital in January 2012 -2013 in December implemented 120 cases of behavioral and psychological symptoms of senile dementia patients treated, and were divided into a control group and observation group two groups of 60 patients, including the control group were treated with risperidone implementation of treatment, the observation group were then implemented using olanzapine treatment. Comparative analysis of the two groups of patients with clinical outcomes and incidence of adverse reactions. Results: Observed among patients treated group total effective rate was 90.0% in the control group of patients was only 76.7%, a significant difference between the two groups, compared with statistical significance (P <0.05); the incidence of adverse reactions observed in patients also were significantly lower than the control group, a

  11. Pharmacokinetics and Bioequivalence of Domestic Olanzapine Tablets in Healthy Chinese Volunteers%国产奥氮平片的人体药动学和生物等效性研究

    Institute of Scientific and Technical Information of China (English)

    俞凌燕; 楼洪刚; 阮邹荣; 江波; 陈金亮

    2012-01-01

    目的 评价国产奥氮平片在中国健康人体中的药动学及生物等效性.方法 采用双周期交叉试验设计,20名健康男性受试者单次口服国产和进口奥氮平片5 mg,采用LC-MS/MS测定奥氮平血药浓度,计算两制剂的主要药动学参数和生物利用度,并进行生物等效性评价.结果 国产和进口奥氮平片的主要药动学参数如下:tmax分别为(4.25±1.33)和(4.55±1.10)h,ρmax分别为(9.62±1.79)和(9.69±2.18)ng·mL-1,t1/2分别为(31.71±6.87)和(32.46±5.67)h,AUC0-t分别为(327.19±60.55)和(324.39±70.84)ng·h·mL-1,AUC0-∞分别为(354.44±74.58)和(350.70±80.94)ng·h·mL-1.受试制剂的相对生物利用度F0-t为(102.93±18.22)%,F0-∞为(103.30±20.75)%,经统计分析,各药动学参数均无显著性差异(P>0.05)结论 两种奥氮平制剂在体内过程相似,两制剂人体生物等效,临床上可以替换使用.%OBJECTIVE To study the pharmacokinetics and bioequivalence of domestic olanzapine tablets in healthy Chinese volunteers. METHODS A single oral dose of 5 mg olanzapine tablets was given to 20 healthy male volunteers in a randomized cross-over study. The concentrations of olanzapine in plasma were determined by LC-MS/MS method. The pharmacokinetie parameters and relative bioavailability were calculated by DAS. Then the bioequivalence of two formulations was evaluated. RESULTS The pharmacokinetie parameters of domestic and imported formulations were as follows ;tmax (4. 25 ±1.33) and (4.55 ± 1. 10) h, pmax(9.62 ± 1.79) and (9. 69 ±2. 18) ng·mL-1, t1/2 (31.71 ±6.87) and (32.46+5.67) h, AUC0-t, ( 327. 19 ± 60. 55 ) and (324. 39 ± 70. 84) ng·h·mL-1 , and AUC 0-∞ (354.44 ±74. 58) and (350. 70 ± 80. 94) ng·h·ml-1 , respectively. The relative bioavailability was ( 102. 93 ±18. 22 ) % for F0-t and ( 103. 30 ± 20. 75 ) % for F0-x. There was no significant difference between the two preparations (P >0. 05). CONCLUSION The two preparations are bioequivalent and can

  12. 奥氮平对首发精神分裂症认知功能影响的多中心研究%A Multicenter Study of Olanzapine on Congnitive Function in First-episode Schizophrenia.

    Institute of Scientific and Technical Information of China (English)

    孙群星; 刘勇; 李四冬; 尹继续

    2011-01-01

    Objective To explore the influence of olanzapine on cognitive function in first-episode schizophrenia. Methods 100 cases of first-episode schizophrenia were conducted a multicenter, randomized clinical trial. The positive and negative scale (PANSS) and 10 neuropsychological tests such as Weschler Adult Intelligence Scale, Weschler Memory Scale, Iorn Nails Tank Test, Flnger Tapping Test, Motor Function Test, Coordinated Hand function Test, Connection Test A and B, Wisconsin Card Sort Test (WCST) and Verbal Fluency Test were adopted to assess these subjectsat baseline and the end of 4,8,12 weeks. Results The total score of PANSS in both groups showed significant difference after treatment than before (P < 0.01 ). The efficiency rate and markedly effective rate in study group was 98.0% and 82.0% respectively, while control group was 96.0% and 78.0%respectively. There were not significant differences in curative effect between the two groups, but clozapine group had more side effects than olanzapine group (P < 0.01 ). Both groups has gradually improved in neuropsychological tests since 81h weekends. Compared with pre-treatment, neuropsychological tests such as tapping test, motor function test, coordinated hand function test and Wisconsin Card Sort Test were significantly different in both groups, and the study group was better than control groups. ( P < 0.05 ). Conclusions Olanzapine can better improve the cognitive function of first-episode schizophrenia.%目的 探讨奥氮平对首发精神分裂症患者认知功能的影响.方法 对100例首发精神分裂症患者进行随机观察.于治疗前,治疗第4周末、8周末、12周末各做一次韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能协调测验、连线测验a和b、威斯康星卡片分类测验(WCST)及言语流利性测验等10项神经心理测查及阳性与阴性症状量表(PANSS)评定.结果 两组PANSS总

  13. 奥氮平与利培酮治疗痴呆患者精神行为症状的对照研究%The comparative study of olanzapine and risperidone in the treatment of dementia patients with behavioral and psychological symptoms

    Institute of Scientific and Technical Information of China (English)

    黄文平; 赵祖安; 白玉红; 曾丽苹

    2012-01-01

    Objective To observe the efficacy and safety of Olanzapine and Risperidone in the treatment of dementia patients with behavioral and psychological symptoms. Methods 80 senile dementia patients were selected and divided into two groups randomly, Olanzapine group (40 cases) and Risperidone group (40 cases). Before the treatment and the treatment for two, four and eight weeks, the two groups were both given the BEHAVE-AD scale to evaluate the efficacy and TESS scale to evaluate the adverse reactions. Results In the treatment of the 8th week, the differences of all the BE-HAVE-AD scales compared with before the treatment in the two groups were statistically significant (P < 0.01). In the treatment of the 2nd week, the difference of total scales compared with before the treatment in the Olanzapine group was statistically significant (P < 0.01), the Risperidone group was not; but at the 8th week the difference of efficiency rate between the two groups was not statistically significant. In security, the difference of total adverse reactions rate was not statistically significant, but the incidence of extrapyramidal side effects (EPS) in the Risperidone group was higher than in the Olanzapine group(P < 0.05). Conclusion The efficacy of Olanzapine and Risperidone in the treatment of dementia patients with behavioral and psychological symptoms are equal, but Olanzapine works faster, side effects are less, so Olanzapine is more suitable to treat dementia patients with behavioral and psychological symptoms.%目的 观察奥氮平和利培酮治疗老年痴呆患者精神行为症状的疗效和安全性.方法 将80例老年痴呆患者随机分为奥氮平组和利培酮组,每组各40例,共观察8周.治疗前及治疗第2、4、8周末分别用BEHAVE-AD量表评定疗效,用TESS量表评定不良反应.结果 奥氮平组和利培酮组在治疗第8周末,BEHAVE-AD量所有项目评分与治疗前比较,差异均有高度统计学意义(均P < 0.01),

  14. 茶多酚对奥氮平诱导肥胖大鼠的减肥作用及其机制%Anti-obesity effects and its mechanism of tea polyphenols on obesity rats induced by olanzapine

    Institute of Scientific and Technical Information of China (English)

    钟满群; 唐言利; 吴铎; 吕俊华

    2011-01-01

    AIM To study the anti-obesity effects of tea polyphenols (TP) on olanzapine induced weight gain in rats and its mechanism. METHODS Fifty female SD rats were randomized into 2 groups, 10 rats in the normal control group and 40 rats in the obesity model group. The obesity model rats received olanzapine (1.2 mg-kg"1-d"1) daily via gavage 1 h before the beginning of the dark-phase for 2 weeks, while the rats in the normal control group received an equivalent volume of distilled water. At the beginning of wk 3, the obesity model rats were randomized into 4 groups: model group (distilled water) , sibutramine (2.5 mg ·kg-1·d-1) group, low-dose (150 mg·kg-1·d-1) group and high-dose (300 mg·kg-1·d-1) group of TP, 10 rats in each group, and the rats were administered with olanzapine continuously. TP and sibutramine were given by gavage for 5 weeks. The body weight and fat weight around the kidney and uterus were measured, and Lee' s index and fat coefficient were calculated. The levels of serum leptin and adiponectin ( ADP) , superoxide dismutase (SOD) activity and malondialchehyche (MDA) content were tested respectively. RESULTS Compared with the normal control group, the body weight, fat weight, Lee' s index, fat coefficient, the level of serum leptin were significantly increased and serum ADP decreased significantly in the model group (P 0.05). CONCLUSION TP can reduce olanzapine induced weight gain in rats, which may be associated with the enhanced regulation of ADP and antioxidative ability.%目的 探讨茶多酚对奥氮平诱导肥胖大鼠的减肥作用及其机制.方法 SD雌性大鼠50只,随机分为正常对照组(10只)和奥氮平诱导肥胖模型组(40只).肥胖模型组于黑暗时相前1 h奥氮平1.2 mg·kg-1·d-1灌胃,正常对照组给予等容量蒸馏水,连续2 wk.于wk 3开始,再将肥胖模型大鼠随机分为4组:模型组、西布曲明(2.5 mg·kg-1·d-1)组、茶多酚低(150 mg·kg-1·d-1)剂量组和茶多酚高(300 mg·kg-1·d-1)

  15. 奥氮平联合氨磺必利治疗难治性精神分裂症的临床效果研究%Clinical effect of olanzapine combined with amisulpride in treatment of refractory schizophrenia

    Institute of Scientific and Technical Information of China (English)

    夏永兵; 杨立身

    2015-01-01

    目的:探讨奥氮平联合氨磺必利治疗难治性精神分裂症的临床效果。方法选择本院2013年6月~2014年6月收治的难治性精神分裂症患者60例,将其平均分为观察组和对照组,对照组单用奥氮平进行治疗,观察组给予奥氮平联合氨磺必利治疗,比较两组的临床疗效、治疗前后生活质量评分、抑郁及焦虑评分、不良反应发生情况。结果观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗后两组生活质量评分均较治疗前提高,差异有统计学意义(P<0.05);且观察组提高程度明显优于对照组,差异有统计学意义(P<0.05)。治疗后两组抑郁及焦虑评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组降低幅度明显优于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为3.33%,低于对照组的20.00%,差异有统计学意义(χ2=4.0431,P<0.05)。结论奥氮平联合氨磺必利治疗难治性精神分裂症效果显著,可有效改善患者的生活质量,减缓患者的抑郁及焦虑情绪,降低药物不良反应发生率,值得临床推广应用。%Objective To investigate the clinical effect of olanzapine combined with amisulpride in treatment of refrac-tory schizophrenia. Methods 60 patients with refractory schizophrenia accepted in our hospital from June 2013 to June 2014 were selected,and were randomly divided into observation group and control group,30 cases in each group,patients in observation group were treated with olanzapine combined with amisulpride,but patients in control group were treated with olanzapine only.The clinical effect,improvement of the life quality before and after treatment and the improvement of depression score and anxiety score,adverse reaction was observed. Results After treatment,the total effective rate of observation group was 93.33%,higher than 73.33%of the control group

  16. A control study of olanzapine vs.haloperidol in the treatment of acute symptoms in patients with amphetamine induced psychosis%奥氮平、氟哌啶醇治疗苯丙胺类兴奋剂所致精神障碍急性期症状的疗效观察

    Institute of Scientific and Technical Information of China (English)

    薛晓斌; 陈建平; 范强; 陈旭

    2016-01-01

    目的:比较分析奥氮平、氟哌啶醇对苯丙胺类兴奋剂所致精神障碍急性期精神病性症状的治疗效果。方法124例急性期苯丙胺所致精神障碍患者分为奥氮平组(奥氮平治疗,63例)和氟哌啶醇组(氟哌啶醇治疗,61例),治疗4周,于治疗前及治疗后第1、2、4周末采用简明精神病评定量表(BPRS)、临床总体印象-严重程度量表(CGI-SI)评价疗效,并记录治疗中的不良反应。结果奥氮平组见效时间早于氟哌啶醇组(P <0.05),两组有效率比较差异无统计学意义(P >0.05)。治疗后第1、2、4周末奥氮平组 BPRS 总分及各因子分均较治疗前下降(P <0.05);氟哌啶醇组治疗后第1周末激活性因子分较治疗前下降(P <0.05),治疗后第2周末除缺乏活力因子分外 BPRS 总分及各因子分均较治疗前下降(P <0.05),治疗后第4周末总分及各因子分均较治疗前下降(P <0.05)。组间比较发现,奥氮平组治疗后第1、2周末 BPRS 总分及焦虑抑郁、缺乏活力因子分均低于氟哌啶醇组(P <0.05);治疗后第4周末焦虑抑郁、缺乏活力及思维障碍因子分均低于氟哌啶醇组(P <0.05)。奥氮平组总不良反应发生率低于氟哌啶醇组(P <0.01)。结论奥氮平、氟哌啶醇治疗苯丙胺类兴奋剂所致精神障碍急性期症状疗效相当,但奥氮平起效相对快,且不良反应少。%Objective To compare the efficacy of olanzapine and haloperidol for treating acute symptoms in patients with amphetamine induced psychosis.Methods 124 patients with acute symptoms of amphetamine induced psychosis were divided into olanzapine group treated with olanzapine (n =63)and haloperidol group treated with haloperidol (n =61)for 4 weeks.All patients were assessed with Brief Psychiatric Rating Scale (BPRS)and Clinical Global Impressions Scale-Severity Item (CGI-SI),and the

  17. Energy metabolism, leptin, and biochemical parameters are altered in rats subjected to the chronic administration of olanzapine Metabolismo calórico, leptina e parâmetros bioquímicos se alteram em ratos submetidos à administração crônica de olanzapina

    Directory of Open Access Journals (Sweden)

    Alexandra I. Zugno

    2012-06-01

    Full Text Available OBJECTIVES: Olanzapine, an atypical antipsychotic drug with affinities for dopamine, serotonin, and histamine binding sites appears to be associated with substantial weight gain and metabolic alterations. The aim of this study was to evaluate weight gain and metabolic alterations in rats treated with olanzapine on a hypercaloric diet. METHODS: We used 40 rats divided into 4 groups: Group 1, standard food and water conditions (control; Group 2, standard diet plus olanzapine; Group 3, cafeteria diet (hypercaloric; and Group 4, olanzapine plus cafeteria diet. Olanzapine was administered by gavage at a dose of 3 mg/kg for 9 weeks. RESULTS There were no significant changes in the cholesterol levels in any group. Glucose levels increased in Group 3 by the fourth week. Triglyceride levels were altered in group 2 toward the end of the experiment. Leptin levels decreased in Groups 2 and 4. Complex II activity in the muscles and liver was altered in Group 2 (muscle, and Groups 2, 3, and 4 (liver. Complex IV activity was altered only in the liver in Group 2, without significant alterations within the muscles. CONCLUSION: These results suggest that olanzapine is correlated with weight gain and the risks associated with obesity.OBJETIVOS: A olanzapina, uma droga antipsicótica atípica com afinidade por locais de ligação de dopamina, serotonina e histamina, parece se associar a um ganho de peso e a alterações metabólicas consideráveis. O objetivo desse estudo foi avaliar o ganho de peso e as alterações metabólicas em ratos tratados com olanzapina numa dieta hipercalórica. MÉTODOS: Usamos 40 ratos divididos em 4 grupos: Grupo 1, condições padrão de alimento e água (controle; Grupo 2, dieta padrão mais olanzapina; Grupo 3, dieta hipercalórica; e Grupo 4, olanzapina mais dieta hipercalórica. Olanzapina foi administrada por gavagem a uma dose de 3 mg/kg por 9 semanas. RESULTADOS: Não houve alterações significativas nos níveis de colesterol

  18. Efficacy and electrocardiogram abnormality of olanzapine in the treatment of old schizophrenic patients%奥氮平治疗老年精神分裂症患者的疗效观察及对心电图的影响

    Institute of Scientific and Technical Information of China (English)

    袁国锋; 俞玉礼

    2011-01-01

    AIM: To explore the efficacy and the electrocardiogram abnormality of olanzapine or risperidon in the treatment of old schizophrenic patients.METHODS: 120 patients with old schizophrenia were randomly divided into olanzapine group (60 cases) and risperidon group(60 cases) treated for 8 weeks.The efficacy was measured with the positive and negative symptoms scale (PANSS) and PANSS and the electrocardiogram test was used to evaluate the efficacy and adverse effects respectively before and at the ends of 2,4,6,8 weeks of treatment.The amount and information of electrocardiogram abnormality were analyzed.RESULTS:The efficacy rate of olanzapine was 78.3%, in which 56.7% was improved markedly.The efficacy rate of risperidon was 75.0%, in which 51.7% were improved markedly.There were no difference between two groups (P> 0.05 ).There were significant differences on extrapyramidal side effect and liver function between them.At the 2nd week, the efficacy of olanzapine was more than that of the risperidon (P < 0.05 ).There were significant difference in electrocardiogram abnormality between olanzapine group and risperidon group ( P < 0.05).CONCLUSION: There are no significant differences in the efficacy and the electrocardiogram abnormality between two groups.Olanzapine has less sideeffect especially.The two drugs adapt to old schizophrenic.%目的:比较奥氮平与利培酮治疗老年精神分裂症患者的疗效及对心电图的影响.方法:选取120例老年精神分裂症患者,随机分为奥氮平组(研究组)和利培酮组(对照组),各60例,分别于治疗前及治疗后第2、4、6、8周末采用阳性与阴性症状量表(PANSS)评定疗效,并进行心电图检查,统计异常心电图的数目和相关信息.结果:两组PANSS评分治疗后均较治疗前明显下降(P0.05).奥氮平组以嗜睡为主,利培酮组以锥体外系副反应和转氨酶升高为主,两组在锥体外系副反应和转氨酶升高两方面有统计学差异(P<0

  19. 奥氮平与利培酮治疗老年痴呆伴精神行为症状对照观察%A control study of olanzapine vs .risperidone in senile demen-tia with behavioral and psychological symptoms

    Institute of Scientific and Technical Information of China (English)

    韩曙林; 孟红凤

    2015-01-01

    目的:比较奥氮平与利培酮治疗老年痴呆伴精神行为症状患者的疗效及安全性。方法将52例老年痴呆伴精神行为症状患者随机分为奥氮平组与利培酮组,分别予以奥氮平与利培酮治疗,观察8周。治疗前后采用痴呆病理行为评定量表、副反应量表评定临床疗效及不良反应。结果奥氮平组治疗第2周末起,利培酮组治疗第4周末起痴呆病理行为评定量表评分较治疗前显著降低(P<0.01),治疗第2周末奥氮平组显著低于利培酮组(P<0.05或0.01);奥氮平组有效率为92.3%,利培酮组为88.5%,两组比较差异无显著性( P>0.05);奥氮平组不良反应发生率显著低于利培酮组(P<0.05)。结论奥氮平与利培酮治疗老年痴呆伴精神行为症状患者疗效显著且相当,但奥氮平起效更快,安全性更高。%Objective To compare the efficacy and safety between olanzapine and risperidone in senile de‐mentia with behavioral and psychological symptoms (BPS) .Methods Fifty‐two senile dementia patients with BPS were randomly assigned to olanzapine and risperidone group treated with olanzapine or risperi‐done for 8 weeks .Efficacies were assessed with the Rating Scale of the Behavioral Pathology in Alzheime‐r′s Disease (BEHAVE‐AD) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results The BEHAVE‐AD score lowered more significantly since the end of the 2nd week in olanzapine group and since the 4th in risperidone group compared with pretreatment (P0 .05);the incidence of adverse reactions was significantly lower in olanzapine than in ris‐peridone group (P<0 .05) .Conclusion Both olanzapine and risperidone have an equivalent and evident effect in senile dementia with BPS ,but the former takes effect more rapidly and has higher safety .

  20. 奥氮平与喹硫平治疗以阴性症状为主精神分裂症的对照研究%A comparative study of olanzapine and quetiapine in the treatment of negative symptoms of schizophrenia

    Institute of Scientific and Technical Information of China (English)

    张香云; 李广田; 刘忠; 李亚忠; 栗克清; 狄亚琴; 韩彦超; 于雪竹; 高月霞; 黄静; 余红; 梁汝沛

    2012-01-01

    Objective To compare the efficacy and safety of olanzapine in the treatment of negative symptoms of schizophrenia. Methods Eighty patients diagnosed negative symptoms of schizophrenia by DSM -IV were randomly allocated to two groups and treated with olanzapine or quetiapine for 8 weeks, respectively. The efficacy and side effects were evaluated by PANSS, CGI and TESS. Results The significant efficacy rates for the olanzapine and quetiapine groups were 87. 2% and 81. 1%. There was no significant difference in efficacy between the two groups. The rates of side effects were similar in two groups, including lethargy and weight gain. Conclusion The results suggest that olanzapine is as effective and safe as quetiapine for patients with negative symptoms of schizophrenia.%目的 评价国产奥氮平治疗以阴性症状为主的精神分裂症的疗效和安全性.方法 将80例符合DSM-Ⅳ精神分裂症患者随机分为2组,分别给予奥氮平和喹硫平治疗,疗程共8周,用阳性症状与阴性症状量表(PANSS)、临床疗效总评量表(CGI)评定疗效,药物副反应量表(TESS)评定不良反应.结果 奥氮平组显效率87.2%、喹硫平组显效率为81.1%,两药对阴性症状的疗效无显著性差异(P>0.05).2组在治疗过程中出现较多的不良反应是嗜睡、体质量增加,但两者之间无显著性差异(P>0.05).结论 奥氮平对以阴性症状为主的精神分裂症有较好的疗效,与喹硫平的疗效和不良反应相当.

  1. 齐拉西酮与奥氮平对初诊精神分裂症患者急性期的疗效和代谢影响比较%The comparison of the efficacy of Ziprasidone and Olanzapine in first-visiting patients with acute schizo phrenia and the effect on metabolic index

    Institute of Scientific and Technical Information of China (English)

    吴小立; 钟智勇; 王继辉; 韩自力

    2011-01-01

    目的:研究齐拉西酮和奥氮平对首次接受治疗的精神分裂症急性期疗效及代谢的影响.方法:将80例首次接受治疗的精神分裂症患者分为奥氮平组(44例)和齐拉西酮组(36例),分别给予奥氮平和齐拉西酮单药治疗4周.在治疗基线和4周末,分别检测体质量、血糖、血脂等相关代谢指标,并用阳性症状与阴性症状量表(PANSS)评定疗效.结果:①治疗后,奥氮平组PANSS总分及阳性因子分、阴性因子分、一般精神病理因子分[分别为(62±16)、(13±5)、(16±5)、(28±6)]较基线[分别为(104±14)、(25±5)、(24±6)、(44±6)]明显下降,齐拉西酮组PANSS总分及阳性因子分、阴性因子分、一般精神病理因子分[分别为(73±21)、(16±5)、(19±8)、(33±10)]较基线[分别为(105±17)、(23±3)、(26±8)、(45±13)]明显下降,比较差异具统计学意义(P<0.01);奥氮平组PANSS总分、阳性症状分的改善优于齐拉西酮组(P<0.05).②治疗后,齐拉西酮组体质量和BMI略增加(P<0.05),奥氮平组体质量、BMI、腰围、腰臀比、胰岛素、胰岛素抵抗指数、总胆固醇、甘油三脂、LDL及载脂蛋白B100显著增高(P<0.01);奥氮平组体质量、腰围、腰臀比、总胆固醇、LDL、载脂蛋白B100均高于齐拉西酮组(P<0.05或0.01).结论:齐拉西酮和奥氮平对首次接受治疗的精神分裂症急性期均具有确切疗效,两者对阴性症状和一般精神病理症状疗效相似,奥氮平对急性期患者阳性症状的改善优于齐拉西酮.与奥氮平相比,齐拉西酮对首次治疗的精神分裂症急性期的体质量影响轻微,对血糖血脂几乎没有影响.%Objective; To study the efficacy of Ziprasidone and Olanzapine in first-visiting patients with acute schizophrenia and the effect on metabolic index. Methods: Eighty inpatients with drug-naive acute schizophrenia were divided into either Olanzapine group (n = 44) or Ziprasidone group (n =36) for 4

  2. Efficacy and safety study of the donepezil combined olanzapine flow in the treatment of behavioral and psychological symptoms of dementia%多奈哌齐合并奥氮平治疗老年痴呆精神行为症状的疗效和安全性对照研究

    Institute of Scientific and Technical Information of China (English)

    张玉琦; 徐文炜; 程灶火; 吴越; 顾君; 汤莉; 季萍; 李桂林

    2012-01-01

    目的:探讨多奈哌齐合并奥氮平治疗老年痴呆精神行为症状的疗效和安全性.方法:103例伴精神行为症状的痴呆病人随机分为多奈哌齐合并奥氮平组与单用奥氮平组.治疗前和研究结束时进行简易智力状态检查(MMSE)评分,在治疗2、4、6、8周末以痴呆病理行为评定量表(BEHAVE-AD)减分率评定疗效:≥60%为显效,≥30%为有效,<30%为无效.以副反应量表(TESS)评定记录治疗中各项药物不良反应.结果:多奈哌齐合并奥氮平组MMSE评分较治疗前提高2分以上,治疗结束后组内比较差异有统计学意义(t=2.060,P<0.05).治疗前后BEHAVE-AD量表评分两组组内比较,至第4周末时均明显下降,差异有显著统计学意义(P<0.01或P<0.05).多奈哌齐合并奥氮平组有效率为88.46%,显效率为67.31%;单用奥氮平组有效率70.59%,显效率为45.10%,两组比较有效率和显效率差异均有统计学意义(x2=5.067,P<0.05;x2=5.701,P<0.05).两组均无不能耐受的不良药物反应.结论:多奈哌齐合并奥氮平治疗老年痴呆精神行为症状安全有效且优于单用奥氮平.%AIM: To investigate the efficacy and safety of donepezil combined olanzapine or single olanzapine in the treatment of behavioral and psychological symptoms. METHODS: 103 dementia patients with behavioral and psychological symptoms were randomly divided into donepezil combined olanzapine group and the single olanzapine group. The mini-mental state examination (MMSE) score were evaluated before treatment and the end of the study. The efficacies were evaluated in 2,4,6,8 weekend of the treatment by reduced rate of the behavioral pathology in Alzheimer' s Disease Scale ( BEHAVE-AD) , ≥60% was markedly effective, > 30% was effective, <30% was not effective. The treatment emergent symptom scale (TESS) assessment record treatment of the adverse drug reactions. RESULTS: The MMSE scores of donepezil combined olanzapine group

  3. Contrast study of synergistic effect of Quetiapine and Olanzapine on patients with depression combined with anxiety disorder treated with Paroxetine%喹硫平与奥氮平对帕罗西汀治疗抑郁症伴焦虑障碍患者增效作用的比较

    Institute of Scientific and Technical Information of China (English)

    王学燕; 周玉珍; 杨红梅; 孙克峰; 梁家騋

    2015-01-01

    Objective: To compare efficacy and safety of Paroxetine combined with Quetiapine or Olanzapine in treatment of patients with depression combined with anxiety disorder. Methods:60 patients suffering from depression with anxiety disorder were randomly divided into Paroxetine combined with Quetiapine group (n=30, combined Quetiapine group) and Paroxetine combined with Olanzapine group ( n=30, combined Olanzapine group). The treatment continued for eight weeks. Hamilton depression scale ( HAMD) , Hamilton anxiety scale ( HAMA) , and treatment emergent symptom scale ( TESS) were used to evaluate efficacy and ad-verse reactions. Results:One week after the treatment, the scores of HAMD and HAMA of the two groups decreased compared with those before the treatment, the differences of the same group were significant (P0. 05). No big difference between the two groups in the obvious effective rate (P>0. 05). For the ad-verse reactions ( nausea, dry mouth, constipation, tachycardia, loss of appetite and weight gain):the occurrence rates of increased ap-petite and body mass gain of combined Olanzapine group were higher than those of combined Quetiapine group, and the differences had statistical significance (P0.05)。两组患者显效率无明显差异(P>0.05)。对于不良反应(如恶心、口干、便秘、心动过速、食欲和体质量增加等),合并奥氮平组患者除了食欲和体质量增加发生率高于合并喹硫平组,差异有统计学意义(P<0.05)外,余项无明显差异。结论:帕罗西汀合并喹硫平和合并奥氮平治疗抑郁症伴焦虑障碍疗效相当,起效快,不良反应少,依从性好,均为较好增效策略。肥胖者合并喹硫平治疗更安全。

  4. 多萘哌齐联用奥氮平治疗老年期痴呆认知功能临床观察%Donepezil Plus Olanzapine in the Treatment of Cognitive Impairments in Senile Dementia

    Institute of Scientific and Technical Information of China (English)

    陈彩霞; 刘丹

    2015-01-01

    Objective:To compare the effect of combination therapy of Donepezil and Olanzapine and only Donepezil therapy in the treatment of cognitive function in senile dementia .Methods:A total of 65 senile dementia patients were randomly divided into two groups ,Donepezil group ( single group ) and Done-pezil combined with Olanzapine group ( combination group ) ,receiving treatment for 8 weeks.The Mini-mental State Examination(MMSE),was used to assess before treatment ,and at 4 weekend and 8 week-end.Results:Before treatment,there was no significant difference in MMSE score in both two groups .In 4 weeks after treatment ,there was no significant difference in MMSE score in both two groups .At 8 week-end,the significant difference was found in both two groups (t=4.786~7.825,P<0.05).In addition,to compare the two groups ,in 4 weeks after treatment ,there was no significant difference in MMSE score ,At 8 weekend,the significant difference was found in MMSE between the two groups (t=2.59,P<0.05). Conclusion:Both groups can improve the cognitive function in senile dementia , but combination group can more effectively improve the cognitive function in senile dementia.%目的:比较多萘哌齐联用奥氮平与单独使用多萘哌齐治疗老年期痴呆认知功能的临床疗效。方法:共65例老年期痴呆患者随机分为联合使用组与单独使用组,针对两组病人,双盲对照治疗,治疗过程以8周为一个疗程,分别在治疗前、治疗第4周末、治疗第8周末用简易智能精神状态量表( MMSE)测评临床疗效,评估认知功能。结果:在治疗前联合使用组与单独使用组MMSE评分无显著差异。临床治疗第4周末与治疗前比较,联合使用组及单独使用组MMSE评分均无显著差异。疗程第8周末,单独使用组及联合使用组分别与治疗前比较MMSE评分均有显著差异(t=4.786~7.825;P<0.05)。此外,联合使用组与单独使用组在治疗第4周

  5. Síndrome neuroléptica maligna: relato de caso com recorrência associada ao uso de olanzapina Neuroleptic malignant syndrome: case report of a recurrence related to olanzapine

    Directory of Open Access Journals (Sweden)

    RICARDO A. HANEL

    1998-12-01

    Full Text Available A síndrome neuroléptica maligna (SNM consiste em reação idiossincrática a neurolépticos, provavelmente relacionada a bloqueio dos receptores dopaminérgicos nos gânglios da base, sendo por isso também conhecida como síndrome da deficiência aguda de dopamina.A SNM é caracterizada por hiperpirexia, alteração do nível de consciência, hipertonia, disfunção autonômica e insuficiência respiratória, podendo ainda ser encontrados rabdomiólise e leucocitose. O haloperidol é a droga mais frequentemente associada à síndrome. Relatamos o caso de um paciente de 30 anos que apresentou SNM em duas ocasiões diferentes, a primeira delas relacionada ao uso de haloperidol e clorpromazina e a segunda relacionada ao uso de olanzapina, fato este sem menção anterior na literatura indexada.The neuroleptic malignant syndrome (NMS consists in an idiosyncratic reaction to neuroleptic drugs, probably related to a blockage of dopamine receptors in basal ganglia. Research criteria for diagnosing NMS from DSM-IV require severe rigidity and fever accompanied by 2 of 10 minor features including diaphoresis, dysphagia, tremor, incontinence, altered mentation, mutism, tachycardia, elevated or labile blood pressure, leukocytosis and elevation of creatine phosphokinase. From a clinical point of view, the NMS may range a large spectrum of presentations. Haloperidol is the most frequent drug associated with this syndrome. We report the case of a 30 year-old man who developed NMS at two different occasions, the first related to haloperidol and chlorpromazine and the second related to olanzapine, to our knowledge without previous mention in the indexed literature.

  6. Compare safety of amisulpride and olanzapine in the treatment of first-episode schizophrenia%氨磺必利与奥氮平治疗精神分裂症患者安全性比较

    Institute of Scientific and Technical Information of China (English)

    程万良; 朱文礼; 王伟; 王继轩; 储贝贝; 杨永春

    2016-01-01

    目的 比较氨磺必利与奥氮平治疗首发精神分裂症的安全性.方法 对80例使用氨磺必利或奥氮平的精神分裂症患者病案资料回顾性调查分析,统计一般人口学资料、副反应、精神症状测评、实验室检查结果.结果 全部80例病例中,氨磺必利组(amisulpride group,AG)性激素异常25例,奥氮平组(olanzapine group,OG)18例,差异有统计学意义(X2=4.220,P=0.40).进一步研究发现AG组在血清泌乳素水平高于OG组[(63.12±38.74) ng/mL;(37.84±36.50) ng/mL];差异有统计学意义(t=-3.003,P=0.004).AG组与OG组在一般人口学资料、副反应、精神症状测评等方面差异无统计学意义.结论 氨磺必利对治疗首发精神分裂症安全性与奥氮平相当,需注意氨磺必利对精神分裂症患者内分泌的影响.

  7. A control of schizophrenia ’ s metabolic syndrome caused by olanzapine and risperidone%奥氮平与利培酮治疗精神分裂症所致代谢综合征对照研究

    Institute of Scientific and Technical Information of China (English)

    于君; 郝增平; 徐鹏波; 王志敏; 林晓东; 孙军伟; 李红梅

    2014-01-01

    Objective To explore schizophrenia’s metabolic syndromes caused by olanzapine and risperi-done .Methods Eighty-six schizophrenics were randomly assigned to two groups taking orally olanzapine or risperidone for 12 weeks .Mental symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) before and after treatment and changes of BP ,body height (BH) ,body mass (BM) ,waist circumference (WC) ,fasting blood sugar (FBS) and blood fit (BF) detected simultaneously .Results Af-ter treatment the PANSS scores of both groups lowered more significantly compared with pretreatment (P0 .05) .Af-ter treatment BM and BMI of both groups increased more significantly ,FBS ,triacylglycerol ,total choles-terol (TC) ,LDL levels heightened and HDL lowered ,and differences had significances since the end of the 8th week (P0 .05) .There were no significant group differences in over-standard WC ,the elevation of FBS ,tria-cylglycerol .TC and LDL ,the reduction of HDL and the detection rate of metabolic syndrome (P>0 .05) . Conclusion Olanzapine and risperidone have therapeutic equivalence in schizophrenia ,different influences on patients’ glucose and lipid metabolism and the risk of causing metabolic syndromes ,so clinically all metabolic indexes should be closely watched .%目的:探讨奥氮平与利培酮治疗精神分裂症导致代谢综合征的发生状况。方法将86例精神分裂症患者随机分成两组,分别口服奥氮平及利培酮治疗,观察12周。于治疗前后采用阳性与阴性症状量表评定精神症状,同时检测血压、身高、体质量、腰围及空腹血糖、血脂水平的变化。结果治疗后两组阳性与阴性症状量表评分均较治疗前显著下降( P<0.05或0.01),治疗各时段两组评分比较差异均无显著性(P>0.05)。治疗后两组体质量及体质量指数均较治疗前显著增加,空腹血糖、三酰甘油、总胆固醇、低密度脂

  8. 氨磺必利与奥氮平治疗首发男性精神分裂症的疗效及对糖脂代谢的影响%Efficacy of Amisulpride,Olanzapine on First-episode Male Patients with Schizophrenia and Glucolipid Metabolism

    Institute of Scientific and Technical Information of China (English)

    凌仲民

    2015-01-01

    Objective:To explore the effect of amisulpride,olanzapine on first-episode male patients with schizophrenia and glucolipid metabolism.Methods:The first 64 cases of male patients with schizo-phrenia were randomly divided into amisulpride and olanzapine group.Before treatment,2,4,6,8 week-end,using the PANSS assessment of psychiatric symptoms,while collecting the data of fasting blood col-lected fasting blood glucose(FBS),total cholesterol(TC),high density lipoprotein(HDL),triglycerides (TG),low density lipoprotein(LDL).Results:61 cases were completed in 8 weeks.At 2nd weekend, olanzapine group's PANSS positive factor scored below the amisulpride group(16.19 ±4.51、19.10 ± 5.68,t=2.216,P=0.031).At 4th,6th,8th weekend,amisulpride group's PANSS negative factor scored below the olanzapine group(P<0.05).To the end of the study,there were no significance between the two groups in total psychopathology scores.Olanzapine group had higher TG in the first two weekends( P<0.05) and higher FBS, TC,TG at 4th weekend than the amisulpride group ( P <0.05 ) .Olanzapine group had higher FBS,TC,TG than before treatment whereas,there were no difference in FBS,TC,TG be-tween after and before treatment in amisulpride group .Conclusion:Olanzapine and amisulpride have the similar effect.Olanzapine has better effect on acute positive symptoms and amisulpride is suited for nega -tive symptoms and have less influence on glucolipid metabolism.%目的:对比氨磺必利、奥氮平对首发男性精神分裂症患者的疗效特点和对糖脂代谢的影响。方法:将64例首发男性精神分裂症患者采用随机分组方法,分为氨磺必利治疗组和奥氮平治疗组,于治疗前,治疗第2、4、6、8周末,使用PANSS量表对精神症状评定,同时采空腹血测定空腹血糖(FBS),总胆固醇(TC),高密度脂蛋白( HDL),三酰甘油( TG),低密度脂蛋白( LDL)。结果:8周末实际完成61例,第2周末奥氮平组PANSS

  9. Observation of early curative effect of cognitive behavior therapy combined with olanzapine on female first-episode paranoid schizophrenia%认知行为治疗对女性首发偏执型精神分裂症的早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    邱玲玲; 王继丰; 吴迎春; 刘大威; 朱德超

    2014-01-01

    目的:观察认知行为治疗( CBT)对首发偏执型精神分裂症的早期疗效和预后观察。方法:选取首发偏执型精神分裂症患者60例,随机分为研究组和对照组,研究组( CBT合并奥氮平组)和对照组(奥氮平组)各30例,研究组在口服奥氮平基础上,进行为期12周的CBT治疗,随访6个月。采用阳性与阴性症状量表(PANSS)评价疗效,社会功能缺陷量表(SDSS)评定社会功能,副反应量表(TESS)评定不良反应。结果:治疗12周末及随访结束时,研究组与对照组同期对比,PANSS各项评分显著降低(P<0.05或P<0.01)。半年随访时,研究组SDSS大部分项目评分显著低于对照组(P<0.01);研究组与对照组复发率分别为23.3%和51.7%,研究组与对照组停药率分别为6.7%和31.0%,均有显著性差异(P<0.05)。结论:CBT合用奥氮平治疗首发偏执型精神分裂症,比单一药物治疗更具有优越性,近期疗效更明显,治疗依从性更好,复发率明显降低。%Objective:To observe early curative effects and prognosis of cognitive behavior therapy ( CBT ) on first-episode paranoid schizophrenia. Methods:60 cases of first episode paranoid schizophrenia were randomly divided into study group (30 cases, CBT combined with olanzapine group) and control group (30 cases, olanzapine group). The cases in study group were treated by CBT combined with olanzapine for 12 weeks whereas those in control group were only treated by olanzapine, and they were all followed up for 6 months. Positive and negative symptoms scale ( PANSS) was used to assess the efficacy, social function defect scale ( SDSS) was used to evaluate the social function, and treatment emergent symptom scale ( TESS) was used to assess the adverse reactions. Results:12 weeks after the treatment and at the end of the follow-up, the PANSS scores of study group and control group in the same period de-creased significantly (P<0. 05 or P<0. 01). When the six-month follow-up was

  10. A controlled study on effect of olanzapine and risperidone on quality of life in first-episode schizophrenia patients%奥氮平与利培酮治疗精神分裂症首次发病患者的疗效

    Institute of Scientific and Technical Information of China (English)

    徐彩; 李美银; 邓文

    2012-01-01

    目的:探讨奥氮平与利培酮治疗首发精神分裂症的疗效以及对生活质量的影响. 方法:68例首发精神分裂症患者随机分为奥氮平组和利培酮组各34例,分别给予奥氮平和利培酮治疗8周,随访6个月.于治疗前后采用阳性与阴性症状量表(PANSS)及治疗中出现的症状量表(TESS)评定疗效及不良反应;于治疗6个月前后,采用生活质量综合评定问卷(GQOLI)评定生活质量. 结果:两组PANSS评分治疗后均有显著下降(P<0.05或P<0.01).奥氮平组GQOLI总分及各维度与利培酮组GQOLI总分及躯体功能、心理功能维度治疗前后差异均有统计学意义(P均<0.01);两组间比较,治疗前两组GQOLI评分差异无统计学意义,6个月后随访,在躯体功能及社会功能差异有统计学意义(P均<0.01). 结论:奥氮平与利培酮治疗首发精神分裂症疗效相当,但奥氮平在提高生活质量方面略优于利培酮.%Objective: To study the curative powers and effect of olanzapine and risperidone on quality of life in the treatment of first onset schizophrenia patients. Method: 68 first onset schizophrenia patients were randomly divided into olanzapine group and risperidone group, each of which (n = 34 ) received the olanzapine or risperidone treatment respectively for 8 weeks and 6 months follow-up. The efficacy was assessed using positive and negative syndrome scales (PANSS) , and the adverse reaction using treatment emergent symptom scale (TESS). Generic quality of life inventory (GQOLI) was conducted before and 6 months after the treatment for assessmet of patients quality of life. Results: PANSS score of two groups decreased singnificanty after the treatment ( P < 0.05 or P < 0.01). The significant differences were found on GQOLI total score and each dimension score in olanzeoine group and GQOLI total score, physical function,psychological function in risperidone group between before and after treatment (all P<0.01). After 6

  11. 氯丙嗪、奥氮平、齐拉西酮对慢性精神分裂症患者认知功能的影响比较%Comparison of the effects of chlorpromazine, olanzapine and ziprasidone on cognitive function of patients with chronic schizophrenia

    Institute of Scientific and Technical Information of China (English)

    金国林; 汤庆平; 徐松泉

    2013-01-01

    Objective To compare the effects of chlorpromazine,olanzapine and ziprasidone on cognitive function of patients with chronic schizophrenia.Methods A total of 120 patients with chronic schizophrenia were randomly divided into chlorpromazine group(n =38),olanzapine group(n =41) and ziprasidone group(n =41).The patients were subjected to the Brief Psychiatric Rating Scale(BPRS),Wisconsin Card Sorting Test(WCST),Personal and Social Function of Scale (PSP) and Wechsler Adult Intelligence Scale-Revised (WAIS-RC) assessment respectively,before and after treatment for 12 weeks.Results After treatment for 12 weeks,the score of BPRS significantly decreased in three groups compared with that before treatment [F (5,41) =6.49,P < 0.05].After treatment for 12 weeks,the results of WCST [F (5,47) =18.30,P < 0.05],PSP [F (5,47) =10.02,P < 0.05] and WAIS-RC [F(5,47) =6.74,P < 0.05] test in ziprasidone and olanzapine group were better than that of chlorpromazine group.Conclusion Chlorpromazine,olanzapine and ziprasidone could improve the cognitive function and mental syndrome of patients with chronic schizophrenia.In addition,the effect of ziprasidone and olanzapine was better than chlorpromazine.%目的 比较氯丙嗪、奥氮平和齐拉西酮对慢性精神分裂症患者认知功能的影响.方法 将120例慢性精神分裂症患者按数字表法随机分为三组,分别为氯丙嗪组(38例)、奥氮平组(41例)和齐拉西酮组(41例),于入组前、治疗后第12周时采用简明精神病量表(BPRS)、个人和社会功能量表(PSP)、威斯康星卡片分类测验(WCST)、修订韦氏成人智力量表(WAIS-RC)进行随访评定.结果 经12周治疗,三组治疗前后BPRS测试结果差异均有统计学意义[F(5,41) =6.49,P<0.05],而三组之间差异无统计学意义;第12周末,齐拉西酮组和奥氮平组WCST[F(5,47)=18.30,P<0.05]、PSP[F(5,47)=10.02,P<0.05]和WAIS-RC[F(5,47) =6.74,P <0.05]评分显著优于氯丙嗪组.结论 氯丙嗪、

  12. Rapid tranquilization for agitated patients in emergency psychiatric rooms: a randomized trial of olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone Tranquilização rápida para pacientes agitados nos serviços de emergência psiquiátrica: um ensaio clínico randomisado de olanzapina, ziprasidona, haloperidol mais prometazina, haloperidol mais midazolam e haloperidol em monoterapia

    Directory of Open Access Journals (Sweden)

    Leonardo Baldaçara

    2011-03-01

    Full Text Available OBJECTIVE: To compare the effectiveness of intramuscular olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone as the first medication(s used to treat patients with agitation and aggressive behavior. METHOD: One hundred fifty patients with agitation caused by psychotic or bipolar disorder were randomly assigned under double-blind conditions to receive olanzapine, ziprasidone, haloperidol plus midazolam, haloperidol plus promethazine or haloperidol alone. The Overt Agitation Severity Scale, Overt Aggression Scale and Ramsay Sedation Scale were applied within 12 hours after the first dosage. RESULTS: All medications produced a calming effect within one hour of administration, but only olanzapine and haloperidol reduced agitation by less than 10 points, and only olanzapine reduced aggression by less than four points in the first hour. After twelve hours, only patients treated with haloperidol plus midazolam had high levels of agitation and aggression and also more side effects. Ziprasidone, olanzapine and haloperidol alone had more stable results for agitation control, while ziprasidone, haloperidol plus promethazine and olanzapine had stable results for aggression control. CONCLUSION: Olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol were effective in controlling agitation and aggression caused by mental illness over 12 hours. Although all the drugs had advantages and disadvantages, haloperidol plus midazolam was associated with the worst results in all the observed parameters.OBJETIVO: Comparar a eficácia da olanzapina, ziprasidona, haloperidol associado ao midazolam, haloperidol associado à prometazina e haloperidol isoladamente por via intramuscular como primeira escolha no tratamento de pacientes em agitação e agressividade. MÉTODO: Cento e cinquenta pacientes com agitação psicomotora por transtorno psicótico ou transtorno bipolar foram

  13. 奥氮平合并艾司西酞普兰治疗精神分裂症阴性症状%Olanzapine Combined with Escitalopram for Negative Symptoms of Schizophrenic

    Institute of Scientific and Technical Information of China (English)

    孙晓丹; 周升宝; 田月礼; 周玉德; 赵继舒; 张峰

    2014-01-01

    Objective To explore the efficacy and safety of olanzapinein combined with escitalopram in the treatment of negative symptoms of schizophrenic .Methods 75 schizophrenic patients with predominant negative symptoms were randomly divided into study group(n=38)treated with olanzapine combined with escitalopram and control group (n=37)treated with olanzapine for 12 weeks.Posi-tive and Negative Syndrome(PANSS),Negative Symptoms(SANS),Clinical Global Impression Severity of Illness (CGI-SI),Treatment Emergent Symptoms Scale(TESS)were used to evaluate the efficacy and the side effect at the baseline and at the end of the 2,4,8,12 week after treatment.Results The clinical effective rates in study group and control group were 78.95%and 62.16%respectively(χ2=12.103,P<0.01).After 2 weeks,the total scores and factors scores of PANSS showed significantly difference ( P<0.01) in study group(P<0.05 or P<0.01 ).However,the scores of the negative symptoms in control group decreased significantly after 4 weeks(t=2.418,P<0.05).The negative symptom scores in the study group were significantly lower than those the control group at the 8th and 12th week(t=2.595,2.796;P<0.05).The total scores of SANS in both groups decreased significantly after 4 weeks(t=8.574, 4.438;all P<0.01.)The factor score of apathy of SANS in study group decreased after 4 weeks(t=5.415,P<0.01).After 8 weeks, the total scores and scores of emotional dull ,attention dysfunction of SANS in study group were significantly lower than those in control group (t=4.120,3.429,2.165;P<0.05). After 12 weeks,the scores of volition abulia and interest -social lack in study group were significantly lower (t=3.402,4.014,all P<0.01).The scores of CGI-SI in study group were significantly lower than those in control group at the 8th and 12th week(t=2.729,3.284;all P<0.01).Adverse effects were low in both groups.Conclusion Olanzapine com-bined with escitalopram has rapid response ,good efficacy and safety in the treatment of negative

  14. Inhibition and mechanism of olanzapine on white adipose tissue beiging in mice%奥氮平对小鼠白色脂肪米色化的抑制作用及其机制

    Institute of Scientific and Technical Information of China (English)

    张学丽; 郑啸; 柳亚敏; 邵华

    2015-01-01

    从奥氮平(olanzapine,OLA)对白色脂肪米色化(beiging)的调节作用探讨其引起代谢紊乱的可能机制.C57BL6/J小鼠连续28 d灌胃给予高、低剂量(4,8 mg/kg) OLA,隔天记录体重及摄食变化;通过糖耐量实验和冷应激考察小鼠血糖调控和产热能力的变化.分离小鼠肾周(pWAT)、附睾(eWAT)及腹股沟(iWAT)处白色脂肪,通过解偶联蛋白-1(UCP-1)免疫组化技术和苏木精-伊红染色确证米色化程度的改变;通过Western blot考察奥氮平对米色脂肪分化关键调控蛋白哺乳动物雷帕霉素靶蛋白(mTOR)活化和Notch1胞内结构域(N1ICD)表达的影响.实验结果表明:OLA可致小鼠基础产热明显降低,并可抑制环境适应性产热和葡萄糖利用.OLA引起腹股沟处米色脂肪分化异常,抑制冷应激诱导的白色脂肪米色化及UCP-1激活,并显著上调磷酸化mTOR(p-mTOR)与N1ICD的表达.以上结果提示,白色脂肪米色化的抑制作用参与到OLA诱导的代谢紊乱,mTOR-Notch信号通路的激活可能是其中的关键分子事件.

  15. 艾司西酞普兰联合奥氮平治疗难治性抑郁症的临床疗效%The Clinical Efficacy of Escitalopram Combined with Olanzapine in the Treatment of Refractory Depression

    Institute of Scientific and Technical Information of China (English)

    刘振东

    2016-01-01

    目的:探讨艾司西酞普兰联合奥氮平治疗难治性抑郁症患者的临床疗效。方法选取2013年1月至2015年5月于临沂市精神卫生中心心理科门诊就诊的难治性抑郁症患者96例,将其按抽签法分成对照组和观察组,各48例。对照组患者给予艾司西酞普兰10~20 mg,早餐后1次,口服;观察组患者在此基础上给予奥氮平5.0~7.5 mg,口服,晚餐后1次,口服,总疗程12周。比较两组患者治疗前及治疗后汉密尔顿抑郁量表(HAMD)评分及汉密尔顿睡眠障碍因子评分。结果观察组患者治疗后总有效率显著高于对照组[81.25%(39/48)比52.08%(25/48)],差异有统计学意义(P<0.05)。两组疗效比较差异有统计学意义(P<0.05)。两组HAMD评分治疗2、4、8、12周后均较治疗前呈下降趋势,且观察组下降速度更快,两组在组间、时点间、组间·时点间交互作用差异有统计学意义( P<0.05)。两组主观睡眠障碍因子评分治疗后2、4、8、12周均较治疗前呈下降趋势,且观察组下降速度更快,两组在组间、时点间、组间·时点间交互作用差异有统计学意义(P <0.05)。观察组患者体质量增加率显著高于对照组(P<0.05)。结论艾司西酞普兰联合奥氮平治疗难治性抑郁症患者可以快速有效缓解患者抑郁症状,改善患者睡眠质量,值得临床推广。%Objective To analyze the clinical efficacy of escitalopram combined olanzapine in treatment of refractory depression.Methods From Jan.2013 to May 2015 96 patients with refractory depression in Linyi City Center offor Mental Health were included in the study and divided into a control group and an ob-servation group according to the drawing method,48 cases each.The control group was treated with escitalo-pram 10-20 mg,oral,one time after breakfast;the observation group was addedolanzapine 5.0-7.5 mg,oral, one time after

  16. Evaluation Clinical Curative Effect of Fluoxetine Combine With Small Dose of Olanzapine in Treatment of Major Depressive Disorder%氟西汀联合小剂量奥氮平治疗重度抑郁症的临床疗效评价

    Institute of Scientific and Technical Information of China (English)

    刘锡亮; 曲春晖; 姜丽丽

    2015-01-01

    目的 探讨氟西汀联合小剂量奥氮平治疗重度抑郁症的临床效果.方法 研究我院2013年6月~2015年4月收治的99例重度抑郁症患者的临床资料,根据治疗方法分为单一组(n=49)、联合组(n=50).单一组给予氟西汀治疗,联合组在对照组治疗的基础上,联合服用小剂量奥氮平治疗,观察比较两组患者的临床治疗效果及不良反应.结果 联合临床治疗总有效率为96.0%高于单一组的75.5%,P0.05,差异不具有统计学意义.结论 对重度抑郁症患者实施氟西汀联合小剂量奥氮平治疗,可以改善抑郁症状,减少不良反应发生,提高生存质量,是一种较为理想的临床治疗方法.%Objective Analysis fluoxetine in combine with small dose of olanzapine in the treatment of major depressive disorder.Methods Selected 99 cases with major depression from June 2013 to April 2015 in our hospital, according to the treatment were divided into the single group ( n=49 ) and the joint group ( n=50 ). Single group was treated with lfuoxetine, combined treatment group patients in the control group, on the basis of combining the small dose of olanzapine treatment, observed the clinical therapeutic effect of two groups were compared and the adverse reactions.Results The joint group the total effective rate was 96.0% higher than the single group 75.5%,P0.05, had no difference statistically signiifcance.Conclusion The implementation of lfuoxetine in patients with major depressive disorder in combination with small dose of olanzapine can improve depressive symptoms, reduce the adverse reaction, improve the quality of survival, is a kind of ideal clinical treatment.

  17. Clinical analysis and study on lfuoxetine combined with small dose olanzapine in treatment of severe depression%氟西汀联合小剂量奥氮平治疗重度抑郁症的临床分析与研究

    Institute of Scientific and Technical Information of China (English)

    胡海涛

    2016-01-01

    目的:探讨氟西汀联合小剂量奥氮平治疗重度抑郁症的临床效果。方法对我院94例重度抑郁症患者进行研究,依据随机平均原则划分为对照组和观察组和47例。对照组47例单纯给予氟西汀治疗,观察组47例给予氟西汀联合小剂量奥氮平治疗。对两组治疗效果和不良反应情况进行比较。结果观察组治疗有效率明显优于对照组,P <0.05;两组不良反应比较差异不明显,P >0.05。结论对重度抑郁症患者给予氟西汀联合小剂量奥氮平进行治疗效果良好,可有效改善患者的抑郁症状,且治疗过程安全可靠,不良反应少,值得临床推广。%Objective to explore the fluoxetine in combination with small dose of olanzapine in the treatment of major depressive disorder.Methods in our hospital 94 cases of patients with major depression were studied, based on the principles of average random divided into control group and observation group, and 47 cases. 47 cases were simply given fluoxetine treatment, observation group of 47 cases were given fluoxetine treatment in combination with small dose of olanzapine.On two groups to compare the effect and adverse reactions.Results efficient observation treatment group was better than control group,P 0.05.Conclusion given fluoxetine in patients with major depressive disorder in combination with small dose of olanzapine in treatment effect is good, can effectively improve the patient's depressive symptoms, and treatment process is safe and reliable, and less adverse reactions, worthy of clinical promotion.

  18. Effect of olanzapine combined with clozapine in the treatment of negative symptoms in male treatment-resistant schizophrenic patients%奥氮平合并氯氮平对男性难治性精神分裂症阴性症状的疗效及安全性的研究

    Institute of Scientific and Technical Information of China (English)

    向伟; 易正辉; 徐庆华

    2009-01-01

    Objective To explore the efficacy and side effects of olanzapine combined with clozapine for trea-ting negative symptoms of male patients with treatment-resistant schizophrenia. Methods A total of 43 male treatment-resistant schizophrenic inpatients with negative symptoms treated with clozapine were assigned to re-ceiving olanzapine 5-20mg/d for 8 weeks, at the same time reducing clozapine to a maintenance dose in 2 weeks . The Positive and Negative Symptom Scale(PANSS) and Treatment Emergent Symptoms Scale (TESS) were used to measure therapeutic efficacy and side effects before the treatment and at 2nd.4th and 8th weekends after the treatment. Results After treatment, the scores of PANSS and TESS in patients significantly dereased.Conclusion Olanzapine combined with clozapine in male inpatients with treatment-resistant schizophrenia can improve negative symptoms with fewer side effects.%目的 观察奥氮平合并氯氮平治疗男性以阴性症状为主的难治性精神分裂症的疗效以及安全性.方法 对43例男性原服用氯氮平且以阴性症状为主的难治性精神分裂症患者合并奥氮平5~20mg/d治疗8周,同时于2周内将氯氮平减量且氯氮平剂量2周后不再变化,并于合并治疗前及后2周、4周、8周评定阳性症状与阴性症状量表(PANSS)、副反应量表(TESS).结果 合并奥氮平治疗后2周、4周、8周末PANSS总分和TESS评分较合并前有明显差异.结论 奥氮平合并氯氮平对于男性难治性精神分裂症患者的阴性症状有明显的改善,副反应也有减少.

  19. Control study of effect and safety of olanzapine and amisulpride in the treatment of first-episode schizophrenia%奥氮平与氨磺必利治疗首发精神分裂症的效果和安全性对照研究

    Institute of Scientific and Technical Information of China (English)

    马周

    2014-01-01

    目的:探讨奥氮平与氨磺必利治疗首发精神分裂症的临床效果和安全性。方法选取2008年3月~2013年4月本院收治的的首发精神分裂症患者200例,将其随机分为实验组和对照组,每组各100例。实验组给予奥氮平治疗,对照组给予氨磺必利治疗,比较两组的治疗效果和不良反应发生情况。结果两组的治疗效果、不良反应发生情况、复发时间、持续治疗时间比较,差异无统计学意义(P>0.05)。结论奥氮平与氨磺必利治疗首发精神分裂症均可以获得满意的临床效果,不良反应较少,具有临床推广价值。%Objective To discuss the clinical effect and safety of olanzapine and amisulpride in the treatment of first-episode schizophrenia. Methods Two hundred patients with first-episode schizophrenia who accepted treatment in our hospital from March 2008 to April 2013 were selected and randomly divided into experimental group (n=100) and the control group (n=100).The experimental group was treated with olanzapine,while the control group was treated with amisulpride. The clinical effect and adverse reaction in both groups were compared. Results There was no statistical difference of therapeutic effect,adverse reaction,recurrence time and continuous curative time in the two groups (P>0.05). Conclusion Olanzapine and amisulpride can obtain a satisfied clinical effect on treating first-episode schizophre-nia with few adverse reaction,and it has clinical promotion value.

  20. Clinical Analysis of Olanzapine in the Treatment of Behavioral and Psy-chological Symptoms of 50 Patients with Senile dementia%奥氮平治疗50例老年痴呆患者精神行为症状临床分析

    Institute of Scientific and Technical Information of China (English)

    乐守江

    2014-01-01

    Objective To investigate the efficacy of olanzapine in the treatment of senile dementia. Methods 98 cases of senile dementia patients were divided into two groups, 50 patients in research group were treated with olanzapine, 48 cases in control group were given risperidone. Results The to-tal effective rate of research group was 94.00%, the incidence rate of adverse reaction was 12.00%, to-tal effective rate of the control group was 68.75%, the incidence rate of adverse reaction was 33.33%. The research group has higher efficiency, lower incidence rate of adverse reaction. After treatment, PANSS score decreased more obviously, there was a significant difference between the two groups.(P<0.05). Conclusion Olanzapine in the treatment of behavioral and psychological symptoms of senile de-mentia, can achieve better curative effect, PANSS score decreased significantly.%目的:探讨奥氮平治疗老年痴呆患者的疗效。方法将98例老年痴呆症患者分为两组,研究组50例给予奥氮平治疗,对照组48例给予利培酮治疗。结果研究组总有效率为94.00%,不良反应发生率为12.00%,对照组总有效率为68.75%,不良反应发生率为33.33%,研究组研究组总有效率较高,不良反应发生率较低,治疗后PANSS量表评分下降更明显,两组差异有统计学意义(P<0.05)。结论奥氮平治疗老年痴呆患者精神行为症状,可取得较好的疗效,PANSS量表评分下降明显。

  1. Escitalopram West Peptide Alvin Joint Olanzapine in the Treatment of Senile Patients with Treatment-resistant Depression Curative Effect Analysis%艾司西肽普兰联合奥氮平治疗中老年难治性抑郁症的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈宇晖

    2016-01-01

    目的:研究艾司西酞普兰联合奥氮平治疗中老年难治性抑郁症临床疗效,判断分析艾司西酞普兰、奥氮平联合治疗效果与影响。方法随机选取2010年1月~2015年12月收治的60例中老年难治性抑郁症患者,分为实验组40例,采用艾司西酞普兰联合奥氮平治疗,对照组20例,采用艾司西酞普兰治疗,对比两组患者临床疗效。结果采用汉密尔顿抑郁量表评定法,实验组患者评分(11.61±2.22)分,评分低于对照组,(14.22±3.51)分,差异具有统计学意义(P<0.05)。结论艾司西酞普兰联合奥氮平治疗中老年难治性抑郁症在临床表现上具有显著影响效果,它可以在短时间内控制缓解患者焦虑抑郁等情绪,在药效作用上优于单使用艾司西酞普兰药物药效。%Objective To study the escitalopram citalopram in combination with olanzapine treatment the clinical curative effect of senile patients with treatment -resistant depression, judgment analysis of escitalopram citalopram, olanzapine combined treatment effect and influence.Methods Randomly selected from a hospital in January 2010 -December 2015 were 60 cases of senile patients with treatment-resistant depression, divided into experimental group 40 cases, using escitalopram citalopram in combination with olanzapine treatment, the control group, 20 cases with escitalo-pram citalopram treatment, compared two groups of patients with clinical efficacy.Results Using the Hamilton depres-sion rating scale evaluation method, the experimental group patients score (92.61~2.16), score lower than the control group(81.16~4.62), statistically significant difference (P<0.05).Conclusions Escitalopram citalopram in combi-nation with olanzapine treatment of middle-aged and old treatment-resistant depression has significant influence on clinical effect, it can control patients′mood swings, change in a short time, on the therapeutic effects is better

  2. 加味苓桂术甘汤对奥氮平诱导肥胖大鼠的减肥作用及其机制%Effect of Jia-wei Ling-gui-shu-gan Tang on olanzapine-induced obesity in rats

    Institute of Scientific and Technical Information of China (English)

    蔡素华; 吕俊华; 韩超; 刘霞

    2011-01-01

    Objective: To investigate the effect and mechanism of Jia-wei Ling-gui-shu-gan Tang (LCSC) on olanzapine-induced obesity in rats. Methods: 70 female SD rats were randomly divided into groups (re = 10 in each group). Obesity was induced by ig olanzapine for 2 weeks. Then, LCSG and sibutramine hydrochloride were administered in addition to olanzapine for 5 weeks. Spontaneous activity was continuously monitored using the SMART video-tracking system in the light and dark phases. The body weight, Lee's index, fat weight around the kidney and uterus, coefficient of fat, the levels of serum leptin and adiponectin contents were observed. Results: After LGSG treatment for 5 weeks, food intake, body weight, fat weight, and coefficient of fat were significantly decreased as compared with obesity control (P<0.05 or0.01). Lee's index in the higher dose LGSG group was significantly decreased (F<0.05). No significant changes were observed in serum leptin and adiponectin. Spontaneous activity in higher dose LGSG group was significantly increased ( P < 0.05 or 0.01). Conclusion: LGSG can decrease olanzapine-induced weigh gain in rats, which might not be associated with the serum leptin and adiponectin.%目的:探讨加味苓桂术甘汤( LGSG)对奥氮平诱导肥胖大鼠的减肥作用及其机制.方法:SD雌性大鼠70只,取其中10只为对照组,其余60只ig奥氮平2周.将造模成功的40只肥胖大鼠随机分为模型组、盐酸西布曲明组、LGSG低、高剂量组,每组10只.动物继续ig奥氮平,同时ig上述药物5周,利用SMART video-tracking system测定大鼠黑暗时相的自主活动,并于药物处理结束时测定大鼠体质量、Lee's指数、肾和子宫周围脂肪垫湿重、脂肪系数、血清瘦素和脂联素含量.结果:LGSG处理肥胖大鼠5周后,饮食量和体质量明显低于模型组大鼠,脂肪湿重和脂肪系数明显减少(P <0.05或0.01),其中高剂量LGSG还能明显降低肥胖大鼠的Lee's指数(P<0.05),但

  3. Comparison of the Effcacy of Olanzapine and Risperidone in the Treatment of Behavioral and Psychological Symptoms of Dementia%奥氮平与利培酮治疗老年痴呆精神行为症状的疗效比较

    Institute of Scientific and Technical Information of China (English)

    孙玮

    2016-01-01

    Objective To comparison of olanzapine and risperidone in the treatment of the clinical effcacy of behavioral and psychological symptoms of dementia, study of olanzapine clinical value.MethodsFrom March 2010 to May 2015, 92 cases of senile dementia patients were selected, according to the order of admission, the patients were divided into observation group and control group, 46 cases in each group. Patients in the control group were given risperidone in the treatment, experimental group given olanzapine for the treatment of drug and using Tess analysis of two groups in the treatment process of adverse reactions occurred, and compared between the two groups of patients for half a month, one month and two months after treatment.Results The scores of PANSS in observation group and 1 months after treatment, the total effective rate was signiifcantly higher than that of the control group, the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, which had statistical signiifcance (P<0.05).Conclusion Olanzapine treatment effect better, fast effect, clinical adverse reactions less for elderly behavioral and psychological symptoms of dementia treatment.%目的:对比奥氮平与利培酮治疗老年痴呆精神行为症状的临床疗效,探讨奥氮平的临床治疗价值。方法从我院2010年3月~2015年5月收治的老年痴呆症患者中选择92例,根据入院顺序将患者平分为观察组和对照组各46例。对照组给予利培酮药物治疗,实验组给予奥氮平药物治疗,使用TESS量表分析两组在治疗过程中的不良反应发生情况,并比较两组患者的半个月、一个月和2个月后的治疗效果。结果观察组治疗半个月和1个月后的PANSS量表评分、治疗总有效率高于对照组,对比差异具有统计学意义(P<0.05)。观察组各项不良反应发生率均低于对照组,对

  4. Clinical study of refractory auditory hallucination in schizophrenia patients treated with olanzapine and amisulpride%奥氮平联合氨磺必利治疗精神分裂症顽固性幻听的临床研究

    Institute of Scientific and Technical Information of China (English)

    王坚

    2015-01-01

    Objective To investigate the effect of olanzapine combined with amisulpride treatment on refractory auditory hallucination in schizophrenia patients. Methods 140 patients with schizophrenia in our hospital from April 2013 to May 2014 were randomly divided into study group (n=70) and control group (n=70). The control group was given olanzapine ,and the study group received therapy of olanzapine combined with amisulpride for 8‐week treatment. The clinical efficacy before and af‐ter 4‐and 8‐week treatment and adverse events at 8‐week treatment were compared in two groups.Results The clinical effec‐tive rate was 87.14% in study group and 64.29% in control group ,with a significant difference. The scores of PNASS ,AHRS and CGI were significantly lower in both groups after treatment ,and the difference had statistically significance compared study group with control group after 4‐and 8‐week treatment(P<0.05);Adverse reactions occurred in 13 cases(18.57% ) in study group and 46 cases(65.71% ) in control group ,with a significant difference.Conclusion Clinical effect of olanzapine combined amisulpride for refractory auditory hallucinations in schizophrenia is significant ,with a good safety and few adverse reactions. It's worthy of clinical applitcation.%目的:探讨奥氮平联合氨磺必利治疗精神分裂症顽固性幻听的临床疗效。方法选择2013‐04—2014‐05来院就诊的精神分裂症患者140例,随机分为治疗组(n=70)和对照组(n=70)。对照组采用奥氮平治疗,治疗组采用奥氮平联合氨磺必利治疗,治疗8周,观察比较2组在治疗前和治疗第4、8周末时临床疗效及不良反应情况。结果治疗组临床有效率(87.14%)与对照组(64.29%)相比差异有统计学意义;2组在给药后PNASS、AHRS和CGI评分均显著降低,治疗组在治疗4周和8周时与对照组相比,差异具有统计学意义( P<0.05);治疗组发生不良反应13

  5. Effect comparison of olanzapine and risperidone treating patients with Alzheimer disease associated with psychiatric symptom%奥氮平与利培酮治疗阿尔茨海默病患者伴精神行为症状的效果比较

    Institute of Scientific and Technical Information of China (English)

    钟华; 刘少华

    2015-01-01

    Objective To compare the effect of olanzapine and risperidone treating patients with Alzheimer disease as-sociated with psychiatric symptom. Methods 68 patients with Alzheimer disease received by our hospital from January 2013 to January 2015 of our hospital were selected as study object and were randomly divided into observation group and control group.Observation group was treated by olanzapine and control group was treated by risperidone. Clinical effect of patients in two groups was compared. Results The total effective rate of observation group was 91.2% and the control group was 88.2%,and there was no statistical difference (P>0.05).After treatment,the total score of BEHAVE-AD and BPRS of patients in two groups had no statistical difference when compared with before treatment (P0.05).The incidence rate of adverse reaction in observation group was 20.6% and the control group was 50.0%,and there was a statistical difference (P0.05)。治疗后,两组患者的痴呆病理行为评定量表(BEHAVE-AD)总分、简明神经精神量表(BPRS)总分与治疗前比较,差异有统计学意义(P0.05)。观察组的不良反应发生率为20.6%,对照组为50.0%,两组的不良反应发生率比较,差异有统计学意义(P<0.05)。结论奥氮平与利培酮治疗阿尔茨海默病伴精神行为症状患者具有良好效果,但奥氮平药物起效快,且安全性高。

  6. Therapeutic effects of aripiprazole and olanzapine on the patients with first-episode acute schizophrenia and their influence on plasma prolactin level%阿立哌唑与奥氮平对首发精神分裂症 急性期疗效及对催乳素的影响

    Institute of Scientific and Technical Information of China (English)

    吴小立; 王继辉; 钟智勇; 韩自力

    2011-01-01

    AIM:To study the efficacy on first-episode acute schizophrenia treated with aripiprazole and olanzapine and the effect on plasma prolactin level. METHODS: 65 inpatients with first-episode acute schizophrenia were divided into either olanzapine group [n = 42, M21, F21; age(23. 9±6. 6)year] or aripiprazole group[(n=23, M1l, F12; age (23. 7 ± 7. 2) year] for 4 week treatment. The plasma prolactin level, the Positive and Negative Syndrome Scale (PANSS) and clinical global impressionglobal improvement (CGI-I) were measured before and after 4 week treatment. RESULTS: The score of PANSS (59 ± 13) after therapy in olanzapine group was significantly lower than that before therapy (103+15) (P 0.05) in the CGI-I score between the two groups. The difference of negative symptoms and general psychopathological sub-scale scoreschanging from base to end between the two groups was statistically significant (P<0. 01). Compared with the prolactin baseline level (547 ±382) uIu/mL,the plasma prolactin level (418 ±362) ulu/mL in olanzapine group was significantly decreased after treatment, and there was no difference. Compared with the prolactin baseline level (351 ±299) ulu/mL, the plasma prolactin level (123 ±114) ulu/mL in aripiprazole group was significantly decreased after treatment, and there was significant difference ( P < 0.01). CONCLUSION: The therapeutic effects were similar in the aripiprazole and olanzapine group for first-episode acute schizophrenia. Olanzapine is better for the general psychopathological symptoms, and aripiprazole is better for the negative symptoms. Aripiprazole maybe decrease the plasma prolactin level of first-episode acute schizophrenia.%目的:研究奥氮平和阿立哌唑对首发精神分裂症患者急性期疗效及对血中催乳素(PRI)水平的影响.方法:65例首发精神分裂症患者分为奥氮平组42例[男21例,女21例;年龄(23.9±6.6)岁]和阿立哌唑组23例[男11例,女12例;年龄(23.7±7.2)岁].分别给予奥

  7. Comparison of Short-term Metabolic Risk in First-episode Young-adult Schizophrenia Treated with Aripiprazole and Olanzapine%阿立哌唑与奥氮平对首发年轻成人精神分裂症患者短期内代谢风险的比较

    Institute of Scientific and Technical Information of China (English)

    吴小立; 魏钦令; 钟智勇; 张晋碚

    2011-01-01

    摘要:[目的]比较阿立哌唑与奥氮平对首发年轻成人精神分裂症患者短期内的代谢风险.[方法]采用开放对照的临床观察方法,对符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)精神分裂症诊断标准的首发住院精神分裂症患者,分别使用阿立哌唑(21例)和奥氮平(42例)治疗,自然观察时间不低于2周,不大于4周,于治疗前后各检测一次体质量、腰围、空腹血脂血糖及胰岛素、C肽.[结果]观察结束时:阿立哌唑组的体质量、体质量指数(BMI)、腰围、腰臀比均有增高(P<0.05),糖脂改变无统计学差异,男女患者间各项代谢指标的变化无统计学差异(P>0.05);奥氮平组的体质量、体质量指数(BMI)、腰围、腰臀比、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白AI和B100及脂蛋白LPa较治疗前增高(P<0.0l),且胰岛素(INS)水平和胰岛素抵抗指数(IR)增高(P<0.05),多元逐步回归分析显示胰岛素抵抗与甘油三脂的增高有关(R2 =0.107,P=0.007);奥氛平组男性患者的空腹胰岛素和C肽、胰岛素抵抗指数均增高(P<0.05),女性患者则没有.[结论]阿立哌唑和奥氮平对首发年轻成人精神分裂症患者短期内的代谢风险即有差异,性别差异可能影响着非典型抗精神病药物的代谢风险.%[Objective] To compare the short-term metabolic risk in the first-episode young-adult schizophrenia treated with Aripiprazole and Olanzapine. [ Methods] The open-lable, natural observed, compared method was designed for this study. All of these cases were diagnosed as first-episode schizophrenia in accordance with the DSM-IV diagnosis criteria and respectively allocated into two groups for either Aripiprazole or Olanzapine treatment. The natural observed period was from two weeks to four weeks. Weight, waist circumference, fasting glucose, and lipid concentration, fasting insulin and C peptide

  8. A suspected case of olanzapine induced hyponatremia

    National Research Council Canada - National Science Library

    Bakhla, Ajay Kumar; Guria, Rishi Tuhin; Kumar, Abhishek

    2014-01-01

    Here we report a case of a 63-year-old male diagnosed with recurrent depressive disorder and current episode of severe depression with psychotic symptoms, developed hyponatremia soon after addition...

  9. 奥氮平对首次发病精神分裂症患者肝脏脂肪含量的影响%Effects of olanzapine treatment upon liver fat content in first-episode schizophrenia patients: a preliminary study

    Institute of Scientific and Technical Information of China (English)

    陈方斌; 陈琪; 潘园园; 孙剑; 徐乐平; 王焕林

    2014-01-01

    目的 观察奥氮平对首次发病精神分裂症患者肝脏脂肪含量(liver fat content,LFC)的影响.方法 首次发病精神分裂症25例患者(患者组)接受奥氮平单药治疗,剂量为10~ 20 mg/d,疗程8周.患者组分别于治疗前、治疗后(第8周末),采用质子磁共振波谱分析测定LFC,并与25名健康人(对照组)进行比较;患者组另予测定人体学指标[体质量指数(body mass index,BMI)、腰围/身高比(waist-height ratio,WHR)]、血清代谢指标(空腹血糖、甘油三酯、胆固醇)及稳态模型评估的胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR).结果 (1)治疗后患者组LFC较治疗前增高(分别为4.99%±1.79%、3.98%±0.83%,=2.958,P <0.01),并高于对照组(4.02%±0.80%,t=2.436,P<0.05),差异有统计学意义;(2)治疗后患者组BMI、WHR、甘油三酯、胆固醇、HOMA-IR较治疗前增高;(3)治疗前患者组LFC值与HOMA-IR、BMI、WHR、甘油三酯呈正相关(r=0.447、0.424、0.421、0.413,均P<0.05);治疗后LFC值与HOMA-IR、甘油三酯呈正相关(r=0.425、0.400,均P<0.05);治疗前后LFC变化值与HOMA-IR、WHR变化值呈正相关(r=0.478,P<0.01;r =0.430,P <0.05);(4)治疗后患者组有4例(4/25,16%)LFC高于脂肪肝诊断临界值(LFC>5.5%).结论 奥氮平治疗可能增加精神分裂症患者肝脏的脂肪沉积.%Objective To observe the effects of olanzapine treatment upon liver tat content (LFC)in first-episode schizophrenia patients.Methods A total of 25 first-episode schizophrenia patients were administered olanzapine alone with dosage ranging from 10 to 20 mg per day for eight weeks.1H-magnetic resonance spectroscopy (1H-MRS) was used for LFC measurements before and after eight-week olanzapine treatment.The results were compared with those of the normal control group (n =25).Other indicators,including body mass index (BMI),waist-height ratio (WHR),fasting plasma glucose (FPG),triglyceride (TG

  10. Clinical observation of aripiprazole orally disintegrating tablets in the improvement of women's weight,prolactin increase caused by risperidone,sulpiride,olanzapine%阿立哌唑口腔崩解片改善利培酮、舒必利、奥氮平致女性体重、泌乳素增加的临床观察

    Institute of Scientific and Technical Information of China (English)

    卓子禄; 王群英; 熊英; 胡俊英

    2015-01-01

    目的:探讨阿立哌唑口腔崩解片改善利培酮、舒必利、奥氮平等精神类药物所致体重、泌乳素增加的临床效果。方法:收治因服用利培酮、舒必利、奥氮平等精神类药物后引起体重增加及高催乳素血症患者60例,所有患者均维持原抗精神类药物的治疗方案,根据随机数字表将患者分为阿立哌唑口腔崩解片组(观察组)30例和安慰剂组(对照组)30例,两组患者干预12周后测量患者体质指数(BMI)变化及催乳素(PRI)的水平,同时采用不良反应量表(TESS)评定阿立哌唑口腔崩解片治疗的不良反应。结果:与对照组相比,观察组治疗后 BMI 及PRL 显著下降,差异有统计学意义(P<0.01)。观察组总有效率93.33%,对照组总有效率76.67%,两组比较有统计学意义(P<0.05)。TESS 评分观察组(5.12±1.12)分,对照组(4.98±1.08)分,两组比较差异无统计学意义(P>0.05)。结论:阿立哌唑口腔崩解片能有效改善利培酮、舒必利、奥氮平等抗精神病药所致体重、泌乳素增加症状,且安全、可靠,值得临床应用和推广。%Objective:To explore the clinical effect of aripiprazole orally disintegrating tablets in the improvement of women's weight,prolactin increase caused by sulpiride,risperidone,olanzapine.Methods:60 cases of weight gain and hyperprolactinemic patients caused by sulpiride,risperidone,olanzapine were selected.All patients maintained antipsychotic drug treatment scheme of the original.According to the random number table,they were divided into the aripiprazole orally disintegrating tablets group(observation group) with 30 cases and the placebo group(control group) with 30 cases.After 12 weeks of treatment,we measured body mass index patients(BMI) changes and prolactin(PRI) level.At the same time,we evaluated the adverse reactions of aripiprazole orally disintegrating tablets treatment using side effects scale

  11. 草酸艾司西酞普兰联合小剂量奥氮平治疗老年期抑郁症的效果观察%Effect observation of escitalopram combined with small dose of olanzapine in the treatment of senile depression

    Institute of Scientific and Technical Information of China (English)

    孙祥虹; 孙平

    2015-01-01

    Objective To observe the clinical curative effect of escitalopram combined with small dose of olanzapine in the treatment of senile depression. Methods From June 2013 to July 2014,60 patients with senile depression were random-ly divided into experimental group and control group,each of 30 cases. The experimental group was given escitalopram com-bined with small dose of olanzapine for treatment,while the control group was only given escitalopram for treatment. Both groups were treated for 8 weeks. The clinical effect was evaluated by using Hamilton depression scale(HAMD),adverse reaction scale (TESS). Results The effective rate of the experimental group was 83. 00% ,which was higher than 73. 00% of the control group,the difference was statistically significant(P 0. 05). Conclusion The curative effect of escitalopram combined with small dose of olanzapine in the treatment of senile depression is remarkable, which is worthy of clinical application.%目的:观察草酸艾司西酞普兰联合小剂量奥氮平治疗老年期抑郁症的临床疗效。方法选取2013年6月-2014年7月老年科收治的住院或门诊患者60例,随机分为试验组和对照组各30例。试验组予草酸艾司西酞普兰合并奥氮平治疗,对照组仅予草酸艾司西酞普兰治疗,治疗共进行8周,采用汉密顿抑郁量表(HAMD),不良反应量表(TESS)进行测评。结果试验组显效率83.00%明显高于对照组的73.00%,差异有统计学意义(P <0.05);2组治疗后 HAMD 评分比较差异有统计学意义(P <0.05)。试验组嗜睡、体质量增加不良反应发生人数较对照组高,比较差异有统计学意义(P <0.05);而2组口干、恶心、心动过速等不良反应比较差异无统计学意义(P >0.05)。结论老年抑郁症患者可以考虑草酸艾司西酞普兰合并小剂量奥氮平治疗,疗效显著。值得临床推广运用。

  12. Control study of olanzapine combined magnesium valproate sustained-release tablets in treatment of personality changes due to brain injury mainly caused by impulsive attacks%奥氮平合并丙戊酸镁缓释片治疗以冲动攻击为主的脑外伤所致人格改变的对照研究

    Institute of Scientific and Technical Information of China (English)

    马驰; 邵晓林; 王尚红

    2014-01-01

    目的:探讨奥氮平联合丙戊酸镁缓释片治疗以冲动攻击为主的脑外伤所致人格改变的疗效与安全性。方法:将51例根据中国精神障碍分类与诊断标准第3版(CCMD-3)确诊为脑外伤所致人格改变的患者随机分为实验组(25例)和对照组(26例)。实验组患者应用奥氮平、丙戊酸镁缓释片,对照组患者应用丙戊酸镁缓释片治疗,疗程8周。两组患者于治疗前及治疗第1、2、4、6、8周时使用修改版外显攻击行为量表( MOAS)及副反应量表( TESS)评定临床疗效和不良反应。结果:两组患者间在治疗2周末起MOAS评分比较差异均有统计学意义(P<0.05),实验组患者评分降低更为明显,两组患者不良反应多为轻度,可耐受。结论:奥氮平合并丙戊酸镁缓释片治疗以冲动攻击为主的脑外伤所致人格改变起效更快,疗效好且安全,可快速控制冲动攻击行为。%Objective:To investigate effects and safety of olanzapine combined with magnesium valproate sustained-release tablets on personality change after traumatic brain injury. Methods:A total of 51 patients with personality change after traumatic brain injury diagnosed according to Chinese classification and diagnostic criteria of mental disorders 3rd edition (CCMD-3) were randomly divided into experimental group (25 cases) and control group (26 cases). The cases in experimental group were given olanzapine com-bined with magnesium valproate sustained-release tablets for 8 weeks, whereas those in control group were only given magnesium val-proate sustained release tablets for 8 weeks. The modified overt aggression scales ( MOAS) and treatment emergent symptom scale ( TESS) were used to evaluate the effects and adverse reactions for the two groups before and 1, 2, 4, 6, and 8 weeks after the treat-ment. Results:Starting from 2 weeks after the treatment, the differences of MOAS scores between the two groups were statistically sig

  13. 奥氮平联合运动疗法对糖尿病患者焦虑、抑郁状况的影响%EFFECT OF OLANZAPINE COMBINED WITH EXERCISE THERAPY ON ANXIETY AND DEPRESSION,PATIENTS WITH DIABETES MELLITUS

    Institute of Scientific and Technical Information of China (English)

    孟怡红

    2015-01-01

    Objective To investigate the effects of olanzapine combined with exercise therapy on blood glucose in diabetic patients ,the anxiety and depression status .Methods 108 patients with diabetes mellitus anxiety and depression were randomly divided into observation group and control group (cases) .All 54 pa‐tients were treated with metformin (0 .5 g/times ,3 times /d) ,diet control ,health education and other measures .The control group based on given paroxetine (20mg ,QD) were observed group on the basis of the implementation of olanzapine in the treatment of (1 .25 mg /time ,1 time /D) combined with exercise therapy intervention ,2 months after treatment ,comparative analysis two groups before and after treat‐ment in patients with fasting blood glucose (FBG) ,postprandial Hamilton Anxiety and depression and 2H plasma glucose (2hFPG) scale (HAMD) anxiety and depression scores .Results The levels of 2hFPG and FBG in the two groups were lower than those before treatment ( P< 0 .05) ,the scores of anxiety and de‐pression in the two groups were lower than those in the control group ( P < 0 .05) ,and the observation group was significantly lower than that in control group ( P < 0 .05) .Conclusion Olanzapine combined with exercise therapy intervention ,reduce blood sugar and shorten the time of blood glucose control ,obvi‐ously alleviate the anxiety and depression symptoms in diabetic patients ,improve the quality of life of the patients ,the incidence of side effect was low ,safe and effective .%目的:探讨奥氮平联合运动疗法对糖尿病患者血糖、焦虑及抑郁状况的影响。方法选取108例糖尿病焦虑及抑郁状况患者,随机分为观察组与对照组各54例,均给予二甲双胍降糖治疗(0.5 g/次,3次/d)、饮食控制、健康教育等措施治疗。对照组在此基础上给予帕罗西汀(20mg/次,1次/d),观察组在此基础上实施奥氮平治疗(1.25 mg/次,1次/d)联

  14. 阿立哌唑与奥氮平治疗老年期痴呆精神行为症状的效果观察%Effect observation on senile dementia with behavioral and psychological symptoms in the treatment with Aripiprazole and olanzapine

    Institute of Scientific and Technical Information of China (English)

    秦素萍

    2012-01-01

    Objective To Investigate the clinical efficacy on senile dementia with behavioral and psychological symptoms in the treatment with Aripiprazole and Olanzapine. Methods 84 patients with senile dementia associated with behavioral and psychiatric symptoms were selected in the hospital from March 2009 to December 2011, who were divided into two groups randomly. 42 patients who used Olanzapine treatment were as the control group. 42 patients who used Aripiprazole in the treatment were as the observation group. The course of treatment was 8 weeks. After treatment of 1 weeks, 2 weeks, 4 weeks, 8 weeks, AD behavioral pathology In scale (BEHAVE-AD), treatment emergent symptom scale (TESS) of patients were performed. Before the treatment and after treatment of 8 weeks, minimum mental state examination was performed. Results After treatment, AD behavioral pathology in scale total score and each factor scores in the control group and observation group decreased significantly. The incidence rate of adverse drug reactions (19.0%) in the observation group was significantly lower than that In the control group (45.2%), the differences were statistically significant (P < 0.05). Minimum mental state examination scores in the control group and observation group evaluated. Total efficiency of AD behavioral pathology In scale score and minimum mental state examination score In the observation group was slightly higher than those In the control group, while there were no significant differences between them (P > 0.05}. Conclusion Aripiprazole and Olanzapine in the treatment of senile dementia with behavioral and psychological symptoms have equivalent clinical efficacy. But Aripiprazole has better security, which is more suitable for clinical use.%目的 探讨阿立哌唑与奥氮平治疗老年期痴呆的精神行为症状的临床疗效.方法 选取我院2009年3月~2011年12月收治的老年期痴呆伴精神行为症状患者84例,随机分为两

  15. The Correlation between Influence of Metformin on Lipid and Insulin Resistance in Schizophrenia Patients with Olanzapine Treatment%二甲双胍对奥氮平治疗的精神分裂症患者血脂的影响及与胰岛素抵抗的关系

    Institute of Scientific and Technical Information of China (English)

    苏宗荣; 赵汉清; 汪莉; 徐乐平

    2014-01-01

    目的:探讨二甲双胍对奥氮平治疗的精神分裂症患者血脂的影响及其与胰岛素抵抗的关系。方法接受奥氮平单药治疗的精神分裂症患者( n=48),加用二甲双胍750 mg/d治疗,疗程8周。分别于治疗前、治疗后4、8周末,测定甘油三酯( TG)、胆固醇( TC)、低密度脂蛋白胆固醇( LDL-C)、高密度脂蛋白胆固醇( HDL-C)及稳态模型评估的胰岛素抵抗指数( HO-MA-IR)。结果①治疗后4、8周时,TG、TC、LDL-C均较治疗前下降,差异有统计学意义( t=2.084~2.674,P=0.042~0.018);HOMA-IR也较治疗前显著下降,差异有统计学意义(t=2.870、2.904,P=0.009、0.007);②治疗后4、8周时的TG变化值与HOMA-IR变化值正性相关(r=0.354、0.386,P=0.016、0.008)。结论二甲双胍可降低奥氮平治疗的精神分裂症患者血脂水平,并可能与二甲双胍对患者胰岛素抵抗的改善作用有关。%Objective To explore the dynamic changes of lipids in olanzapine-treated schizophrenia patients with metformin addition and its relationship with insulin resistance .Methods Schizophrenia patients with olanzapine mono therapy ( n=48 ) received metformin (750mg/d)therapia for 8 weeks.Serum level of TG,TC,LDL-C,HDL-C and the homeostasis model assessment of insulin resistance index(HOMA-IR)were assessed pre and 4,8 weeks pro metformin addition.Results The serum level of TG,TC and LDL-C (t=2.084~2.674,P=0.042~0.018)were significantly decreased 4,8 weeks after metformin treatment .An uniform lowing of HOMA-IR (t=2.870,2.904;P=0.009,0.007) were observed at the same time point of the study .There was a positive relationship between the diversify of TG and HOMA-IR at the time of 4,8 weeks(r=0.354,0.386;P=0.016,0.008)post metformin addition.Conclusion The improvement of insulin resistance might be one of origin of modulation effects for metformin on lipids in schizophrenia

  16. 氨磺必利和国产奥氮平治疗难治性精神分裂症疗效及安全性对比%The Effect and Safety Contrast of Refractory Schizophrenia Cured by Amisulpride and Olanzapine Agent

    Institute of Scientific and Technical Information of China (English)

    贾艳洁; 李辉

    2015-01-01

    Objective To compare the clinical effects and safety contrast of refractory schizophrenia cured by amisulpride and olanzapine agent. Methods 100 patients who suffered from the refractory schizophrenia and who accepted treatments in our hospital from March 2014 to March 2015 were taken as the research objects, and these patients were randomly divided into the control group and the study group, with 50 patients in each group. In the study group, they were treated with the amisulpride glucose while in the control group, they were treated with the olanzapine agen. Then, the treatment effect and adverse reactions of these two groups of patients were compared with the positive and negative symptoms scale (PANSS) and the response scale (TESS). Results After the treatment, the positive symptoms and the negative symptoms of the symptoms of these two groups of patients were significantly decreased than that before the treatment (P0.05). The adverse reaction rate between the study group and the control group had no significant difference (P>0.05). Conclusion The amisulpride and olanzapine agent in the treatment of refractory schizophrenia are effective, which the incidence of adverse reactions is low and the patient compliance is good.%目的:比较氨磺必利和国产奥氮平治疗难治性精神分裂症疗效及安全性。方法从我院2014年3月~2015年3月收治的精神分裂症患者中随机性抽取100例作为研究对象,并将其分为研究组和对照组,每组各50例。研究组患者给予氨磺必利治疗,对照组给予国产奥氮平治疗。使用阳性与阴性症状量表(PANSS)和副反应量表(TESS)比较两组患者治疗前后的疗效和不良反应。结果两组患者在治疗后的阳性症状分和阴性症状分较治疗前均有明显下降(P <0.05);两组患者治疗后的 PANSS 评分无明显差异(P >0.05);研究组与对照组不良反应发生率比较无明显差异(P >0.05)。结论氨

  17. Comparative analysis of treatment with Olanzapine and Quetiapine on behavioral and psychological symptoms of patients with Alzheimer's%奥氮平和喹硫平治疗老年期痴呆患者精神行为症状的对比分析

    Institute of Scientific and Technical Information of China (English)

    徐燕

    2015-01-01

    目的:探讨奥氮平和喹硫平治疗老年期痴呆患者精神行为症状的临床疗效与不良反应。方法将我院收治的120例老年期痴呆患者随机分为奥氮平组与喹硫平组,每组60例,奥氮平组使用奥氮平,初始剂量2.5 mg/d,4周内逐渐增至5~15 mg/d;喹硫平组应用喹硫平,初始剂量25 mg/d,4周内逐渐增至200~400 mg/d。比较2组患者治疗前后的BEHAVE-AD、MMSE。结果2组患者治疗后BEHAVE-AD、MMSE及ADL评分均较治疗前明显改善(P0.05);2组患者的嗜睡、头晕、便秘、震颤、静坐不能、直立性低血压、失眠比较无统计学差异(P>0.05),奥氮平组患者的口干、体重增加、锥体外系反应明显多于喹硫平组,2组比较差异显著(P0.05);there was no significant difference in somnolence, dizziness,constipation,tremor,akathisia,orthostatic hypotension and between the two groups (P>0.05);the dry mouth, weight gain and extrapyramidal reactions of the patients of Olanzapine Group were significantly more that of the Quetiapine Group,there was significant difference between the two groups (P<0.01).Conclusions Both of Olanzapine and quetiapine can achieve satisfactory results on treatment for patients with Alzheimer's,with fewer adverse reactions, therefore they are worthy of clinical application.

  18. 奥氮平配合行为矫正治疗及综合康复模式治疗救助精神分裂症患者的对照研究%A controled study of olanzapine medication, behavior modification therapy and comprehensive rehabilitation model which treatment for patients with schizophrenia

    Institute of Scientific and Technical Information of China (English)

    马振玉; 毕崇波; 孙红立

    2014-01-01

    Objective: To explore effective rehabilitation treatment of patients with schizophrenia. Methods: Divided 100 patients into control group and study group. The control group used conventional antipsychotics and traditional occupational recreational rehabilitation therapy, study group with olanzapine drug therapy, in conjunction with behavior modification therapy and comprehensive rehabilitation model. Compare scores of scales before treatment and 3 months after treatment. Results:The two groups assessed PANSS, ADL, SDSS, lPRO before treatment and 3 months after treatment separately , there was a significant difference (P <0.05) in each group, scores of PANSS, ADL, SDSS, lPRO showed significant differences (P <0.05) between the two groups. Conclusion: Olanzapine medication and behavior modification therapy, meanwhile use comprehensive rehabilitation model, which can effectively improve their living skils and social adaptability.%目的::探讨救助精神分裂症患者的有效治疗方法。方法:将100例救助精神分裂症病人随机分为对照组和研究组各50例。对照组应用常规抗精神病药物治疗及传统工娱疗康复模式,研究组采用奥氮平系统治疗,同时配合行为矫正治疗及综合康复模式,比较两组在治疗前、治疗后3个月末各量表的评分。结果:研究组或对照组治疗前与治疗后3个月末评定PANSS、ADL、SDSS、lPRO,评分有显著性差异(P<0.05),且治疗后3个月研究组与对照组PANSS、ADL、SDSS、lPRO评分亦有显著性差异(P<0.05)。结论:应用奥氮平药物配合行为矫正治疗的同时,采用综合康复模式,能有效提高精神分裂症患者的生活自理能力及社会适应能力。

  19. 奥氮平与氯氮平治疗男性精神分裂症患者的疗效及对糖脂代谢的影响%Study on effects of olanzaPine and clozaPine on glucose and liPid metabolism in Patients with male schizoPhrenia

    Institute of Scientific and Technical Information of China (English)

    林晓东; 侯强; 王志敏; 李金明; 袁迎娣; 于君; 徐伟平

    2016-01-01

    目的:探讨奥氮平、氯氮平治疗男性精神分裂症患者的疗效及对糖脂代谢的影响。方法:70例男性精神分裂症患者随机分为奥氮平组和氯氮平组各35例治疗8周;采用阳性与阴性症状量表(PANSS)在治疗前后进行评估,同时检测血总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)及空腹血糖(FPG)水平并进行比较。结果:两组 PANSS 各项评分治疗后均显著下降(P 0.05)。两组血 TC、TG、LDL 交互效应(F =2.932,F =4.159,F =3.911)、TC、LDL、FPG 组间主效应(F =4.595,F =4.798,F =5.856)、TC、TG、FPG 时间主效应(F =3.224,F =5.389,F =3.979)均存在统计学意义(P 0. 05). There were statistical significance on interaction effect of the two groups TC,TG,LDL(F = 2. 932,F = 4. 159, F = 3. 911;P < 0. 05 or P < 0. 01),TC,LDL,FPG group main effect(F = 4. 595,F = 4. 798,F = 5. 856;P <0. 05 or P < 0. 01)and TC,TG and FPG time effect(F = 3. 224,F = 5. 389,F = 3. 979;P < 0. 05 or P < 0. 01). Conclusion:Olanzapine and clozapine have similar curative effect in the treatment of schizophrenia,and both have effect on glucose and lipid metabolism,but the effect of olanzapine was more obvious.

  20. Comparative Study on the Efficacy and Safety of Olanzapine and Risperidone in the Treatment of Behavioral and Psychological Symptoms of Dementia%奥氮平与利培酮治疗痴呆精神行为症状的疗效及安全性比较研究

    Institute of Scientific and Technical Information of China (English)

    梁静涛; 吴丽娟

    2016-01-01

    目的探讨奥氮平与利培酮治疗痴呆精神行为症状的临床效果以及安全性。方法将我院2013年1月~2014年1月收治的70例患有痴呆精神行为症状的患者随机分成对照组和治疗组,对照组行利培酮进行治疗,治疗组行奥氮平进行治疗,比较两组患者的治疗效果。结果治疗后,治疗组总有效率为85.71%,对照组为91.43%,对比显示差异无统计学意义(>0.05);与治疗前相比,两组患者治疗2、4、8w后的BEHAVE-AD评分均有明显改善,且差异显示具有统计学意义(0.05);治疗组不良反应率为11.43%,明显低于对照组的31.43%,且差异显示具有统计学意义( 0.05); compared with before treatment, the two groups of patients after treatment BEHAVE 2,4,8w -AD scores showed significant improvement, and show a statistically significant difference ( 0.05); adverse reaction rate was 11.43% in treatment group was significantly 31.43% lower than the control group, and the difference was statistically significant display ( <0.05). Conclusion Olanzapine and risperidone behavioral and psychological symptoms of dementia have some clinical effect, but Olanzapine security even more significant, can reduce the incidence of adverse events, help patients get better treatment, worthy of promotion.

  1. 帕利哌酮缓释片和奥氮平治疗首发精神分裂症的对照研究%A control study of paliperidone extended - release tablets and olanzapine in the treatment of first - episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    毛智群; 李达; 查智群; 顾曙光; 季萍

    2011-01-01

    Objective To compare efficacy and safety of paliperidone extended -release tablets and olanzapine in the treatment of first - episode schizophrenia. Methods 90 adult patients with first - episode schizophrenia in accordance with CCMD - HI were randomized into study group treated with paliperidone extended - release tablets and control group treated with olanzapine for 8 weeks. The Positive and Nenative Syndrome Scale ( PANSS) and Treatment Emergent Side effect Scale ( TESS) were used to evaluate efficacy and side effects respectively at the baseline and at the ends of the 2nd, 4th and 8th weekends of the treatment. Results There was no significant difference in effective rate between study group and control group (91. 2% vs. 96. 5% , P >0. 05). Total score and factor scores of PANSS at each interview - point showed no significant differences between the two groups ( P > 0.05 ). The incidence rate of side effects in both groups was low and the severity was mild. Conclusion Paliperidone extended - release tablets have equivalent efficacy and safety in the treatment of first - episode schizophrenia.%目的 评价帕利哌酮缓释片和奥氮平治疗首发精神分裂症的疗效和安全性.方法 对符合CCMD -3中首发精神分裂症诊断标准的90例患者,随机分为帕利哌酮缓释片组和奥氮平组,分别治疗8周.采用阳性和阴性症状量表( PANSS)和副反应量表(TESS)评定疗效及副反应.结果 帕利哌酮缓释片组有效率为91.2%,奥氮平组有效率为96.5%,差异无统计学意义(P>0.05);两组治疗前后各时点PANSS总分及各因子分比较差异均无统计学意义(P>0.05).两组治疗中的不良反应发生率低、程度轻.结论 帕利哌酮缓释片与奥氮平治疗首发精神分裂症疗效相当,不良反应轻.两种药物均为疗效好、安全性高的抗精神病药.

  2. Association study between G-protein β3 subunit gene polymorphism and olanzapine-induced weight gain%G蛋白β3亚单位基因多态性与奥氮平所致体重增加的相关性

    Institute of Scientific and Technical Information of China (English)

    张文跃; 祁小飞; 鲍晨曦; 易正辉; 朱强; 杨忠; 魏英; 马俊峰; 陆忠桃

    2016-01-01

    目的:探讨G蛋白β3亚单位(G-proteinβ3 subunit,GNB3)基因C825T多态性与精神分裂症患者使用奥氮平治疗过程中体重增加的关系。方法对90例首次住院的精神分裂症患者予奥氮平治疗12周,监测治疗前后的体重、体重指数(body mass index,BMI)变化,并检测患者GNB3基因C825T多态性,分析基因多态性与体重变化的相关性。结果治疗后患者体重、BMI增加有统计学意义(均P<0.01)。TT基因型者治疗后的增重率(weight gain rate,WGR)及BMI增加较CC基因型者更明显(均P<0.01),携T等位基因(TT型+CT型)者治疗后的WGR及BMI增加较非携T等位基因(CC型)者更明显(均P<0.01)。治疗后WGR≥7%者GNB3基因C825T基因型分布(CC型15.69%,CT型54.90%,TT型29.41%)与WGR<7%者(CC型38.46%,CT型43.59%,TT型17.95%)差异有统计学意义(P<0.05),WGR≥7%者T等位基因频率(63.33%)高于WGR<7%者(39.74%)(P<0.05)。多因素线性回归显示TT基因型(以CC型为参照)影响奥氮平治疗后的体重变化(β=1.83,标准化β=0.29,P<0.01)。结论 GNB3基因C825T多态性与奥氮平所致的体重增加有关。%Objective To explore the relationship between G-protein β3 subunit (GNB3) gene C825T polymor⁃phism and the weight gain of schizophrenics treated with olanzapine. Methods Ninety schizophrenics of first time hospi⁃talization were collected and treated with olanzapine for 12 weeks. The changes of body weight and body mass index (BMI) were detected before and after 12-week olanzapine treatment. The GNB3 gene C825T polymorphism in patients was determined by polymerase chain reaction (PCR) and DNA sequencing technique. The correlation of GNB3 gene C825T polymorphism and change of clinical parameters was analyzed. Results Body weight and BMI in patients were all increased significantly after treatment (all P<0.01). Weight gain rate (WGR) and increase of BMI in the

  3. 阿立哌唑联合奥氮平治疗老年阿尔茨海默病伴精神障碍的临床疗效及安全性评价%Clinical efficacy and safety of aripiprazole combined with olanzapine in the treatment of elderly Alzheimer’ s disease with mental disorders

    Institute of Scientific and Technical Information of China (English)

    付旭; 秦晓霞

    2016-01-01

    目的:观察阿立哌唑联合奥氮平治疗老年阿尔茨海默病伴精神障碍的临床疗效及安全性。方法将80例老年阿尔茨海默病伴精神障碍患者随机分为对照组40例和试验组40例。对照组予以口服奥氮平2.5 mg,每晚一次;试验组予以口服奥氮平2.5 mg,每晚一次联合阿立哌唑2.5 mg,每晚一次。2组患者一个疗程均为2周,共治疗4个疗程。比较2组患者的临床疗效、简易智能精神状态表(MMSE)评分、临床失智表(CDR)评分、日常生活能力表(ADL)评分、阿尔茨海默病评价表-认知分量表(ADAS-cog)评分、精神神经科问卷(NPI)评分、激动性问卷( CMAI)评分,以及不良反应发生率。结果治疗后,试验组的总有效率97.50%显著高于对照组47.50%( P<0.05)。治疗后,试验组的MMSE评分显著高于对照组( P<0.05),试验组的CDR、ADL、ADAS-cog、NPI、CMAI的评分显著低于对照组(P<0.05)。试验组的不良反应发生率7.50%显著低于对照组40.00%( P<0.05)。结论阿立哌唑联合奥氮平治疗老年阿尔茨海默病伴精神障碍的临床疗效确切,有利于患者神经功能的恢复,且不良反应较小。%Objective To evaluate the clinical efficacy and safety of aripiprazole combined with olanzapine in the treatment of elderly Alzhei-mer’s disease with mental disorders.Methods Eighty patients of elder-ly Alzheimer’ s disease with mental disorders were randomly divided into treatment group ( n=40) and control group ( n=40).Patients in control group were received olanzapine 2.5 mg, oral, qn.Patients in treatment group were given olanzapine 2.5 mg, oral, qn and aripiprazole 2.5 mg, oral, qn.The course of treatment was 2 weeks in two groups.A total of treatment was 4 courses.They were compared with clinical efficacy, easy-mental state table ( MMSE) score, clinical dementia table ( CDR) score, table of daily living ( ADL

  4. 多奈哌齐联合奥氮平治疗伴精神行为症状血管性痴呆的远期疗效观察%Long-term therapeutic effect of donepezil combined with olanzapine in the treatment of behavioral and psychological symptoms of vascular dementia

    Institute of Scientific and Technical Information of China (English)

    彭小莲; 邝云航; 朱小苑

    2014-01-01

    目的:探讨不同剂量多奈哌齐与新型抗精神病药奥氮平联合使用治疗伴精神行为症状血管性痴呆(VaD)的远期疗效及安全性。方法选择2012年2月至2014年1月该院收治的80例伴精神行为症状VaD患者作为研究对象。依门诊号或住院号的末位数奇偶随机分组,奇数者为研究组,偶数者为对照组,每组各40例。研究组(大剂量组)服用多奈哌齐10 mg/d,奥氮平10 mg/d;对照组(小剂量组)服用多奈哌齐5 mg/d,奥氮平5 mg/d。治疗期间对两组患者进行不良反应量表(TESS)、简明精神病量表(BPRS)、Hachinski缺血指数记分表(HIS)、痴呆简易筛查量表(BSSD)、日常生活能力量表(ADL)评分比较。结果研究组治疗后3、6、9、12个月BPRS评分变化与对照组比较,差异有统计学意义(P<0.05);研究组治疗12个月后HIS、BSSD、ADL评分变化与对照组比较,差异均有统计学意义(P<0.05);两组患者治疗及随访期间无不良反应发生。结论多奈哌齐联合奥氮平治疗伴精神行为症状VaD远期疗效明显、不良反应小、安全可靠,值得在临床上推广应用。%Objective To explore the long-term results and security of different doses of donepezil combined with novel antipsychotic drugs-olanzapine in treating behavioral and psychological symptoms of vascular dementia (VaD). Methods This study selected 80 patients with behavioral and psychological symptoms of VaD as research objects,who were received in the hospital from February 2012 to January 2014. According to the last number of admission number (AD),all the patients were divided into research group(with odd number) and control group(with even number),40 cases in each group. The research group(high-dose group) was administered with 10 mg donepezil and 10 mg olanzapine daily;the control group(low-dose group) was taken 5 mg donepezil and 5 mg olanzapine daily. During treatment

  5. 氟西汀合用小剂量奥氮平对重度抑郁症患者睡眠及焦虑躯体症状的改善作用%Improvement of sleep and anxiety in patients of major depression with fluoxetine combined with small dose of olanzapine

    Institute of Scientific and Technical Information of China (English)

    瞿玮; 覃园园

    2005-01-01

    的脱落率;两组各观察时段的减分率.结果:奥氮平组脱落率明显低于阿普唑仑组(P<0.05),而且于治疗后1周显效(显效率67%);奥氮平组各观察时段HAMD及HAMA的评分较阿普唑仑组明显低(P<0.01),睡眠障碍及躯体化因子各观察时段改善比阿普唑仑组更明显(P<0.01).结论:小剂量奥氮平合并氟西汀治疗重度抑郁症,能迅速改善抑郁症患者睡眠及焦虑的躯体症状,显著提高其生活质量.%BACKGROUND: Major depression is a subtype of depression. Application of thymoleptics alone has bad effect. It has shown from relevant studies abroad that application of fluoxetine combined with atypical antipsychotic drugs maybe an effective treating strategy.OBJECTIVE: To observe the curative effects of fluoxetine combined with olanzapine and the time of its taking effect.DESIGN: Comparative study of open clinical test with completely random sampling for the first visit outpatients SETTING: A psychological consulting clinic in a hospital of a Military Medical College of Chinese PLA.PARTICIPANTS: Totally 140 patients visiting psychological counseling outpatient clinic in the hospital were collected from January 2004 to August 2004. Inclusion criteria: According to the diagnostic criterion of depression of CCMD-3, patients with total scores of 17 items in Hamilton depression rating scale≥28and age ≥18 years old .EXclusion criteria;①slight to middle edgree of depression(Hamt≤27);②secondary depression;③convalesscent period of schizophrenia and other affective disorder caused by psychosis;④severe of unstable body diseases ,including diseases of liver,kidney,cardiae vessel,respiration,gastro-intestine,endocrine,nervous system,innune system or hematological system,cet.⑤drug or alcohol addict;⑥women in pregnancy and lactation. Totally 110 patients accorded with the inclusive criteria. Among them, there were 40 males and 70 females with the course of disease for 4 months to 5 years, aged 18 to 63 with the

  6. Neuroleptic malignant syndrome associated with concomitant use of levodopa and benserazide hydrochloride, olanzapine, and chlorpromazine%多巴丝肼与奥氮平及氯丙嗪合用致抗精神病药恶性综合征

    Institute of Scientific and Technical Information of China (English)

    王海飞

    2015-01-01

    1例71岁男性帕金森病患者应用多巴丝肼(0.25 g,2次/d口服)治疗2年,因出现脑器质性精神障碍加用奥氮平2.5 mg,2次/d口服.第3天因患者出现兴奋躁动,肌内注射氯丙嗪50 mg.第5天患者出现发热(38.8℃)、肌酸激酶升高(424 U/L)、四肢肌强直.第11天患者体温39.2℃,出现木僵状态,尿液呈酱油样.实验室检查:外周血白细胞计数9.5×109/L,中性粒细胞0.9,肌酸激酶939 U/L.诊断为抗精神病药恶性综合征.停用奥氮平和多巴丝肼,给予纳洛酮、中/长链脂肪乳、复方氨基酸、肠内营养混悬液及地塞米松对症支持治疗.第13天,患者体温恢复正常.第15天,患者肌酸激酶降至109 U/L.第17天恢复多巴丝肼治疗.%A 71-year-old man with Parkinson' s disease received levodopa and benserazide hydrochloride 0.25 g twice daily for two years.Olanzapine 2.5 mg twice daily was added to his regimen for brain organic mental disorders.On day 3,the patient developed agitation and received an intramuscular injection of chlorpromazine 50 mg.On day 5,he developed temperature of 38.8 ℃,elevated serum creatine kinase (424 U/L),and muscle rigidity.On day 11,he presented with temperature of 39.2 ℃,stupor,and soy-colored urine.Laboratory tests showed the following findings:white blood cell count 9.5 × 109/L,neutrophile granulocyte 0.9,and creatine kinase 939 U/L.Neuroleptic malignant syndrome was diagnosed.Olanzapine and levodopa and benserazide hydrochloride were withdrawn.Meanwhile symptomatic and supportive treatments such as naloxone,medium and long chain fat emulsion,compound amino acid,enteral nutritional suspension,and dexamethasone were given.On day 13,his body temperature returned to within normal range.On day 15,the creatine kinase level decreased to 109 U/L.On day 17,levodopa and benserazide hydrochloride was resumed.

  7. Efficacy and safety study of Olanzapine or Quetiapine joint Donepezil in the treatment of behavioral and psychological symptoms of dementia%奥氮平或喹硫平联合多奈哌齐治疗老年痴呆精神行为症状的疗效和安全性研究

    Institute of Scientific and Technical Information of China (English)

    张玉琦; 徐文炜; 程灶火; 吴越; 顾君; 汤莉; 季萍; 李桂林

    2012-01-01

    目的 探讨奥氮平或喹硫平联合多奈哌齐治疗老年痴呆精神行为症状的疗效和安全性.方法 将103例伴精神行为症状的痴呆患者随机分为奥氮平联合多奈哌齐组(A组)与喹硫平联合多奈哌齐组(B组).治疗前和研究结束时进行简易智力状态检查(MMSE)评分.在治疗后的第2、4、6、8周末以痴呆病理行为评定量表(BEHAVE-AD)减分率评定疗效,以副反应量表(TESS)记录治疗中各项药物不良反应.结果 两组MMSE评分均较治疗前提高2分以上,治疗结束后两组组内比较,差异均有统计学意义(均P < 0.05).治疗前后BEHAVE-AD量表评分两组组内比较,至第4周末时均明显下降,差异有高度统计学意义(均P < 0.01).A组有效率为88.46%(46/52),显著有效率为67.31%(35/52);B组有效率为86.27%(44/51),显著有效率为64.71%(33/51),两组疗效比较差异无统计学意义(P > 0.05).两组均无不能耐受的不良药物反应.结论 奥氮平或喹硫平联合多奈哌齐治疗老年痴呆精神行为症状安全有效.%Objective To investigate the efficacy and safety of Olanzapine or Quetiapine joint Donepezil in the treatment of Alzheimer's behavioral and psychological symptoms. Methods 103 patients with behavioral and psychological symptoms of dementia patients were randomly divided into a combination of Olanzapinewith Donepezil group (group A) and the Quetiapine with Donepezil group (group B). The mini-mental state examination (MMSE) scores were evaluated before treatment and the end of the study. The efficacies were evaluated in 2, 4, 6, 8 weekend of the treatment by reduced rate of the behavioral pathology in Alzheimer's disease scale (BEHAVE-AD), the treatment emergent symptom scale (TESS) was used to record the adverse reactions. Results Two sets of MMSE scores than before treatment, increased by more than two scores after the end of the treatment within the two groups were statistically significant different (all P 0

  8. A control study of amisulpride vs olanzapine in the treatment of schizophrenia characterized by negative symptoms%氨磺必利与奥氮平治疗以阴性症状为主的精神分裂症对照研究

    Institute of Scientific and Technical Information of China (English)

    杨峰一; 张程赪; 温蕾

    2015-01-01

    Objective T o investigate the efficacy and safety of amisulpride in schizophrenia characterized by negative symptoms (NS) .Methods Eighty‐five NS schizophrenics were randomly assigned to two groups ,research group took orally amisulpride and control group did olanzapine for 12 weeks .Efficacies were assessed with the Brief Psychiatric Rating Scale (BPRS) and Scale for the Assessment of Negative Symptoms (SANS) and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results After treatment the BPRS total ,SANS total and each factor score of both groups lowered more significant‐ly compared with pretreatment (P0.05) .Adverse reactions of both groups were mild ,the incidence of insomnia was significantly higher (P<0.05) and that of hyper‐somnia ,constipation and weight gain lower (P<0.05 or 0.01) in research than control group .Conclusion Amisulpride has an evident effect equivalent to olanzapine in the treatment of NS schizophrenia ,higher safety and less influence on body mass and is favorable to the improvement of patients ’ compliance .%目的:探讨氨磺必利治疗以阴性症状为主的精神分裂症患者的临床疗效和安全性。方法将85例以阴性症状为主的精神分裂症患者随机分为两组,研究组口服氨磺必利治疗,对照组口服奥氮平治疗,观察12周。采用简明精神病评定量表和阴性症状评定量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组简明精神病评定量表总分、阴性症状量表总分及各因子分均较治疗前显著下降( P<0.01)。研究组总有效率为66.7%,对照组为67.4%,两组比较差异无显著性( P>0.05)。两组不良反应较轻微,但研究组失眠发生率显著高于对照组(P<0.05),嗜睡、便秘、体质量增加发生率显著低于对照组(P<0.05或0.01)。结论氨磺必利治疗以阴性症状为主的精神分裂症疗效显著且与奥氮平相当,安全

  9. Influence of olanzapine-fluoxetine combination on quality of life in acute treatment of major depressive disorder%重度抑郁症急性期奥氮平联合盐酸氟西汀治疗对患者生存质量的影响

    Institute of Scientific and Technical Information of China (English)

    瞿伟; 马红燕; 谷珊珊; 罗菡; 唐倩影; 郭俊伟

    2012-01-01

    Objective To explore the influence of olanzapine-fluoxetine combination on the quality of life in the acute treatment of major depressive disorders. Methods By the randomized prospective and observational design, the patients with major depressive disorders in the acute treatment were selected. 53 cases received olanzapine-fluoxetine combination treatment(OFC group) and other 50 cases were given the treatment of duloxetine hydrochloride(control group). Two groups were observed for 8 weeks. The observed indicators were the Hamilton Depression Rating Scale for Depression ( HAMD-24 ), 4-factor scores (slow, sleep disorders, anxiety/somatization,hopelessness) ,the Clinical Global Impression-Severity of Iillness(CGI-S) ,WHO quality of life scale(WHO-QOL-BRKF) and sub-item measurements. The HAMD-24 and four factor scores were assessed before treatment and at 1,2,4,8 weeks after treatment,and the WHOQOL-BRKF score and sub-item measurements were assessed before treatment and in 8 weeks after treatment. Results The HAMD-24 scores at 1 week in the OFC group were significantly lower than those in the control group. The sleep factor scores at the end of 4 ,8 weeks in the OFC group were significantly lower than those in the control group. At the end of 8-week treatment, the scores of the physiological field in the OFC group were significantly lower than those in the control group. Conclusion In the acute treatment period using olanzapine-fluoxetine combination for treating severe depression,the depressive symptoms could be improved faster and taking effects is within a week, which is superior to single duloxetine hydrochlo-ride in improving the physiological conditions of sleep and the quality of life.%目的 探讨重度抑郁症急性期患者奥氮平联合盐酸氟西汀治疗对生存质量的影响.方法 采用前瞻性、观察性设计,选择重度抑郁症处于急性治疗期患者103例,53例患者接受奥氮平联合盐酸氟西汀治疗(观察组),50例患者接

  10. Effect of Paroxetine Combined with Low Dose of Olanzapine on Sleep Process and Architecture of Depression Patients with Insomnia%帕罗西汀联合小剂量奥氮平对抑郁症伴失眠患者睡眠进程和睡眠结构的影响

    Institute of Scientific and Technical Information of China (English)

    杨冬林; 刘立芬; 郝英霞; 栾清明

    2016-01-01

    目的:探讨帕罗西汀联合小剂量奥氮平对抑郁症伴失眠患者睡眠进程和睡眠结构的影响。方法:84例抑郁症伴失眠患者随机均分为对照组和观察组。对照组患者给予帕罗西汀片20 mg,每日早晨口服1次;观察组患者在对照组治疗的基础上加用奥氮平片2.5 mg,每日睡前口服1次。观察两组患者治疗前和治疗3、6个月后的睡眠质量[匹兹堡睡眠质量指数(PSQI)]、抑郁情绪评分[汉密顿抑郁量表(HAMD)]、睡眠进程[睡眠潜伏期(SL)、觉醒次数(AT)、实际睡眠总时间(TST)、睡眠效率(SE)、快速眼球运动睡眠(REM)潜伏期(RL)]和睡眠结构[睡眠阶段1(S1)、2(S2)、3(S3)和REM占睡眠时间的比例],并记录不良反应发生情况。结果:治疗后,两组患者PSQI、HAMD评分均显著低于同组治疗前,且随时间延长逐渐降低,观察组低于对照组;观察组患者TST显著高于治疗前和对照组,S1占睡眠比例显著低于同组治疗前;两组患者SE、S3和REM占睡眠比例均显著高于同组治疗前,且观察组高于对照组,SL、AT、RL、S2占睡眠比例均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。两组患者治疗期间未见明显不良反应发生。结论:帕罗西汀联合小剂量奥氮平能显著改善患者抑郁情绪,优化睡眠进程和睡眠结构,提高睡眠质量。%OBJECTIVE:To study the effect of paroxetine combined with low dose of olanzapine on sleep process and architec-ture of depression patients with insomnia. METHODS:84 depression patients with insomnia were randomly divided into control group and observation group. Control group was given 20 mg Paroxetine tablet,once every morning;observation group was addi-tionally given 2.5 mg Olanzapine tablet,once before going to bed. Sleep quality [Pittsburgh Sleep Quality Index(PSQI)],depres-sion scores

  11. Clinical observation of Wuling Capsules combined with escitalopram and olanzapine in treatment of depression%乌灵胶囊联合艾司西酞普兰和奥氮平治疗抑郁症的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王峰

    2016-01-01

    目的:探讨乌灵胶囊联合艾司西酞普兰和奥氮平治疗抑郁症的临床疗效。方法收集2012年7月—2015年7月在河南省中医院接受治疗的抑郁症患者86例,随机分为对照组和治疗组,每组各43例。对照组口服草酸艾司西酞普兰片,10 mg/d,2周后根据病情可加至20 mg/d;同时口服奥氮平片,5 mg/d。治疗组在对照组基础上口服乌灵胶囊,3粒/次,3次/d。两组患者均连续治疗8周。观察两组的临床疗效,同时比较两组患者治疗前后的 HAMD 和 WHOQOL-BREF 评分。结果治疗后,对照组与治疗组总有效率分别为79.07%和95.35%,两组间差异具有统计学意义(P<0.05)。治疗后,两组患者 HAMD评分均降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组降低的更显著,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者生理健康、心理状态、社会关系和周围环境等 WHOQOL-BREF 评分均较治疗前升高,同组比较差异具有统计学意义(P<0.05);且治疗组 WHOQOL-BREF 评分比对照组的升高更明显(P<0.05)。结论乌灵胶囊联合艾司西酞普兰和奥氮平可有效缓解抑郁症患者抑郁状态,提高生活质量。%Objective To observe the clinical efficacies of Wuling Capsules combined with escitalopram and olanzapine in treatment of depression. Methods Patients (86 cases) with depression in Henan Province Hospital of TCM from July 2012 to July 2015 were enrolled in this study and divided into control and treatment groups, and each group had 43 cases. The patients in the control group were po administered with Escitalopram Oxalate Tablets, 10 mg/d, and the dosage could be added to 20 mg/d according to the specific condition after two weeks. In the same time, the patients were po administered with Olanzapine Tablets, 5 mg/d. The patients in the treatment group were po administered with Wuling Capsules on the

  12. The comparative research of Olanzapine combined with magnesium valproate in the treatment of schizophrenia with excitement impulsive aggressive behavior%奥氮平联合丙戊酸镁缓释片治疗精神分裂症伴兴奋冲动攻击行为对照研究

    Institute of Scientific and Technical Information of China (English)

    陈黎明; 侯云跃

    2014-01-01

    目的研究奥氮平联合丙戊酸镁缓释片治疗精神分裂症伴兴奋冲动攻击行为的临床效果。方法回顾性分析我院收治的96例精神分裂症伴兴奋冲动攻击行为患者的临床资料,根据治疗方法不同分为研究组和对照组各48例,其中对照组患者仅给予奥氮平治疗,研究组在对照组治疗基础上加用丙戊酸镁缓释片治疗,比较2组患者治疗前后PANSS评分和MOAS评分以及不良反应发生情况。结果 PANSS评分治疗前2组患者差异无统计学意义(P>0.05),治疗后3 d治疗组低于对照组,但差异无统计学意义(P>0.05),治疗后1周末、2周末治疗组显著低于对照组,P<0.05;MOAS评分治疗前2组患者差异无统计学意义(P>0.05),治疗后3 d和1周末治疗组低于对照组,差异无统计学意义(P>0.05),治疗后2周末治疗组显著低于对照组,P<0.05;2组患者总不良反应发生率差异无统计学意义( P>0.05)。结论奥氮平联合丙戊酸镁缓释片治疗精神分裂症伴兴奋冲动攻击行为患者攻击性和临床症状,效果显著,且安全性高。%Objective To study the clinical effect of Olanzapine combined with magnesium valproate in the treatment of schizophrenia with excitement impulsive aggressive behavior.Methods The clinical data of 96 cases with schizophrenia excite-ment impulsive aggressive behavior in our hospital was taken for retrospective analysis. According to the different treatment methods ,they were divided into the study group and the control group ,and 48 cases in each group. The control group was on-ly given with olanzapine ,and the study group was given magnesium valproate sustained-release tablets on the basis of the con-trol group. The PANSS score and MOAS scores and adverse events of the two groups before and after treatment were com-pared.Results There was no significant difference in PANSS scores between the two groups before

  13. 奥氮平换用齐拉西酮治疗精神分裂症的安全性和有效性研究%Switching from olanzapine to ziprasidone: a 12-Week, open-label, multicenter study evaluating the effectiveness and safety of ziprasidone in patients with schizophrenia.

    Institute of Scientific and Technical Information of China (English)

    段艳平; 司天梅; 苏允爱; 党卫民; 邓红; 陈红辉; 刘铁榜; 陶明

    2013-01-01

    Objective To evaluate the effectiveness and safety of switching to ziprasidone from olanzapine because of inadequate response or intolerance. Methods A total of 100 patients with first-episode or non-refractory schizophrenia (diagnosed according with the criteria of DSM-IV) who had no response to olanzapine or showed poor tolerance to alanzapine were enrolled in a 12-week, open-label, flexible-dose ziprasidone trial. All patients were assessed with Positive and Negative Syndrome Scale (PANSS) , Calgary Depression Scale (CDSS) , global impression scale (CGI) and Social Functions ( SF-12) at baseline and the end of 2nd, 4th, 8th, 12th week to evaluate the efficacy. Extrapyramidal Side Effects Scale (SAS) , laboratory examination and electrocardiogram examination were performed to evaluate the safety at baseline and the end of the 4th, 8th week of the treatment. Results A total of 86 patients completed the trial. Scores of PANSS, CDSS, CGI and SF-12 all decreased significantly with the advance of the treatment (P <0. 001). 61 complete records of adverse reactions were collected. The most common adverse reaction was extrapyramidal effect (32 cases, 36. 07%). The prevalence of relatively rare adverse reactions was 16. 39% (10 cases) , which consisted of agitation (2 cases) , nausea (1 case) , constipation (1 case) , insomnia (1 case) , dizziness (1 case) , headache (1 case) , anxiety (1 case) , dry mouth ( 1 case) and tachycardia ( 1 case). There were no significant changes in fasting glucose, HbAlc, triglyceride, total cholesterol, prolactin, QTc interval, heart rate at different observation time-points with the advance of the treatment. Conclusion Ziprasidone can improve the clinical symptoms effectively in patients who had no response to olanzapine or showed poor tolerance to alanzapine. Ziprasidone has less adverse reactions and has little effect on metabolism.%目的 观察不能耐受奥氮平治疗或经奥氮平治疗无效的精神分裂症

  14. Cognitive effectiveness of risperidone and olanzapine in first-episode schizophrenia%利培酮和奥氮平对首发精神分裂症患者治疗前后认知功能的对比观察

    Institute of Scientific and Technical Information of China (English)

    赵瑾; 吕路线; 张燕; 晁阳阳; 马骏; 杨勇锋; 赵晶媛; 杜云红; 李文强; 宋学勤

    2016-01-01

    目的:观察首发精神分裂症患者部分认知功能领域损害情况以及利培酮和奥氮平对其治疗前后认知功能的潜在作用。方法选取2015年1—10月在新乡医学院第二附属医院住院治疗的57例首发精神分裂症患者和周边社区年龄、性别匹配的30名健康人(健康对照组),采用随机数字表法将患者分为2组,分别给予利培酮和奥氮平单一治疗。因不良反应难以耐受、药物疗效不佳、换用药物共脱落4例,53例患者完成研究。患者组分别于治疗前和治疗8周后评估患者临床症状(PANSS)和认知功能(连线测试、符号编码、言语记忆、工作记忆、Stroop 测试),健康对照组仅评估一次。结果 PANSS 减分率对比两组并无显著差异。治疗前,利培酮组和奥氮平组均较健康对照组表现出显著的操作速度、言语记忆(t =3.191,t =3.743)、工作记忆(t =2.151,t =2.602)和执行功能领域的差异(P <0.05);经过8周的抗精神病药物治疗,利培酮治疗组表现出连线测试(t =3.862, P <0.05)、言语记忆领域(t =-3.073,P <0.05)功能的改善,奥氮平治疗组表现出连线测试(t =3.587,P <0.05)和工作记忆(t =-2.891,P <0.05)功能的改善。抗精神病药物剂量与认知功能减分率相关分析发现利培酮服用剂量与患者连线测试减分率呈负相关(r =-0.391,P =0.048)。结论利培酮和奥氮平对首发精神分裂症患者临床症状和整体认知功能在8周内作用差异无统计学意义,首发精神分裂症患者存在显著的认知功能损害,利培酮和奥氮平能够在改善精神症状的同时一定程度上改善患者的某些认知领域损害,利培酮服用剂量越大,操作速度领域改善情况越差。%Objective To study the impairments of cognitive function in first-episode schizophrenia and the potential effectiveness of risperidone and olanzapine

  15. Aripiprazole Open Controlled Study of Refractory Depression Combined with Fluoxetine and Olanzapine Fluoxetine in the Treatment of Women%阿立哌唑联合氟西汀与奥氮平联合氟西汀治疗女性难治性抑郁的开放式对照研究

    Institute of Scientific and Technical Information of China (English)

    刘希平; 吴彬; 陈湘清

    2012-01-01

      目的 探讨氟西汀联合阿立哌唑与氟西汀联合奥氮平治疗难治性抑郁的疗效与安全性.方法 将48例难治性抑郁患者随机分为1组(氟西汀+阿立哌唑)24例和2组(氟西汀+奥氮平)24例,观察8周.于治疗前和治疗1周、2周、4周及6周末采用汉密尔顿抑郁量表(Hamilton depressive,HAMD-17)评定疗效,用不良反应量表(TESS)评定不良反应.结果 阿立哌唑组显效率为55.0%,奥氮平组为52.3%.奥氮平组第4周HAMD评分低于阿立哌唑组,差异无显著性.阿立哌唑组不良反应较少.结论 阿立哌唑联合氟西汀治疗难治性抑郁的疗效好,起效快,且不良反应少.%  Objective To investigate the efficacy of fluoxetine combined with aripiprazole and combination of fluoxetine and olanzapine in the treatment of refractory depression curative effect and safety. Methods 48 patients with refractory depression patients were randomly divided into 1 groups (fluoxetine plus aripiprazole) in 24 patients and 2 groups (fluoxetine and olanzapine) in 24 cases, observation of 8 weeks.Before treatment and 1 weeks of treatment, 2 weeks, 4 weeks and 6 weeks with the Hamilton Depression Rating Scale (Hamilton depressive, HAMD-17) assessment of efficacy, with adverse effect scale (TESS) assessment of adverse reactions. Results The effective rate was 55.0% in aripiprazole group, the olanzapine group 52.3%.Olanzapine group fourth weeks HAMD score lower than in aripiprazole group, no significant difference.Aripiprazole group and less adverse reaction. Conclusion Aripiprazole combined with fluoxetine in the treatment of refractory depression has good curative effect, quick effect, and less adverse reaction.

  16. 利培酮口服液与奥氮平治疗老年痴呆精神行为症状的疗效比较%Comparison efficacy of risperidone oral solution and olanzapine in the treatment of elderly dementia behavioral and psychological symptoms

    Institute of Scientific and Technical Information of China (English)

    曲春晖; 孙平; 孙忠国

    2016-01-01

    Objective To discuss the clinical value and safety of risperidone oral solution and olanzapine in treatment of elderly dementia behavioral and psychological symptoms (BPSD).Methods 120 patients with BPSD were randomly divided into research group and control group ,each of 60 cases.Research group were treated with risperidone oral solution ,control group were treated with olanzapine ,the treatment course was 8 weeks.Used BEHAVE-AD to evaluate the efficacy ,evaluated the agitated behavior improvement by CMAI , assessed the adverse drug reactions by TESS assessment , observed the medication compliance by self compliance scale .Results 4 weeks after treatment ,the BEHAVE-AD score and CMAI scores of two groups than before treatment decreased ,but the difference was not statistically significant (P>0.05),8 weeks after treatment,the BE-HAVE-AD score and CMAI scores of two groups decreased significantly ,compared with before treatment difference was statisti-cally significant(P0.05).The incidence rate of weight gain,lethargy in research group were lower than control group ,the difference was statistically significant (P0.05),4 weeks,8 weeks after treatment the compliance of research group was better than control group ,the difference was statistically significant(P<0.05).Conclusion Risperidone oral solu-tion is applied to the clinical treatment of elderly dementia with BPSD effective and relatively safe ,patients with better compli-ance .%目的:比较利培酮口服液与奥氮平治疗老年痴呆精神行为症状( BPSD )的疗效和安全性。方法将120例BPSD患者随机分为研究组和对照组各60例。研究组患者给予利培酮口服液治疗,对照组患者给予奥氮平治疗,疗程为8周。2组患者均采用痴呆病理行为评定量表(BEHAVE-AD)评定疗效,Cohan Mansfield 激越行为量表(CMAI)评定激越行为的改善程度,副反应量表(TESS)评定药物不良反应,自编依从性量表观察患者服药

  17. The Effect of Metformin Treatment on Adiponectin and Its Relationship with Body Fat in Schizophrenia with Olanzapine-induced Weight Gain%二甲双胍对奥氮平治疗后增重的精神分裂症患者脂联素的影响及其与体脂变化的相关性

    Institute of Scientific and Technical Information of China (English)

    张丽萍; 杨立夏; 陈蓉蓉

    2015-01-01

    目的:观察二甲双胍对奥氮平致精神分裂症体重显著增加患者脂联素的影响,分析其与体脂变化的关系。方法:接受奥氮平治疗过程中出现显著体重增加的精神分裂症患者随机分为2组,分别接受二甲双胍(二甲双胍组,n=35)、安慰剂(安慰剂组,n=36)治疗,疗程12周。于治疗前、治疗后12周,分别测定患者血清脂联素水平、体重指数( BMI)、腰围( WC)、体脂率( BF%)。结果:①治疗后12周末,二甲双胍组脂联素水平较治疗前显著增高(t=5.127,P<0.01)、BMI、WC、BF%均较治疗前显著下降(t=2.140~3.176,P<0.05~0.01);安慰剂组BMI、WC、BF%均较治疗前显著增高(t=2.157~3.947,P<0.05~0.01)、脂联素较治疗前无显著差异(P>0.05);②二甲双胍组治疗前后脂联素的增加值及BMI、WC、BF%的降低值均显著高于安慰剂组( t=3.775~4.754,P均<0.01);③二甲双胍组治疗前后血清脂联素变化值与WC、BF%变化值显著负相关( r=-0.383,-0.447;P<0.05,0.01),与BMI变化值的相关性不显著(P>0.05)。结论:二甲双胍可增高奥氮平致精神分裂症体重显著增加患者脂联素水平,并可能与其改善体脂的作用有关。%Objective:To investigate the effect of metformin on adiponectin in schizophrenia patients with olanzapine-induced weight gain and explore its relationships with body fat .Methods:Randomized schizophrenia outpatients with olanzapine -induced weight gain were assigned metformin ( metformin group,n=35)or placebo(placebo group,n =36)treatment for 12 weeks.The serum adiponectin,body mass index(BMI),waist circumstance(WC),and body fat percent(BF%)were measured at baseline and end of study.Results:Significantly increased serum adiponectin (t =5.127,P <0.01) and decreased BMI,WC,and BF%(t =2.140 ~3.176,P <0.05) were

  18. Efficacy comparison between olanzapine-fluoxetine combination and duloxetine in treatment of somatoform pain disorder%奥氮平联合氟西汀与度洛西汀治疗躯体形式疼痛障碍的疗效比较

    Institute of Scientific and Technical Information of China (English)

    瞿伟; 谷珊珊; 罗菡; 唐倩影; 郭俊伟

    2012-01-01

    Objective To compare the efficacy of olanzapine-fluoxetine combination ( OFC ) with duloxetine in treatment of persistent somatoform pain disorder. Methods A case-control study was performed. Thirty-five patients were treated with OFC (OFC group) , and other thirty-three patients were treated with duloxetine ( duloxetine group). All the patients were treated for 12 weeks ( acute phase). The indicators including scores of pain intensity-Numerical Rating Scale ( PI-NRS) , Clinical Global Impression-Severity scale ( CGI-S), Clinical Global Impression-efficacy index (CGI-EI) and Hamilton Depression Rating Scale for Depression (HAMD-24) were used for evaluation before treatment and at the 1st, 2nd, 4th, 8th and 12th weekends after treatment. Results At all time points after treatment, PI-NRS scores in the OFC group were significantly lower than those in the duloxetine group (P 0.05). Conclusion The efficacy of OFC is better than that of duloxetine alone in the treatment of somatoform pain disorder at acute phase.%目的 比较小剂量奥氮平联合氟西汀与度洛西汀治疗持续性躯体形式疼痛障碍疗效差异.方法 临床病例对照研究设计.35例患者接受小剂量奥氮平联合氟西汀治疗(OFC组),33例患者接受度洛西汀治疗.2组患者完成急性治疗期12周的治疗.治疗前后观察指标:数字疼痛强度量表(PI-NRS)、临床疾病严重程度评定表(CGI-S)及临床总体疗效指数评分(CGI-EI)、汉密尔顿抑郁量表24项(HAMD-24).观察评定时间分别于治疗前,治疗后1、2、4、8、12周末.结果 OFC组患者在治疗后第1周末及随后各时间观察点,PI-NRS显著低于度洛西汀组(P<0.05,P<0.01)、CGI-EI在各观察时间点则均明显高于度洛西汀组(P<0.01),2组患者在治疗后第1、2、4、8、12周末HAMD-24评分没有显著差异(P>0.05).结论 奥氮平联合氟西汀治疗躯体形式疼痛障碍在急性治疗期比单用度洛西汀疗效更优.

  19. naturalistic study of olanzapine in treatment-resistant schizophrenia ...

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... Two OCD cases achieved clinical recovery at week eight. Conclusion: ..... purchasing cost of the drug was always a cause of complaints by these relatives. ... computer analysis for secretarial services. REFERENCE. 1.

  20. Uso de olanzapina e eletroconvulsoterapia em um paciente com esquizofrenia catatônica refratária e antecedentes de síndrome neuroléptica maligna Olanzapina y ECT en un enfermo con esquizofrenia catatónica refractaria y alto riesgo de síndrome neuroléptico maligno Olanzapine and ECT combined therapy in a refractory catatonic subtype schizophrenia patient with previous neuroleptic malignant syndrome episodes

    Directory of Open Access Journals (Sweden)

    Pedro Gomes de Alvarenga

    2005-12-01

    Full Text Available Este artigo descreve a história clínica e o manejo de um paciente masculino adulto com esquizofrenia catatônica refratária a dois neurolépticos típicos (haloperidol e clorpromazina e a outro agente atípico (risperidona, e com antecedente de dois episódios de síndrome neuroléptica maligna em vigência de neurolépticos típicos. Os autores optaram pela associação de eletroconvulsoterapia (ECT e olanzapina (7,5 mg. Foram obtidos consideráveis benefícios para o paciente.Presentamos un relato clínico referente a la historia precedente y al desarrollo de un enfermo varón con esquizofrenia catatónica refractaria a los neurolépticos convencionales (clorpromazina y haloperidol y a otro agente de nueva generación (risperidona. El enfermo presentó, en dos ocasiones, síndrome neuroléptico maligno, provocado por el uso de los neurolépticos convencionales. Los autores emplearon ECT y olanzapina (7,5 mg obteniendo considerable éxito clínico.This article describes the clinical history and management of an adult male patient with refractory catatonic schizophrenia to two typically used neurolpetic medications (haloperidol and chlorpromazine and to another atypical agent (risperidone.The patient had also presented two neuroleptic malignant syndrome episodes due to typical neuroleptic agents. The authors combined ECT and olanzapine (7.5 mg as treatment, and a considerable clinical improvement was obtained.

  1. Efficacy of risperidone, olanzapine and clozapine in the treatment of therapy resistant schizophrenia

    NARCIS (Netherlands)

    Wardenier, M; Slooff, CJ; Arends, J

    2000-01-01

    Therapy-resistance for positive symptoms is one of the most important problems that occurs with the medical treatment of schizophrenia. In the past years, clozapine has proven its effectiveness in this area and has been included in the treatment protocols and guidelines, Because of the risk of agran

  2. Differences in craving for cannabis between schizophrenia patients using risperidone, olanzapine or clozapine

    NARCIS (Netherlands)

    Machielsen, Marise; Beduin, Albertine Scheltema; Dekker, Nienke; Kahn, Rene S.; Linszen, Don H.; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Krabbendam, Lydia; Myin-Germeys, Inez

    2012-01-01

    Substance abuse and psychotic disorders have a high rate of comorbidity. Both disorders are associated with changes in the dopaminergic transmission in the mesocorticolimbic pathways of the brain. Since antipsychotic medications interact with the dopamine receptors in these pathways, these medicatio

  3. Effects on cognitive functioning after olanzapine-ziprasidone crossover in recent-onset schizophrenia.

    NARCIS (Netherlands)

    Grootens, K.P.; Veelen, N.M. van; Sitskoorn, M.M.; Sabbe, B.G.C.; Peuskens, J.; Buitelaar, J.K.; Verkes, R.J.; Kahn, R.S.

    2010-01-01

    INTRODUCTION: To enhance functional outcome in schizophrenia improvement of cognitive symptoms is crucial. EXPERIMENTAL PROCEDURES: Using a comprehensive test battery, this follow-up examines cognitive effects in patients with recent-onset schizophrenia after a change of medication following

  4. Differential effects of olanzapine and risperidone on cognition in schizophrenia? A saccadic eye movement study

    NARCIS (Netherlands)

    Broerse, A; Crawford, TJ; den Boer, JA

    2002-01-01

    Recent studies suggest that novel antipsychotics have positive effects on certain cognitive functions in schizophrenia. The present study investigated this claim by means of saccadic paradigms, which provide a selective index of cognitive function. Thirty-three first-episode schizophrenic patients w

  5. Prior Haloperidol, but not Olanzapine, Exposure Augments the Pursuit of Reward Cues: Implications for Substance Abuse in Schizophrenia

    OpenAIRE

    Bédard, Anne-Marie; Maheux, Jérôme; Lévesque, Daniel; Samaha, Anne-Noël

    2012-01-01

    Drug abuse and addiction are excessively common in schizophrenia. Chronic antipsychotic treatment might contribute to this comorbidity by inducing supersensitivity within the brain’s dopamine system. Dopamine supersensitivity can enhance the incentive motivational properties of reward cues, and reward cues contribute to the maintenance and severity of drug addiction. We have shown previously that rats withdrawn from continuous haloperidol (HAL) treatment (via subcutaneous minipump) develop do...

  6. Clinical outcomes with olanzapine long-acting injection: impact of the 3-hour observation period on patient satisfaction and well-being

    OpenAIRE

    Anand E; Berggren L; Landry J; Tóth Á; Detke HC

    2016-01-01

    Ernie Anand,1 Lovisa Berggren,2 John Landry,3 Ágoston Tóth,4 Holland C Detke5 1Neuroscience Medical Affairs, Eli Lilly & Company Ltd, Windlesham, UK; 2Global Statistical Sciences, Lilly Deutschland GmbH, Bad Homburg, Germany; 3Global Statistical Sciences, Eli Lilly Canada Inc., Toronto, ON, Canada; 4Neuroscience, Lilly Hungary, Budapest, Hungary; 5Psychiatry and Pain Disorders, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN, USA Background...

  7. In vitro/in vivo evaluation of an optimized fast dissolving oral film containing olanzapine co-amorphous dispersion with selected carboxylic acids.

    Science.gov (United States)

    Maher, Eman Magdy; Ali, Ahmed Mahmoud Abdelhaleem; Salem, Heba Farouk; Abdelrahman, Ahmed Abdelbary

    2016-10-01

    Improvement of water solubility, dissolution rate, oral bioavailability, and reduction of first pass metabolism of OL (OL), were the aims of this research. Co-amorphization of OL carboxylic acid dispersions at various molar ratios was carried out using rapid solvent evaporation. Characterization of the dispersions was performed using differential scanning calorimetry (DSC), Fourier transform infrared spectrometry (FTIR), X-ray diffractometry (XRD), and scanning electron microscopy (SEM). Dispersions with highest equilibrium solubility were formulated as fast dissolving oral films. Modeling and optimization of film formation were undertaken using artificial neural networks (ANNs). The results indicated co-amorphization of OL-ascorbic acid through H-bonding. The co-amorphous dispersions at 1:2 molar ratio showed more than 600-fold increase in solubility of OL. The model optimized fast dissolving film prepared from the dispersion was physically and chemically stable, demonstrated short disintegration time (8.5 s), fast dissolution (97% in 10 min) and optimum tensile strength (4.9 N/cm(2)). The results of in vivo data indicated high bioavailability (144 ng h/mL) and maximum plasma concentration (14.2 ng/mL) compared with the marketed references. Therefore, the optimized co-amorphous OL-ascorbic acid fast dissolving film could be a valuable solution for enhancing the physicochemical and pharmacokinetic properties of OL.

  8. The use of olanzapine in the treatment of anorexia nervosa%奥氮平治疗神经性厌食症

    Institute of Scientific and Technical Information of China (English)

    王怀海; 谭庆荣

    2009-01-01

    目的: 观察奥氮平治疗神经性厌食症的临床疗效. 方法: 10例神经性厌食症住院患者,给予奥氮平2.5~5 mg/d治疗.于治疗前后测量体质量,比较治疗前后体质量变化. 结果: 出院时患者体质量平均增加(3.40±2.63)kg,体质量指数平均增加(1.30±0.99),有效率为50%.体质量变化与住院天数存在明显正相关(r=0.736,P=0.015). 结论: 小剂量奥氮平治疗神经性厌食症具有一定疗效,耐受性好.

  9. Sensitive liquid chromatography/tandem mass spectrometry method for the simultaneous determination of olanzapine, risperidone, 9-hydroxyrisperidone, clozapine, haloperidol and ziprasidone in rat brain tissue.

    Science.gov (United States)

    Zhang, Guodong; Terry, Alvin V; Bartlett, Michael G

    2007-10-15

    One prerequisite for therapeutic effects of psychiatric drugs is the ability to pass the blood brain barrier. Hence, it is important to know the concentration of antipsychotic drugs in brain tissue. In general, determinations of lipophilic compounds from lipophilic matricies such as the brain are a challenge. Here we have adapted a plasma assay for antipsychotics for the target organ the brain. Using modified sample preparation and chromatographic strategies, the analytes were extracted from rat brain homogenate and analyzed by LC-MS/MS. The method used a Waters Atlantis dC-18 (30 mm x 2.1 mm i.d., 3 microm) column with a mobile phase of acetonitrile/5 mM ammonium formate (pH 6.1 adjusted with formic acid) and gradient elution. All analytes were detected in positive ion mode using multiple-reaction monitoring. The method was validated and the linearity, lower limit of quantitation, precision, accuracy, recoveries, specificity and stability were determined. This method was then successfully used to quantify the rat brain tissue concentration of the analytes after chronic treatment with these antipsychotic drugs.

  10. Effects of acute and chronic administration of olanzapine in comparison to clozapine and haloperidol on extracellular recordings of substantia nigra reticulata neurons in the rat brain

    NARCIS (Netherlands)

    Timmerman, W; Heijmen, M; Westerink, B.H.C.; Bruggeman, R; den Boer, J.A.

    1999-01-01

    Rationale : Previously, we have shown that the atypical antipsychotics clozapine and risperidone, unlike haloperidol, decreased the firing rate of substantia nigra reticulata (SNR) neurons. As the SNR receives substantial input from the striatum, an area where motoric side-effects of antipsychotics

  11. The influence of chronic exposure to antipsychotic medications on brain size before and after tissue fixation: a comparison of haloperidol and olanzapine in macaque monkeys

    DEFF Research Database (Denmark)

    Dorph-Petersen, Karl-Anton; Pierri, Joseph N; Perel, James M

    2005-01-01

    It is unclear to what degree antipsychotic therapy confounds longitudinal imaging studies and post-mortem studies of subjects with schizophrenia. To investigate this problem, we developed a non-human primate model of chronic antipsychotic exposure. Three groups of six macaque monkeys each were...

  12. Early response or nonresponse at week 2 and week 3 predict ultimate response or nonresponse in adolescents with schizophrenia treated with olanzapine

    DEFF Research Database (Denmark)

    Stentebjerg-Olesen, Marie; Ganocy, Stephen J; Findling, Robert L;

    2015-01-01

    the curve = 0.88-0.92). At 6 weeks, patients with ER had significantly greater improvements in BPRS-C, Clinical Global Impressions Improvement and Severity scores, greater cross-sectional remission and less all-cause discontinuation (p = 0.047-p event profiles were similar in the ER...

  13. Efficacy of Adjunctive Treatments Added to Olanzapine or Clozapine for Weight Control in Patients with Schizophrenia: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yun-Jung Choi

    2015-01-01

    Full Text Available Objectives. This study was conducted to review systematically adjunctive treatments for weight reduction in patients with schizophrenia and compare efficacies of clinical trials through meta-analysis, so as to provide effective clinical guideline regarding weight control for patients taking atypical antipsychotics. Methods. Candidate clinical trials were identified through searching the Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO. Fourteen randomized clinical trials were included for systematic review and meta-analysis from 132 potential trials. The Comprehensive Meta-Analysis version 2 was used for meta-analysis. Results. Difference in means and significances from meta-analyses regarding weight control by adjunctive treatments showed that topiramate, aripiprazole, or sibutramine was more effective than metformin or reboxetine. Psychiatric evaluations did not show statistically significant changes between treatment groups and placebo groups except topiramate adjunctive treatments. Adverse effects regarding adjunctive therapies were tolerable and showed statistically no significances compared to control groups. Conclusion. Though having several reports related to exacerbation of psychiatric symptoms, topiramate and aripiprazole are more efficacious than other medications in regard to weight reduction and less burden of critical adverse effects as well as being beneficial for clinical improvement.

  14. 奥氮平致非典型的抗精神病药恶性综合征%Olanzapine-induced atypical neuroleptic malignant syndrome

    Institute of Scientific and Technical Information of China (English)

    邱晓燕; 戚玮琳; 王大猷

    2010-01-01

    1例73岁女性精神分裂症患者,口服氯丙嗪(早150 mg、晚100 mg)及苯海索(4 mg,2次/d)治疗30年,加用奥氮平10 mg,1 次/d口服2个月后出现CK升高,迭15 570 U/L,同时伴发热、肌张力增高、心动过速,P 105 次/min.停用奥氮平,继续应用氯丙嗪及苯海索,并给予对症支持治疗,CK水平逐渐下降至接近正常值.停药第19天患者自行应用奥氮平10 mg,1次/d,4 d后CK再次升高迭700 U/L,停药后恢复正常.

  15. Drug–drug conditioning between citalopram and haloperidol or olanzapine in a conditioned avoidance response model: implications for polypharmacy in schizophrenia

    OpenAIRE

    Sparkman, Nathan L; Li, Ming

    2012-01-01

    Patients with schizophrenia often have anxiety and depression, and thus are treated with multiple psychotherapeutic medications. This practice of polypharmacy increases the possibility for drug–drug interactions. However, the pharmacological and behavioral mechanisms underlying drug–drug interactions in schizophrenia remain poorly understood. In the present study, we adopted a preclinical approach and examined a less known behavioral mechanism, drug–drug conditioning (DDC) between haloperidol...

  16. Drug: D10206 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available h psycholeptics N06CA03 Fluoxetine and psycholeptics D10206 Olanzapine - fluoxetine hydrochloride mixt PubChem: 163312237 ... ...D10206 Mixture, Drug Olanzapine - fluoxetine hydrochloride mixt; Symbyax (TN) Olanzapine [DR:D00454], Fluoxe...tine hydrochloride [DR:D00823] Treatment of depressive ATC code: N06CA03 Anatomical...TICS AND PSYCHOANALEPTICS IN COMBINATION N06CA Antidepressants in combination wit

  17. СРАВНИТЕЛЬНАЯ ОЦЕНКА ЭФФЕКТИВНОСТИ ОЛАНЗАПИНА, ГАЛОПЕРИДОЛА И КЛОЗАПИНА В ПЕРИОД АКТИВНОЙ ТЕРАПИИ БОЛЬНЫХ ШИЗОФРЕНИЕЙ И ШИЗОАФФЕКТИВНЫМ РАССТРОЙСТВОМ: РЕЗУЛЬТАТЫ РЕТРОСПЕКТИВНОГО НАТУРАЛИСТИЧЕСКОГО ИССЛЕДОВАНИЯ

    OpenAIRE

    Маляров, С.; Блажевич, Ю.

    2006-01-01

    The data of retrospective naturalistic study correspond to the results of prospective controlled trials and show that olanzapine is superior to haloperidol and clozapine in the treatment of acute psychosis in schizophrenia. The use of olanzapine for acute in-patient treatment helps to achieve positive therapeutic response for the symptoms which are the most important in terms of the prognosis of the illness. Olanzapine as a first-line treatment of schizophrenia allows for reaching the modern ...

  18. 奥氮平与利培酮治疗酒精所致精神障碍对照研究%A comparative study of olanzapine and resperidone in the treatment of mental disorders due to use of alcohol

    Institute of Scientific and Technical Information of China (English)

    岳卫清; 姚明荣; 查显友; 夏江明; 袁天懿; 滕林

    2011-01-01

    目的:比较奥氮平与利培酮治疗酒精所致精神障碍的疗效及不良反应.方法:63例患者接住院号奇数和偶数分为两组,分别服用奥氮平或利培酮6周,分别在治疗0,1,2,4,6周用阳性症状与阴性症状量表(PANSS)和副反应量表(TESS)评定疗效和不良反应,0、6周检查心脑电图和肝肾功能、空腹血糖、血催乳素和甘油三酯(TG)、胆固醇(TC).结果:奥氮平组治愈率为76.66%(23/30),利培酮组治愈率为70.97%(22/31),两组的治愈率相当(P值>0.05),奥氮平组PANSS减分率在第1周末高于利培酮组(P值<0.05),奥氮平组TESS分在第2、4、6周末低于利培酮组(P值均<0.01),很少引起血催乳素升高,利培酮会显著升高血催乳素水平,均会导致甘油三酯升高.结论:奥氮平、利培酮对酒精所致精神障碍的治疗均安全有效,应根据不同的个体需要,选择奥氮平或利培酮治疗.

  19. 奥氮平与利培酮治疗酒精所致精神障碍对照研究%Comparative study of olanzapine and risperidone in the treatment of mental disorders due to use of alcohol

    Institute of Scientific and Technical Information of China (English)

    徐雪云; 李神赐

    2011-01-01

    目的:比较奥氨平与利培酮治疗酒精所致精神障碍的疗效和安全性.方法:将60例酒精所致精神障碍患者随机分成两组.每组各30例.分别给予奥氮平和利培酮治疗,疗程8周.采用阳性与阴性症状量表(PANSS),治疗中出现的副反应量表(TESS)评定疗效及不良反应.结果:两组PANSS总分均较治疗前显著下降(P<0.05),奥氮平组显进率80.0%,利培酮组显进率73.3%,两组疗效相仿(P>0.05).奥氮平组嗜睡、体重增加、血脂升高的不良反应明显高于利培酮(P<0.05),利培酮组锥体外系反应、失眠、兴奋或激惹均明显高于奥氨平组(P<0.05).结论:奥氮平与利培酮对酒精所致精神障碍的疗效相当,安全性较高.

  20. 奥氮平治疗酒精所致精神障碍对照研究%Comparative study of olanzapine in treatment of mental disorder due to alcohol

    Institute of Scientific and Technical Information of China (English)

    石少波; 管洁; 鞠培娟

    2005-01-01

    目的:探讨奥氮平对酒精所致精神障碍的临床疗效. 方法:66例患者随机分入两组,分别服用奥氮平或氟哌啶醇6周,用阳性与阴性症状量表(PANSS)和副反应量表(TESS)评定疗效和不良反应. 结果:奥氮平组有效率69.7%,显著较氟哌啶醇组42.4%为高. 结论:奥氮平对酒精所致精神障碍的临床疗效优于氟哌啶醇,且不良反应较少.

  1. Systematic review of aripiprazole versus olanzapine in the treatment for schizophrenia%阿立哌唑与奥氮平治疗精神分裂症的系统评价

    Institute of Scientific and Technical Information of China (English)

    杜彪

    2010-01-01

    目的 比较阿立哌唑与奥氮平治疗精神分裂症的疗效及不良反应的差异.方法 检索国内关于阿立哌唑与奥氮平对照研究治疗精神分裂症的文献,应用固定效应模型法的方差倒置法,对查阅到8篇进行评估.结果 阿立哌唑与奥氮平的疗效无显著性差异[x2=0.17,P>0.05,OR=0.93,95%CI(0.66~1.30)],阿立哌唑组发生失眠、震颤、头痛、兴奋或激越、静坐不能不良反应,较奥氮平组多,有显著性差异(P<0.01);奥氮平组发生体质量增加不良反应比阿立哌唑组多;有显著性差异(P<0.001).结论 奥氮平与阿立哌唑的疗效相当,但奥氮平不良反应的发生率较低.

  2. Clinical efficacy and safety of olanzapine and risperidone in the treatment of first episode schizophrenia%奥氮平与利培酮治疗首发精神分裂症的疗效及安全性

    Institute of Scientific and Technical Information of China (English)

    杨老虎; 魏昆岭; 苏顺英; 高良会; 成玉敏

    2010-01-01

    目的 评价奥氮平与利培酮治疗首发精神分裂症的疗效及安全性.方法 96例首发精神分裂症患者随机分为奥氮平组与利培酮组,分别治疗8周.采用阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及副反应.结果 奥氮平组与利培酮组的总有效率分别为81.67%和79.36%,差异无统计学意义(P>0.05).2组不良反应发生率低、程度轻,奥氮平组体质量增加比例高于利培酮组;利培酮组锥体外系反应比例高于奥氮平组.结论 2种药物均为疗效好、安全性高的抗精神病药.

  3. 奥氮平合并劳拉西泮治疗广泛性焦虑疗效分析%Curative effect analysis of olanzapine combined with lorazepam in treatment of generalized anxiety disorder

    Institute of Scientific and Technical Information of China (English)

    赵勇; 陈红玉; 鲁晓波

    2013-01-01

    目的:分析奥氮平合并劳拉西泮治疗广泛性焦虑的疗效和安全性.方法:随机将96例广泛性焦虑分为奥氮平合并劳拉西泮治疗组52例和单用劳拉西泮对照组44例.两组在性别、年龄和病程上均无显著性差异(P>0.05).在治疗前和治疗第2、6周末采用汉密尔顿焦虑量表(HAMA)及副反应量表(TESS)评定疗效及不良反应.结果:两组2、6周末的HAMA总分和因子分都有明显降低,随着疗程延长各降分更为明显.两组间比较,治疗组6周末HAMA总分和躯体焦虑因子分降分明显大于对照组(P<0.05),显效率明显高于对照组P<0.05).治疗组奥氮平以小剂量为主,劳拉西泮用量低于对照组(P<0.01),不良反应则明显轻于对照组.结论:小剂量奥氮平合并劳拉西泮治疗广泛性焦虑具有增效及减轻药物不良反应的特点.

  4. Overlapping of Serotonin Syndrome with Neuroleptic Malignant Syndrome due to Linezolid-Fluoxetine and Olanzapine-Metoclopramide Interactions: A Case Report of Two Serious Adverse Drug Effects Caused by Medication Reconciliation Failure on Hospital Admission

    Directory of Open Access Journals (Sweden)

    Faizan Mazhar

    2016-01-01

    Full Text Available Antipsychotic and antidepressant are often used in combination for the treatment of neuropsychiatric disorders. The concomitant use of antipsychotic and/or antidepressant with drugs that may interact can lead to rare, life-threatening conditions such as serotonin syndrome and neuroleptic malignant syndrome. We describe a patient who has a history of taking two offending drugs that interact with drugs given during the course of hospital treatment which leads to the development of serotonin syndrome overlapped with neuroleptic malignant syndrome. The physician should be aware that both NMS and SS can appear as overlapping syndrome especially when patients use a combination of both antidepressants and antipsychotics.

  5. Overlapping of Serotonin Syndrome with Neuroleptic Malignant Syndrome due to Linezolid-Fluoxetine and Olanzapine-Metoclopramide Interactions: A Case Report of Two Serious Adverse Drug Effects Caused by Medication Reconciliation Failure on Hospital Admission

    Science.gov (United States)

    Akram, Shahzad; Haider, Nafis; Ahmed, Rafeeque

    2016-01-01

    Antipsychotic and antidepressant are often used in combination for the treatment of neuropsychiatric disorders. The concomitant use of antipsychotic and/or antidepressant with drugs that may interact can lead to rare, life-threatening conditions such as serotonin syndrome and neuroleptic malignant syndrome. We describe a patient who has a history of taking two offending drugs that interact with drugs given during the course of hospital treatment which leads to the development of serotonin syndrome overlapped with neuroleptic malignant syndrome. The physician should be aware that both NMS and SS can appear as overlapping syndrome especially when patients use a combination of both antidepressants and antipsychotics. PMID:27433163

  6. A comprehensive protocol to evaluate the use of blood and its components in Latin America and the Caribbean.

    Science.gov (United States)

    Pozo, Ana E del; Pérez-Rosales, Maria D; Almeida-Neto, Cesar de; Remesar, Mirta C; Cortes, Armando D; Delgado, Raquel Baumgratz; Mendrone, Alfredo; Sabino, Ester

    2015-06-01

    Blood transfusion safety is a critical part of appropriate health care. Considering the limited information available on the use of blood and its components in Latin America and the Caribbean, the Grupo Cooperativo iberoamericano de Medicina Transfusional (Ibero-American Cooperative Group for Transfusion Medicine; GCIAMT), through its Research and International Affairs committees, carried out a project to develop a protocol that would facilitate the evaluation of blood usage at the country, jurisdiction, and institutional levels in varied country contexts. Experts in blood safety from the Pan American Health Organization (Washington, DC, United States), the University of São Paulo (São Paulo, Brazil), the Hemocentro of São Paulo (São Paulo, Brazil), and GCIAMT designed a 2-step comprehensive blood-use evaluation protocol: step 1 collects data from blood requests, and step 2, from medical charts. At a minimum, 1 000 analyzed requests are necessary; as such, study periods vary depending on the number of transfusion requests issued. An Internet-based application, the Modular Research System-Study Management System (MRS-SMS), houses the data and produces reports on how hospitals request blood, how blood is issued, who requires blood and blood components, and as an added benefit, how many blood units are wasted and what the real demand for blood is.

  7. [Dementia with Lewy bodies; 2 patients with exacerbation due to an atypical antipsychotic, but with a favorable response to the cholinesterase inhibitor rivastigmine

    NARCIS (Netherlands)

    Scheepmaker, A.J.T.M.; Horstink, M.W.I.M.; Hoefnagels, W.H.L.; Strijks, F.E.

    2003-01-01

    In two patients, men aged 80 and 75 years with cognitive deterioration, hallucinations and parkinsonism, the clinical diagnosis 'dementia with Lewy bodies' was established. Treatment with an atypical antipsychotic, risperidone and olanzapine respectively, resulted in an exacerbation of the parkinson

  8. Antipsychotic Medication in Children and Adolescents : A Descriptive Review of the Effects on Prolactin Level and Associated Side Effects

    NARCIS (Netherlands)

    Roke, Yvette; van Harten, Peter N.; Boot, Annemieke M.; Buitelaar, Jan K.

    2009-01-01

    Objective: This review reports the incidence of hyperprolactinemia, its relationship with genotype, and prolactin-related side effects in children and adolescents treated with antipsychotics. Method: Data on prolactin levels were available for haloperidol, pimozide, risperidone, olanzapine, clozapin

  9. Antipsychotic medication in children and adolescents: a descriptive review of the effects on prolactin level and associated side effects.

    NARCIS (Netherlands)

    Roke, Y.; Harten, P.N. van; Boot, A.M.; Buitelaar, J.K.

    2009-01-01

    OBJECTIVE: This review reports the incidence of hyperprolactinemia, its relationship with genotype, and prolactin-related side effects in children and adolescents treated with antipsychotics. METHOD: Data on prolactin levels were available for haloperidol, pimozide, risperidone, olanzapine, clozapin

  10. Antipsychotic Medication in Children and Adolescents : A Descriptive Review of the Effects on Prolactin Level and Associated Side Effects

    NARCIS (Netherlands)

    Roke, Yvette; van Harten, Peter N.; Boot, Annemieke M.; Buitelaar, Jan K.

    2009-01-01

    Objective: This review reports the incidence of hyperprolactinemia, its relationship with genotype, and prolactin-related side effects in children and adolescents treated with antipsychotics. Method: Data on prolactin levels were available for haloperidol, pimozide, risperidone, olanzapine, clozapin

  11. Antipsychotic medication in children and adolescents: a descriptive review of the effects on prolactin level and associated side effects.

    NARCIS (Netherlands)

    Roke, Y.; Harten, P.N. van; Boot, A.M.; Buitelaar, J.K.

    2009-01-01

    OBJECTIVE: This review reports the incidence of hyperprolactinemia, its relationship with genotype, and prolactin-related side effects in children and adolescents treated with antipsychotics. METHOD: Data on prolactin levels were available for haloperidol, pimozide, risperidone, olanzapine, clozapin

  12. Predominant role of the 9-hydroxy metabolite of risperidone in elevating blood prolactin levels

    NARCIS (Netherlands)

    Knegtering, R; Baselmans, P; Castelein, S; Bosker, F; Bruggeman, R; van den Bosch, RJ

    2005-01-01

    Objective: The atypical antipsychotic risperidone significantly raises plasma prolactin levels in patients, but clozapine, olanzapine, and quetiapine do not. The differences in neuroendocrine response may be connected with the metabolism of the medications. The authors examined the contributory role

  13. Differential effects of antipsychotic drugs on insight in first episode schizophrenia : Data from the European First-Episode Schizophrenia Trial (EUFEST)

    NARCIS (Netherlands)

    Pijnenborg, G. H. M.; Timmerman, Marieke; Derks, E.M.; Fleischhacker, W. W.; Kahn, R. S.; Aleman, A.

    2015-01-01

    Although antipsychotics are widely prescribed, their effect of on improving poor illness insight in schizophrenia has seldom been investigated and therefore remains uncertain. This paper examines the effects of low dose haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on insight in

  14. Costi del trattamento con oloprazina nelle fasi iniziali della schizofrenia

    Directory of Open Access Journals (Sweden)

    Domenico Berardi

    2002-06-01

    Full Text Available Objective: In Italy, use of olanzapine in the public sector was limited by law to patients that had failed treatment with conventional antipsychotics, due to the higher purchase price of the drug. This restriction prevented first-episode patients and patients early in the course of their illness from being treated with olanzapine. The present study investigates economic consequences of this policy. Design: The present study retrospectively outlines treatment costs of patients switched to olanzapine during the early stages of schizophrenia as compared to the costs of patients switched during a later stage of the illness. Setting: The study was conducted within Italian Community Mental Health Services. Patients: The cost of pharmacological and non-pharmacological treatment was retrospectively calculated in 25 out-patients with schizophrenia and related disorders over a one-year span. Thirteen patients were switched to olanzapine in the early stage of their illness, prior to drug approval under a compassionate use regimen. Twelve patients started olanzapine under the restriction in a later stage of illness following failed treatment with a conventional antipsychotic. Results: While total treatment costs between the two groups was similar, cost distribution was different. Early Switch patients had higher drug costs and higher rehabilitation costs, while Late Switch patients had higher hospitalisation costs. Conclusions: Small patient numbers and design limitations prevent conclusions being drawn regarding the ultimate impact on outcome and total treatment cost of restriction of olanzapine to second-line use. Despite this, our findings demonstrate that within the context of the Italian CMHS, patients treated with olanzapine while still in the early stages of schizophrenia do not necessarily cost more overall compared to patients who receive olanzapine after failing treatment with a conventional antipsychotic.

  15. РЕТРОСПЕКТИВНОЕ СРАВНЕНИЕ СУММАРНОЙ ПРОДОЛЖИТЕЛЬНОСТИ РЕМИССИИ ПРИ ПРИМЕНЕНИИ ОЛАНЗАПИНА И РИСПЕРИДОНА В ЛЕЧЕНИИ ПАЦИЕНТОВ, СТРАДАЮЩИХ ШИЗОФРЕНИЕЙ

    OpenAIRE

    Сетураман, Г.; Тейлор, С.; Энерсон, М.; Дунаевич, Э.

    2008-01-01

    Background: Available studies suggest comparable efficacy of olanzapine and risperidone for the treatment of schizophrenia over the short term. Method: This retrospective analysis of data from a 28-week, double-blind schizophrenia trial compared the cumulative amount of time that patients met severity criteria for remission during olanzapine (10-20 mg/ day) or risperidone (4-12 mg/day) treatment. Results: The percentage cumulative time spent in remission was 40% for olanzapineand 31% for risp...

  16. Influenza del trattamento della schizofrenia con neurolettici tipici o olanzapina sui costi sanitari e sugli outcomes lavorativi

    Directory of Open Access Journals (Sweden)

    Angelomarco Barioglio

    2005-06-01

    Full Text Available The aim of the present study was to evaluate the global treatment cost of schizophrenia with olanzapine or typical neuroleptics, according to Local Health Care Unit point of view. This analysis was performed through naturalistic observation of a cohort of schizophrenic patients referring to Ascoli Piceno ASL Department of Mental Health during 4 years (2001-2004. During year 2003, investigators have identified a cohort of patients who were undergoing treatment switch from typical neuroleptics to olanzapine. These patients, after the switch, are observed prospectively for the next 2 years and retrospectively for the last 2 years of treament. This method allow us to collect data about 4 years of treatment: 2 years of typical neuroleptic treatment followed by 2 years of olanzapine treatment. The present work is presenting the analysis of the first 3 years of observation. The results of our analysis are demonstrating that olanzapine treatment, through a better patient-physician alliance and with rehabilitative activities, allow lower total medical costs for the treatment of schizophrenia than typical neuroleptics. The higher acquisition cost of olanzapine versus typical neuroleptics was compensated by less hospitalizations and territorial medical interventions. During olanzapine treatment patients followed more rehabilitative activities (+71,26%, p <0,0001 and increased their working activities (+39,13%, p< 0,001.

  17. METHODS ELABORATION ON DETECTION OF SOME ATYPICAL NEUROLYTIC AGENTS FOR CHEMICAL AND TOXICOLOGICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    I. P. Remezova

    2014-01-01

    Full Text Available It is necessary to elaborate methods of atypical neuroleptic agents detection as individual substances and in different combinations as well for diagnosis of poisoning by some of them: clozapine, risperidone, sertindole, olanzapine, aripiprazole. The purpose of this work is methods elaboration of detection of clozapine, risperidone, sertindole, olanzapine, aripiprazole, haloperidol, oxazepam, carbamazapine using TLC, HPLC and UV spectrophotometry methods. During this work we used tablet forms of clozapine, risperidone, sertindole, olanzapine, aripiprazole. It is possible to use solution systems like ethanol-water-25% ammonia solution (8:1:1, toluolacetone-ethanol-25% ammonia solution (45:45:7.5:2.5, dioxan-chloroform-acetone-25% ammonia solution (47.5:45:5:2.5 for preliminary examination of atypical neuroleptic agents under study in combination with typical neuroleptics and tranquilizers with undirected analysis (general screening. System of solvents ethyl-acetate-chloroform-25% ammonia solution (85:10:5 is recommended to use for individual screening of risperidone, sertindole, olanzapine, haloperidol, benzol-ethanol-25% ammonia solution (50:10:0.5 system to use for clozapine, sertindole, olanzapine. Ethanol-25% ammonia solution (100:1.5 system is reasonable to use for chromatographic clearance of extracts from biological substances under study. We recommend using HPLC method and UV spectrophotometry for carrying out of a principal examination of clozapine, risperidone, sertindole, olanzapine and aripiprazole in case one of the substances under study is determined in the object.

  18. A comparative study of risperidone and olanzapine in the treatment of mental disorders due to use of alcohol%利培酮与再普乐治疗酒精所致精神障碍的对照研究

    Institute of Scientific and Technical Information of China (English)

    刘峥嵘; 张威; 林宏

    2008-01-01

    目的:比较利培酮与再普乐对酒精所致精神障碍患者的疗效和不良反应.方法:将70例酒精所致精神障碍患者随机分为利培酮组(37例)和再普乐组(33例),疗程6周,于治疗前及治疗后1、2、4、6周采用阳性症状和阴性症状量表(PANSS)、治疗时出现的症状量表(TESS)评定疗效与不良反应.结果:利培酮与再普乐对酒精所致精神障碍患者的治疗均有明显疗效,统计学上无显著性差异(P>0.05),利培酮组锥体外系不良反应明显高于再普乐组(P<0.05).结论:利培酮与再普乐治疗酒精所致精神障碍患者安全有效.

  19. 喹硫平与再普乐治疗酒精所致精神障碍的对照研究%A comparative study of quetiapine and olanzapine in the treatment of mental disorders due to use of alcohol

    Institute of Scientific and Technical Information of China (English)

    郑云华; 刘峥嵘

    2009-01-01

    目的:比较喹硫平与再普乐对酒精所致精神障碍患者的疗效和不良反应.方法:将68例酒精所致精神障碍患者随机分为喹硫平组(36例)和再普乐组(32例),疗程6周;于治疗前及治疗后1、2、4、6周分别采用阳性症状和阴性症状量表(PANSS)、治疗时出现的症状量表(TESS)、锥体外系副反应量表(RSESE)评定疗效与不良反应.结果:喹硫平与再普乐对酒精所致精神障碍患者的治疗均有明显疗效,统计学上无显著性差异(P>0.05),锥体外系不良反应及其他副反应极少,两组统计学上无显著性差异(P>0.05).结论:喹硫平与再普乐治疗酒精所致精神障碍患者安全有效.

  20. A clinical study of olanzapine in the treatment of behavioral and psychological symptoms of Alzheimer's disease%奥氮平治疗阿尔茨海默病患者行为和精神症状临床研究

    Institute of Scientific and Technical Information of China (English)

    贾荣; 马莉; 佟靓

    2011-01-01

    目的 探讨奥氮平治疗阿尔茨海默病患者行为和精神症状的临床疗效和安全性.方法 对66例阿尔茨海默病患者予以口服奥氮平治疗,观察6周.于治疗前后采用Alzheimer病行为病理学量表评定入组患者的行为和精神症状.结果 入组患者治疗后Alzheimer病行为病理学评定量表评分,除情感障碍因子分无显著变化(P>0.05)外,总分及其他因子分均显著低于治疗前(P<0.01);治疗后偏执与妄想观念、幻觉、行为紊乱、攻击行为及日夜节律紊乱检出率均显著低于治疗前(P<0.01);不引起/不加重患者的认知功能损害,不良反应发生率低,程度较轻微.结论 奥氮平能显著改善阿尔茨海默病患者的行为和精神症状,有效缓解患者的攻击行为,且不损害认知功能,治疗安全性高,依从性好.

  1. 利培酮与奥氮平对精神分裂症急性期的疗效及临床影响因素的比较%Comparison of curative effect and clinical influence factors of risperidone and olanzapine in the treatment of acute phrase of schizophrenia

    Institute of Scientific and Technical Information of China (English)

    倪平; 吕海龙; 国效峰; 张丽丽; 许林勇

    2014-01-01

    目的:比较利培酮、奥氮平治疗精神分裂症急性期的疗效及临床影响因素.方法:利培酮组27例,剂量范围2~6 mg/d,奥氮平组26例,剂量范围10~20 mg/d.两组均以阳性与阴性症状评定量表(PANSS)观察6周,治疗前收集患者的性别、年龄、病程,治疗中准确记录患者用药情况.结果:6周末,利培酮与奥氮平治疗精神分裂症急性期的有效率均为84.6%;奥氮平组患者在一般病理症状、阳性症状中的疗效优于利培酮组患者(P<0.05);治疗时间长,利培酮、奥氮平治疗精神分裂症急性期的疗效增加(P<0.05);治疗时间与利培酮、奥氮平不存在交互作用(P>0.05);治疗时间、病程、剂量对利培酮的疗效有影响(P<0.05),治疗时间对奥氮平的疗效有影响(P<0.05).结论:精神分裂症的急性期,奥氮平的疗效与利培酮相当,但奥氮平疗效的稳定性优于利培酮.

  2. Study diazepam with olanzapine in the treatment of mental and behavioral disorders caused by alcohol efficacy and safety%地西泮合并奥氮平治疗酒精所致精神和行为障碍的疗效和安全性的研究

    Institute of Scientific and Technical Information of China (English)

    林立; 王丽珊

    2016-01-01

    目的:探讨地西泮合并奥氮平治疗酒精所致精神和行为障碍的疗效和安全性.方法:将2012年1月~2015年12月77例白酒或家酿米酒所致精神和行为障碍患者按照随机数字表法分为对照组(n=38)与观察组(n=39).两组均在戒酒的同时给予大剂量的B族维生素,纠正水电解质紊乱及营养支持治疗,对照组在此基础上联合地西泮治疗,观察组则采用地西泮合并奥氮平治疗.比较两组临床疗效、 治疗前后PANSS评分、 血催乳素及TG水平、 不良反应发生情况.结果:①经治疗,观察组临床总有效率为92.31%(36/39),对照组为78.95%(30/38),观察组临床疗效显著优于对照组(P0.05).结论:地西泮合并奥氮平治疗酒精所致精神和行为障碍疗效显著,可以在临床使用.

  3. A control study of paliperidone extended-release tablets and olanzapine in the treatment of elderly schizophrenia%帕利哌酮缓释片治疗30例老年精神分裂症患者对照观察

    Institute of Scientific and Technical Information of China (English)

    袁国锋; 俞玉礼

    2013-01-01

    目的:探讨帕利哌酮缓释片治疗老年精神分裂症的疗效和安全性.方法:将60例老年精神分裂症患者随机分为研究组和对照组,各30 例,分别给予帕利哌酮缓释片(芮达)与奥氮平片(再普乐)治疗,疗程8周,分别于治疗前、治疗第2周、第4周和第8周末采用阳性与阴性症状量表(PANSS)评定疗效;用治疗中出现的症状量表(TESS)来评定不良反应.结果:两组PANSS量表评分治疗后均较治疗前明显减少(P0.05);帕利哌酮缓释片的主要不良反应为锥体外系副反应,奥氮平片主要不良反应为嗜睡和体质量增加,两组差异有统计学意义(P<0.05).结论:帕利哌酮缓释片对治疗老年精神分裂症患者有较高的疗效和安全性.

  4. Compared Study of Donepezil and Olanzapine in the treatment of Alzheimer's disease and Behavioral and psychological symptoms of Dementia%多奈哌齐合并奥氮平治疗伴行为和精神症状的阿尔茨海默病的对照研究

    Institute of Scientific and Technical Information of China (English)

    朱荣申; 杨素封; 沈文龙; 吴洪明

    2005-01-01

    目的研究多奈哌齐合并奥氮平治疗伴行为和精神症状(behavioral and psychological symptoms of dementia BPSD)的阿尔茨海默病(AD)的疗效及安全性.方法开放性对照研究,诊断和人组应用NINCDS-ADRDA(美国国立神经疾病和卒中研究所-老年性痴呆及相关疾病学会)标准、DSM-Ⅳ-R(美国精神病学会的精神障碍诊断和统计手册-R)标准、Hachinski缺血指数量表、HAMD(汉密顿抑郁量表)和MMSE(简易精神状态检查),97例患者分为传统治疗(n=27)、单用多奈哌齐(n=25)、单用奥氮平(n=24)和多奈哌齐合并奥氮平(n=21)等四组,分别于疗程2周末、6周末和12周末进行有效性和安全性评定,有效性评定项目有MMSE、BPRS和CGI,安全性评定有TESS和临床记录.结果MMSE、BPRS、CGI-SI评分及BPRS加减分比较,多奈哌齐合并奥氮平组治疗后2、6、12周末均优于传统治疗组,差异有非常显著牲(P<0.01),MMSE加减分比较,多奈哌齐合并奥氮平组治疗后6、12周末均优于传统治疗组,差异有非常显著性(P<0.01);四组治疗后2、6、12周末TESS分别为2.38±1.92,2.24±1.88和1.71±1.63,四组总体比较及组间两两比较P>0.05,差异无显著性.结论多奈哌齐合并奥氮平治疗AD伴BPSD快速有效安全.

  5. The effects of second generation antipsychotic drugs on sleep variables in healthy subjects and patients with schizophrenia.

    Science.gov (United States)

    Monti, Jaime M; Torterolo, Pablo; Pandi Perumal, Seithikurippu R

    2017-06-01

    Insomnia is a common feature in schizophrenia, and is characterized by an increase of sleep latency (SL), as well as reductions in total sleep time (TST) and sleep efficiency (SE). Regarding sleep architecture, non-rapid-eye-movement (NREM) sleep, slow wave sleep (SWS) and rapid-eye-movement (REM) sleep latency are decreased, whereas REM sleep tends to remain unchanged. According to polysomnographic studies, clozapine, olanzapine, quetiapine and ziprasidone administration increased TST and/or SE in healthy subjects. Additionally, olanzapine and ziprasidone augmented SWS, while changes corresponding to REM sleep were inconsistent. Furthermore, administration of clozapine, olanzapine and paliperidone to patients with schizophrenia was followed in most instances by a significant reduction of SL and an increase of TST and SE. In addition, olanzapine and paliperidone augmented SWS and REM sleep. By contrast, quetiapine administration further disrupted sleep as judged by the increase of SL, wake time after sleep onset (WASO) and REM sleep latency, and the reduction of SWS and REM sleep. No consistent effects on sleep variables were obtained during treatment with risperidone. To date, no polysomnographic studies have been published on the effects of aripiprazole, asenapine, iloperidone and lurasidone on sleep in either healthy subjects or patients with schizophrenia. Taken together, this evidence supports the conclusion that second generation antipsychotics (SGAs) including clozapine, olanzapine and paliperidone may ameliorate insomnia in patients with schizophrenia.

  6. Summary of Clinical Experience of Schizophrenia%精神分裂症的临床经验总结

    Institute of Scientific and Technical Information of China (English)

    刘喜林

    2015-01-01

    目的:对比分析奥氮平与氯氮平治疗精神分裂症的临床疗效。方法选择精神分裂症患者102例,随机分为两组,即奥氮平治疗组和氯氮平治疗组。采用思维和执行能力测试及副作用发生率为观察指标。结果奥氮平治疗组思维和执行能力测试明显优于氯氮平治疗组,副作用发生率低于氯氮平治疗组。结论奥氮平是治疗精神分裂症安全有效的药物。%Objective Comparative analysis clinical effects on olanzapine and clozapine treatment of schizophreniachosis. Methods Selected 102 cases with schizophreniachosis were divided into the olanzapine group and the clozapine group. Think and ability to execute tests and incidence of side effects were observed. Results Olanzapine group with thinking and ability to execute tests was higher than clozapine group, and the incidence of side effects was lower than the olanzapine group. Conclusion Olanzapine is a safe and effective medications treatment of schizophrenia.

  7. Interruzione del trattamento nei pazienti con schizofrenia che ricevono olanzapina o aripiprazolo: metanalisi degli studi clinici controllati

    Directory of Open Access Journals (Sweden)

    Benedetta Santarlasci

    2005-03-01

    Full Text Available BACKGROUND: In schizophrenia the drop-out rate can be used as proxy of effectiveness. The drop-out evaluation is also important considering the relevant economic impact for NHS of an antipsychotic therapy discontinuation in terms of patient hospitalization and other related healthcare resources consumption. OBJECTIVE: To analyze the differences in the rates of drop-out from clinical trials between olanzapine and aripiprazole. METHODS: Literature search was based on MEDLINE, on Iowa-IDIS and Drugdex databases (1966-Dec 2004. Analysis included 12 randomized controlled trials (3.778 patients, 8 for olanzapine (2.559 patients and 4 for aripiprazole (1.219 patients. RCT inclusion criteria were: a Patients affected by schizophrenia; b Randomized assignment to olanzapine or aripiprazole treatment group; c Number of patients included in the treatment group higher than 100; d Drop-out frequency evaluation between 4th and 26th weeks of follow-up. RESULTS: The rate of treatment discontinuation was greater for aripiprazole than for olanzapine (42,2% vs. 31,6% respectively. The comparison between drop-out percentages is statistically significant (p<0,001. CONCLUSIONS: The incidence of drop-outs was better controlled in the olanzapine group of studies than in the aripiprazole group of studies.

  8. Determinação simultânea de olanzapina e cloridrato de fluoxetina em formulações farmacêuticas por espectrofotometria derivativa

    Directory of Open Access Journals (Sweden)

    Jacira Izidório de Moura

    2012-01-01

    Full Text Available Simple, sensitive and accurate spectrophotometric derivative methods were developed for the simultaneous determination of olanzapine and fluoxetine hydrochloride in pharmaceutical formulations by derivative spectrophotometry. On all orders of derivative studied, the linear response range was 10 to 60 mg L-1, with limit of quantitation (LoQ ranging from 0.73 to 1.49 mg L-1 for fluoxetine hydrochloride and from 0.18 to 0.96 mg L-1 for olanzapine. The best orders for derivative analyses showed recoveries ranging from 99 to 103% and from 98 to 100%, and inter-day accuracy < 2.1% and < 2.8%, for fluoxetine hydrochloride and olanzapine, respectively.

  9. Effects of antipsychotic drugs on neurotoxicity, expression of fos-like protein and c-fos mRNA in the retrosplenial cortex after administration of dizocilpine.

    Science.gov (United States)

    Fujimura, M; Hashimoto, K; Yamagami, K

    2000-06-09

    In this study, we examined the effect of clozapine, olanzapine, risperidone and haloperidol on the neuropathology (i.e. neuronal vacuolization) and the expression of Fos-like protein and c-fos mRNA in the retrosplenial cortex of female Sprague-Dawley rats induced by the NMDA receptor antagonist dizocilpine. Pretreatment (15 min) with clozapine or olanzapine, but not risperidone or haloperidol, blocked the neuronal vacuolization produced by dizocilpine (0.5 mg/kg, s.c.) in the rat retrosplenial cortex in a dose-dependent manner. Furthermore, pretreatment (15 min) with clozapine or olanzapine, but not risperidone or haloperidol, significantly attenuated the expression of Fos-like protein in the retrosplenial cortex induced by dizocilpine (0.5 mg/kg, s.c.) in a dose-dependent manner. The marked expression of c-fos mRNA in the rat retrosplenial cortex induced by the administration of dizocilpine (0.5 mg/kg, s.c.) was significantly attenuated by pretreatment (15 min) with clozapine (10 mg/kg) or olanzapine (10 mg/kg), but not risperidone (10 mg/kg) or haloperidol (10 mg/kg). The present results suggest that pharmacologically relevant doses of clozapine or olanzapine, but not risperidone or haloperidol, block the neuropathological changes and the expression of Fos-like protein and c-fos mRNA in the rat retrosplenial cortex elicited by the administration of dizocilpine. It is possible that the blockade of dizocilpine-induced neuropathological changes by clozapine and olanzapine may be related to the unique antipsychotic actions of these drugs in schizophrenic patients, although this remains to be verified.

  10. 奥氮平与利培酮治疗老年性痴呆精神行为症状的临床分析

    Institute of Scientific and Technical Information of China (English)

    彭慧; 莫祥徳

    2016-01-01

    Objective To compare olanzapine and risperidone clinical ef icacy behavioral and psychological symptoms of Alzheimer 's disease treatment.Methods The 80 cases of behavior-al and psychological symptoms of Alzheimer's disease were randomly assigned to olanzapine and risperidone group,the ef icacy of the two groups were compared.Results The clinical ef icacy of olanzapine group was significantly bet er than the risperidone group ;after treatment 4w,olanzapine BEHAVE -AD scores were significantly lower than the risperidone group;olanzapine inci-dence of adverse events was significantly lower than the profit risperidone group,the dif erences were statistical y significant(P <0.05).Conclusion The therapeutic ef ect of olanzapine group than in the risperidone group,a low incidence of adverse reactions.%目的:比较奥氮平与利培酮治疗老年性痴呆精神行为症状的临床疗效。方法将80例老年性痴呆精神行为症状患者,随机分为奥氮平组和利培酮组,比较两组患者的疗效。结果奥氮平组临床疗效显著优于利培酮组;治疗4w 后,奥氮平组 BEHAVE -AD 总分显著低于利培酮组;奥氮平组不良反应发生率显著低于利培酮组,差异均有显著性( P <0.05)。结论奥氮平组的治疗效果优于利培酮组,不良反应发生率低。

  11. Costs and efficacy ofolanzapine and risperidone in schizophrenia

    Directory of Open Access Journals (Sweden)

    Vittorio Mapelli

    2007-06-01

    Full Text Available Introduction: schizophrenia is a serious and long lasting psychiatric disease. The new “atypical” antipsychotic drugs, introduced in the 90s, have substantially improved the effectiveness of medical treatments, compared to previous neuroleptic drugs. Nowadays they tend to be used as first choice drugs. The ddd cost of atypicals may differ by 20% and health authorities may have an incentive to deliver the less costly drug, especially if they are generic. However the various drugs show differential effectiveness rates and a rational choice should consider both cost and effectiveness.
Objective: the purpose of this analysis is to review the existing evidence on cost-effectiveness studies of olanzapine and risperidone, the two most prescribed drugs in Italy. Six published studies were identified, but attention was focused on two articles that reported consistent and methodologically sound results.
Results: most reviewed studies are cost-minimization analyses, since effectiveness indicators show no significant statistical difference between the two drugs, and are inconclusive since the results depend on the evaluation setting. However one observational retrospective study showed a significant severity reduction over 12 months for patients treated with olanzapine (-2.46 on HoNOS scale; p<0.05, compared to a smaller non significant reduction of the risperidone group (-0.57. Despite the higher drug cost, the average total cost per reduced severity score was lower for olanzapine than for risperidone patients (€ 4,554 vs. € 10,897. The only medical and related health care costs for risperidone patients were higher than total costs for olanzapine patients. Another study comparing cohorts of patients with similar starting severity showed a significant severity reduction and global functioning increase over 12 months for olanzapine but no significant increase for risperidone patients (-0.35, p<0.01 on CGI scale; +3.66, p <0.05 on GAF scale

  12. Weight Gain While Switching from Polypharmacy to Ziprasidone: A Case Report.

    Science.gov (United States)

    Lee, Chin-Pang; Chen, Alice Pei-Jung; Juang, Yeong-Yuh

    2015-01-01

    Second-generation antipsychotics (SGAs), valproate, and sulpiride are related to significant weight gain and risk of metabolic syndrome (MetS). Among SGAs, olanzapine and clozapine are associated with the highest metabolic risk while ziprasidone is among one of the SGAs with the lowest risk. Several reports suggest that weight loss is observed in switching other antipsychotics to ziprasidone. Here we describe a female patient with chronic paranoid schizophrenia who had an unexpected weight gain and developed MetS during a cross-switch from a polypharmacy of olanzapine, valproate and sulpiride to ziprasidone monotherapy.

  13. [Three-Dimensional Ultrasonic Gait Analysis in Schizophrenic Patients

    Science.gov (United States)

    Putzhammer, Albert; Heindl, Bernhard; Müller, Jürgen; Broll, Karin; Pfeiff, Liane; Perfahl, Maria; Hess, Linda; Koch, Horst

    2003-05-01

    Schizophrenic disorders as well as neuroleptic treatment can affect locomotion. The study assessed the influence of neuroleptic treatment on human gait via ultrasonic topometric gait analysis. In a control sample the test system proved high test-retest-reliability. Spatial and temporal gait parameters were assessed in schizophrenic patients without neuroleptic treatment (n = 12) and under treatment with conventional neuroleptics (n = 14) and re-assessed after treatment change to the atypical neuroleptic olanzapine in a repeated measures design. After switch from conventional neuroleptics to olanzapine patients showed an increase of gait velocity (p step length (p gait analysis.

  14. Atypical antipsychotic drugs and tardive dyskinesia: relevance of D2 receptor affinity.

    Science.gov (United States)

    Bressan, Rodrigo A; Jones, Hugh M; Pilowsky, Lyn S

    2004-03-01

    Evidence suggests atypical antipsychotic treatment is associated with a lower incidence of tardive dyskinesia (TD) than typical antipsychotic drugs, and is a potential antidyskinetic treatment. We present the case of a middle-aged woman never previously exposed to antipsychotic treatment who developed TD after 6 months of olanzapine monotherapy. Substitution of quetiapine for olanzapine alleviated her TD symptoms. The case demonstrates that atypical antipsychotic drugs have different effects in relation to TD. Potential psychopharmacological mechanisms explaining these differences are discussed, highlighting the importance of D2 receptor occupancy by atypical antipsychotic drugs for TD.

  15. Uso de olanzapina e eletroconvulsoterapia em um paciente com esquizofrenia catatônica refratária e antecedentes de síndrome neuroléptica maligna Olanzapina y ECT en un enfermo con esquizofrenia catatónica refractaria y alto riesgo de síndrome neuroléptico maligno Olanzapine and ECT combined therapy in a refractory catatonic subtype schizophrenia patient with previous neuroleptic malignant syndrome episodes

    OpenAIRE

    Pedro Gomes de Alvarenga; Sérgio Paulo Rigonatti

    2005-01-01

    Este artigo descreve a história clínica e o manejo de um paciente masculino adulto com esquizofrenia catatônica refratária a dois neurolépticos típicos (haloperidol e clorpromazina) e a outro agente atípico (risperidona), e com antecedente de dois episódios de síndrome neuroléptica maligna em vigência de neurolépticos típicos. Os autores optaram pela associação de eletroconvulsoterapia (ECT) e olanzapina (7,5 mg). Foram obtidos consideráveis benefícios para o paciente.Presentamos un relato cl...

  16. Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS): Rationale, Design, and Methods

    Science.gov (United States)

    McClellan, Jon; Sikich, Linmarie; Findling, Robert L.; Frazier, Jean A.; Vitiello, Benedetto; Hlastala, Stefanie A.; Williams, Emily; Ambler, Denisse; Hunt-Harrison, Tyehimba; Maloney, Ann E.; Ritz, Louise; Anderson, Robert; Hamer, Robert M.; Lieberman, Jeffrey A.

    2007-01-01

    Objective: The Treatment of Early Onset Schizophrenia Spectrum Disorders Study is a publicly funded clinical trial designed to compare the therapeutic benefits, safety, and tolerability of risperidone, olanzapine, and molindone in youths with early-onset schizophrenia spectrum disorders. The rationale, design, and methods of the Treatment of Early…

  17. The role of 5-HT(2A) receptor antagonism in amphetamine-induced inhibition of A10 dopamine neurons in vitro

    NARCIS (Netherlands)

    Olijslagers, J.E.; Perlstein, B.; Werkman, T.R.; Mc.Creary, A.C.; Siarey, R.; Kruse, C.G.; Wadman, W.J.

    2005-01-01

    The role of the 5-HT(2A) receptor in modulating amphetamine-induced inhibition of dopamine neuronal firing in A9 and A10 was investigated in rat midbrain slices. The antipsychotic drugs olanzapine and clozapine more potently reversed the amphetamine-induced inhibition in A10 neurons compared to A9 n

  18. The effects of typical and atypical antipsychotics on the electrical activity of the brain in a rat model

    Directory of Open Access Journals (Sweden)

    Oytun Erbaş

    2013-09-01

    Full Text Available Objective: Antipsychotic drugs are known to have strongeffect on the bioelectric activity in the brain. However,some studies addressing the changes on electroencephalography(EEG caused by typical and atypical antipsychoticdrugs are conflicting. We aimed to compare the effectsof typical and atypical antipsychotics on the electricalactivity in the brain via EEG recordings in a rat model.Methods: Thirty-two Sprague Dawley adult male ratswere used in the study. The rats were divided into fivegroups, randomly (n=7, for each group. The first groupwas used as control group and administered 1 ml/kg salineintraperitoneally (IP. Haloperidol (1 mg/kg (group 2,chlorpromazine (5 mg/kg (group 3, olanzapine (1 mg/kg(group 4, ziprasidone (1 mg/ kg (group 5 were injectedIP for five consecutive days. Then, EEG recordings ofeach group were taken for 30 minutes.Results: The percentages of delta and theta waves inhaloperidol, chlorpromazine, olanzapine and ziprasidonegroups were found to have a highly significant differencecompared with the saline administration group (p<0.001.The theta waves in the olanzapine and ziprasidonegroups were increased compared with haloperidol andchlorpromazine groups (p<0.05.Conclusion: The typical and atypical antipsychotic drugsmay be risk factor for EEG abnormalities. This studyshows that antipsychotic drugs should be used with caution.J Clin Exp Invest 2013; 4 (3: 279-284Key words: Haloperidol, chlorpromazine, olanzapine,ziprasidone, EEG, rat

  19. Exceptional Family Transitional Training Program (EFTTP)

    Science.gov (United States)

    2009-01-01

    891 ULULANI STREET Hilo 96720 1-808-961-3413 VR&E, 203 HO’OHANA STREET Kahului 96732 1-808-873-9426 IDAHO MEDICAL CENTER: *500 WEST FORT STREET Boise...olanzapine, and risperi- done) may be helpful but are associat- ed with side effects that include seda - tion and weight gain. Recently, howev- er, new

  20. Self-limiting Atypical Antipsychotics-induced Edema: Clinical Cases and Systematic Review

    Science.gov (United States)

    Umar, Musa Usman; Abdullahi, Aminu Taura

    2016-01-01

    A number of atypical antipsychotics have been associated with peripheral edema. The exact cause is not known. We report two cases of olanzapine-induced edema and a brief review of atypical antipsychotic-induced edema, possible risk factors, etiology, and clinical features. The recommendation is given on different methods of managing this side effect. PMID:27335511

  1. Electrooxidation potential as a tool in the early screening for new safer clozapine-like analogues

    NARCIS (Netherlands)

    Mouithys-Mickalad, A; Kauffmann, JM; Petit, C; Bruhwyler, J; Liao, Y; Wikstrom, H; Damas, J; Delarge, J; Deby-Dupont, G; Geczy, J; Liegeois, JF

    2001-01-01

    The chemical modification of clozapine (1) has permitted the finding of new analogues, e.g., olanzapine (2), quetiapine (3), 5-(4-methylpiperazin-1-yl)-8-chloropyrido[2,3-b] [1,5]benzoxazepine fumarate (9), with a clinical or psychopharmacological profile similar to that of clozapine. However, when

  2. Antipsychotic drugs classified by their effects on the release of dopamine and noradrenaline in the prefrontal cortex and striatum

    NARCIS (Netherlands)

    Westerink, B.H.C.; Kawahara, Y; de Boer, P; Geels, C; de Vries, J.B; Wikström, H.V; van Kalkeren, A; van Vliet, B; Kruse, C.H; Long, S.K

    2001-01-01

    Dose-effect curves were established for the effects of the antipsychotic drugs haloperidol, clozapine, olanzapine, risperidone and ziprasidone on extracellular levels of dopamine and noradrenaline in the medial prefrontal cortex, and of dopamine in the striatum. Haloperidol was more effective in sti

  3. [Electroconvulsion therapy for neuroleptic malignant syndrome].

    Science.gov (United States)

    Buggenhout, S; Vandenberghe, J; Sienaert, P

    2014-01-01

    A 64-year-old man, diagnosed with recurrent depression, developed a neuroleptic malignant syndrome (nms) during treatment with olanzapine and mirtazapine. Psychotropic drugs were discontinued. Supportive therapy in an intensive care setting was initiated and electroconvulsive therapy (ect) was administered, after which the patient recovered. This case report discusses the place of ect in the treatment of nms.

  4. Potentiating effect of fluphenazine decanoate and risperidone on development of neuroleptic malignant syndrome.

    Science.gov (United States)

    Liu, Pang-Yen; Wu, Pei-Chuan; Chen, Chun-Yen; Chen, Yi-Chyan

    2011-01-01

    We present the case of a woman with paranoid schizophrenia who was receiving oral risperidone. She developed neuroleptic malignant syndrome (NMS) following the addition of depot fluphenazine for the treatment of refractory delusions. NMS subsided and psychotic features were controlled after both antipsychotics were discontinued and the patient was treated instead with olanzapine.

  5. Antipsychotic medication prescribing trends in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Riyaz Ahmed Siddiqui

    2016-08-01

    Conclusions: Atypical antipsychotics are more commonly used as compared to the typical ones. Atypical antipsychotics like olanzapine, resperidone and quetiapine are preferred because of their lesser propensity to cause extrapyramidal adverse effects and they also helps in improving negative symptoms of schizophrenia. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1417-1420

  6. Livello di dipendenza dai Servizi Territoriali e costi relativi al trattamento della schizofrenia

    Directory of Open Access Journals (Sweden)

    Giorgio D’Allio

    2005-12-01

    Full Text Available The present study was designed to evaluate the level of dependence from Mental Health Care Department, in Casale Monferrato, of three groups of psychotic patients treated with olanzapine (31, risperidone (30 or typical neuroleptics (31. The observation was retrospective, lasting one year (2003-2004, and collected data relative to health care resources as specialist visits, home interventions operated by nurses or physicians, drug administration, rehabilitation, psychotherapy, hospitalizations. The data collected allowed to evidentiate substantial differences among olanzapine and risperidone treated patients, usually younger, versus typical treated patients, usually older and more chronic. In general, atypical treated patients, evidentiate a reduction of home nurse intervention in respect to typical treated patients while olanzapine shows a trend in hospitalization and specialist visits reduction versus risperidone. Total health care costs are not significantly different among the three groups but evidentiate interventions more oriented to rehabilitation in the group treated with olanzapine while risperidone treated patients needed a major number of hospitalizations. Typical treated patients requested, instead, an high number of home intervention due to their chronic conditions and cognitive imparement.

  7. Antipsychotics for the management of psychosis in Parkinson's disease: systematic review and meta-analysis

    OpenAIRE

    Jethwa, Ketan Dipak; Onalaja, Oluwademilade A.

    2015-01-01

    Background Antipsychotics can exacerbate motor symptoms in Parkinson's disease psychosis. Aims To systematically review the literature on the efficacy and acceptability of antipsychotics for Parkinson's disease psychosis. Method Randomised controlled trials comparing an antipsychotic with placebo were systematically reviewed. Results The final selection list included nine studies using quetiapine (3), clozapine (2), olanzapine (3) and pimavanserin (1). A narrative synthesis and meta-analyses ...

  8. A Canadian naturalistic study of a community-based cohort treated for bipolar disorder

    Directory of Open Access Journals (Sweden)

    Chandresena Ranjith

    2010-03-01

    Full Text Available Abstract Background Bipolar illness is associated with significant psychosocial morbidity and health resource utilization. Second generation antipsychotics, used alone or in combination with mood stabilizers are effective in treating acute mania in community settings. This study was designed to compare the change in clinical parameters and resource utilization at one month in a group of patients who required treatment intervention for exacerbation of mania. The clinical response at one year was also evaluated. Methods 496 patients were enrolled at 75 psychiatric practices across Canada. The Olanzapine cohort (n = 287 included patients who had olanzapine added to their medication regimen or the dose of olanzapine increased. The Other cohort (n = 209 had a medication other than olanzapine added or the dose adjusted. Changes from baseline in the Young Mania Rating Scale (YMRS, Montgomery Asberg Depression Rating Scale, Beck Anxiety Inventory and SF-12 Health Survey were compared at one month using ANCOVA. Categorical variables at one month for health resource utilization, employment status, abuse/dependency, and the number of suicide attempts were compared using Fisher's Exact test. Patients were followed for one year and a subgroup was evaluated. Results At one month, patients in the Olanzapine cohort recorded a mean reduction in the YMRS of 11.5, significantly greater than the mean reduction in the Other cohort of 9.7 (ANCOVA P = 0.002. The Olanzapine cohort was significantly improved compared to the Other cohort on the scales for depression and anxiety and did not experience the deterioration in physical functioning seen in the Other cohort. No significant differences were detected in health-related quality-of-life measures, employment status, drug abuse/dependency, number of suicide attempts, mental functioning, emergency room visits or inpatient psychiatric hospitalizations. In a subgroup treated for 12 months with a single second generation

  9. Adverse Renal, Endocrine, Hepatic, and Metabolic Events during Maintenance Mood Stabilizer Treatment for Bipolar Disorder: A Population-Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Joseph F Hayes

    2016-08-01

    Full Text Available There is limited, poorly characterized information about adverse events occurring during maintenance treatment of bipolar disorder. We aimed to determine adverse event rates during treatment with lithium, valproate, olanzapine, and quetiapine.We conducted a propensity score adjusted cohort study using nationally representative United Kingdom electronic health records from January 1, 1995, until December 31, 2013. We included patients who had a diagnosis of bipolar disorder and were prescribed lithium (n = 2148, valproate (n = 1670, olanzapine (n = 1477, or quetiapine (n = 1376 as maintenance mood stabilizer treatment. Adverse outcomes were chronic kidney disease, thyroid disease, hypercalcemia, weight gain, hypertension, type 2 diabetes mellitus, cardiovascular disease, and hepatotoxicity. The propensity score included important demographic, physical health, and mental health predictors of drug treatment allocation. The median duration of drug treatment was 1.48 y (interquartile range 0.64-3.43. Compared to patients prescribed lithium, those taking valproate, olanzapine, and quetiapine had reduced rates of chronic kidney disease stage 3 or more severe, following adjustment for propensity score, age, and calendar year, and accounting for clustering by primary care practice (valproate hazard ratio [HR] 0.56; 95% confidence interval [CI] 0.45-0.69; p < 0.001, olanzapine HR 0.57; 95% CI 0.45-0.71; p < 0.001, quetiapine HR 0.62; 95% CI 0.47-0.80; p < 0.001. Hypothyroidism was reduced in those taking valproate (HR 0.60; 95% CI 0.40-0.89; p = 0.012 and olanzapine (HR 0.48; 95% CI 0.29-0.77; p = 0.003, compared to those taking lithium. Rates of new onset hyperthyroidism (valproate HR 0.24; 95% CI 0.09-0.61; p = 0.003, olanzapine HR 0.31; 95% CI 0.13-0.73; p = 0.007 and hypercalcemia (valproate HR 0.25; 95% CI 0.10-0.60; p = 0.002, olanzapine HR 0.32; 95% CI 0.14-0.76; p = 0.008, quetiapine HR 0.23; 95% CI 0.07-0.73; p = 0.013 were also reduced relative

  10. Incidence of extrapyramidal symptoms and tardive dyskinesia in schizophrenia: thirty-six-month results from the European schizophrenia outpatient health outcomes study.

    Science.gov (United States)

    Novick, Diego; Haro, Josep Maria; Bertsch, Jordan; Haddad, Peter M

    2010-10-01

    The incidence of treatment-emergent extrapyramidal symptoms (EPSs) and tardive dyskinesia (TD) in schizophrenic patients, and the clinical characteristics associated with an increased risk of developing EPSs and TD were examined. Patients (N = 7728) in the 3-year, prospective, observational Schizophrenia Outpatient Health Outcomes study were examined according to baseline antipsychotic drug exposure. At baseline, 4893 patients (63.3%) had no EPS, and 6921 (89.6%) had no TD. Extrapyramidal symptoms and TD were assessed separately during follow-up: frequency and time to appearance from Kaplan-Meier survival curves and factors associated with time to appearance using Cox proportional hazard regression models. The cumulative incidence of EPS ranged from 7.7% (olanzapine) to 32.8% (depot typical drugs). Compared with olanzapine, patients taking depot typical drugs, oral typical drugs, risperidone, and amisulpride had a significantly higher risk of developing EPS. Differences from clozapine were marginally significant. High baseline clinical severity was associated with a significantly higher risk of developing EPS. The incidence of TD ranged from 2.8% (olanzapine) to 11.1% (depot typical agent). Compared with olanzapine, patients taking depot typical agents, oral typical agents, and risperidone had a significantly higher risk of developing TD. Baseline factors associated with a significantly higher risk of developing TD were age, EPS, a higher negative Clinical Global Impression score, and presence of gynecomastia. In summary, patients treated with typical antipsychotic agents (oral and depot) and risperidone had a higher risk of developing EPS and TD than patients treated with olanzapine. Higher baseline clinical severity was associated with EPS development, whereas age, presence of EPS, a higher negative Clinical Global Impression score, and presence of gynecomastia were associated with TD development.

  11. Treatments for acute bipolar depression: meta-analyses of placebo-controlled, monotherapy trials of anticonvulsants, lithium and antipsychotics.

    Science.gov (United States)

    Selle, V; Schalkwijk, S; Vázquez, G H; Baldessarini, R J

    2014-03-01

    Optimal treatments for bipolar depression, and the relative value of specific drugs for that purpose, remain uncertain, including agents other than antidepressants. We searched for reports of placebo-controlled, monotherapy trials of mood-stabilizing anticonvulsants, second-generation antipsychotics, or lithium for acute major depressive episodes in patients diagnosed with type I or II bipolar disorder and applied random-effects meta-analysis to evaluate their efficacy, comparing outcomes based on standardized mean drug-placebo differences (SMD) in improvement, relative response rates (RR), and number-needed-to-treat (NNT). We identified 24 trials of 10 treatments (lasting 7.5 weeks, with ≥ 50 collaborating sites/trial) that met eligibility criteria: lamotrigine (5 trials), quetiapine (5), valproate (4), 2 each for aripiprazole, olanzapine, ziprasidone, and 1 each for carbamazepine, lithium, lurasidone, and olanzapine-fluoxetine. Overall, pooled drug-over-placebo responder-rate superiority (RR) was moderate (29% [CI: 19-40%]), and NNT was 8.2 (CI: 6.4-11). By SMD, apparent efficacy ranked: olanzapine + fluoxetine ≥ valproate > quetiapine > lurasidone > olanzapine, aripiprazole, and carbamazepine; ziprasidone was ineffective, and lithium remains inadequately studied. Notably, drugs were superior to placebo in only 11/24 trials (5/5 with quetiapine, 2/4 with valproate), and only lamotrigine, quetiapine and valproate had > 2 trials. Treatment-associated mania-like reactions were uncommon (drugs: 3.7%; placebo: 4.7%). Controlled trials of non-antidepressant treatments for bipolar depression remain scarce, but findings with olanzapine-fluoxetine, lurasidone, quetiapine, and perhaps carbamazepine and valproate were encouraging; lithium requires adequate testing. © Georg Thieme Verlag KG Stuttgart · New York.

  12. 2 967 cases of hospitalized children with hepatitis B vaccine based immune level of immunity after investiga-tion and analysis%乙型肝炎疫苗基础免疫后儿童2967例的免疫水平调查分析

    Institute of Scientific and Technical Information of China (English)

    刘贞君; 丁德和

    2014-01-01

    Objective To understand the protective effects of children after hepatitis B vaccine immunization since 1992,when the hepatitis B vaccine into childhood immunization strategy .Methods Hospitalized children from venous blood,using enzyme-linked immunosorbent assay(ELISA),to investigate and analyze the immune status based hepatitis B immune of hospitalized children (Infection,Pediatric),by five indicators of hepatitis B as the judgment standard.Results The total anti-HBs-positive rate was 55.05%,including infection anti-HBs-positive rate 52.18%, the pediatric anti-HBs-positive rate 55.92%.Male anti-HBs positive rate was 54.17%,the female anti-HBs positive rate was 56.6%,there was no statistical significance among departments and sexs (P>0.05).Conclusion Hepatitis B vaccination is the effective control means for hepatitis B ,however,the anti-HBs positive rate is low in this region after hepatitis B vaccine immunization ,needed to reseed .%目的:调查分析乙型肝炎疫苗基础免疫后所取得的保护效果。方法对2967例住院患儿静脉血,使用酶联免疫吸附试验,以乙型肝炎五项指标检测为判断标准,分析其乙型肝炎疫苗基础免疫后的免疫状态。结果患儿总体抗-HBs 阳性率55.05%,其中感染科抗-HBs 阳性率52.18%,儿科抗-HBs 阳性率55.92%;男性抗-HBs阳性率54.17%,女性抗-HBs阳性率56.6%;抗-HBs阳性率在科室和性别间差异均无统计学意义(χ2=2.99、0.51,均P>0.05)。结论乙型肝炎疫苗基础免疫为行之有效的控制乙型肝炎的手段,但抗-HBs阳性率偏低,需进行补种。

  13. Analisi farmacoeconomica del trattamento di pazienti psicotici cronici con olanzapina, antipsicotici atipici e neurolettici tipici: uno studio regionale

    Directory of Open Access Journals (Sweden)

    Felice Vadruccio

    2005-06-01

    Full Text Available BACKGROUND: Psychotic disorders are a ravaging and costly mental illness. Treatment of these disorders involves pharmacological and non pharmacological resources. Pharmacological therapy with antipsychotic drugs contribute strongly to relieve psychotic patients symptoms. By the end of 90’s the new atypical antipsychotic have been introduced. This kind of drugs is supposed to be more effective but also more expensive compared with the old typical neuroleptics. OBJECTIVE: To compare costs and outcomes associated with 12 months treatment of psychotic disorders using typical and atypical antipsychotics in addition to psychiatric services. Moreover to extend the same comparison among the atypical drugs currently used in the clinical practice (olanzapine, risperidone, quetiapine and clozapine. METHODS AND PATIENTS: A multicentre observational study was carried out in 131 patients affected by psychotic disorders (schizophrenia and bipolar. Data were collected with reference to patients followed by several Psychiatric Services of Regione Puglia (Italy. Patients were classified in five groups (typical neuroleptics, olanzapine, risperidone, quetiapine and clozapine according to their main antipsychotic therapy. Treatment outcomes had been assessed during 12 months of observation considering the patients improvement in their work and social functioning. For these patients we analyzed pharmacological, non pharmacological (medical/ nurse visits, social assistance, rehabilitative sessions and hospital interventions, choosing the perspective of the Italian Mental Health Centers for costs attribution. Moreover indirect costs (caregiver and private assistance to the patient had been evaluated for each group of treatment. The study is based on the observation of real clinical behaviours; therefore patients are not randomised to different treatments. RESULTS: The analysis of treatment outcomes didn’t generate significant differences among the groups despite a

  14. [Clozapine for the treatment of psychosis in 3 elderly patients with Parkinson's disease].

    Science.gov (United States)

    Diraoui, S; van Melick, E J M; Jansen, P A F

    2004-11-27

    Three patients with Parkinson's disease developed psychosis. None of the three showed any other somatic cause for the psychosis except the Parkinson's disease. The first patient, a 73-year-old male, was initially treated with olanzapine and rivastigmine, without any effect. While treating the second patient, a 75-year-old male who had been suffering from Parkinson's disease for years, the Parkinson medication was first reduced and later on olanzapine and rivastigmine were prescribed, without a lasting effect on the psychotic symptoms. In the third patient, an 85-year-old male, medication reduction was unsuccessful. Finally, all three were treated effectively with clozapine. Psychosis in Parkinson's disease is a serious disorder that is often difficult to treat. In most cases, antipsychotic medication is needed. The atypical antipsychotic clozapine is effective without aggravation of the motor symptoms. Despite the side effects, such as the risk of agranulocytosis, drowsiness and weight gain, clozapine should be considered as a possible treatment.

  15. Measuring treatment response in psychotic depression

    DEFF Research Database (Denmark)

    Østergaard, Søren Dinesen; Meyers, Barnett S; Flint, Alastair J

    2014-01-01

    BACKGROUND: There is no established psychometric instrument dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to investigate whether a new composite rating scale, the Psychotic Depression Assessment Scale (PDAS), covering both the psychotic...... and the depressive domains of PD, could detect differences in effect between two psychopharmacological treatment regimens. METHODS: We reanalyzed the data from the Study of Pharmacotherapy of Psychotic Depression (STOP-PD), which compared the effect of Olanzapine+Sertraline (n=129) versus Olanzapine+Placebo (n=130......). The response to the two regimens was compared using both a mixed effects model and effect size statistics on the total scores of three rating scales: the 17-item Hamilton Depression Rating Scale (HAM-D17), its 6-item melancholia subscale (HAM-D6), and the 11-item PDAS consisting of the HAM-D6 plus five items...

  16. 2016 updated MASCC/ESMO consensus recommendations

    DEFF Research Database (Denmark)

    Einhorn, Lawrence H; Rapoport, Bernardo; Navari, Rudolph M;

    2017-01-01

    PURPOSE: This review summarizes the recommendations for the prophylaxis of acute and delayed nausea and vomiting induced by multiple-day chemotherapy, high-dose chemotherapy, and breakthrough nausea and vomiting as agreed at the MASCC/ESMO Antiemetic Guidelines update meeting in Copenhagen in June......-induced nausea and vomiting, a phase III randomized trial investigating the use of olanzapine versus metoclopramide in patients receiving highly emetogenic chemotherapy and a second single arm study looking at the effectiveness of olanzapine were identified. CONCLUSIONS: It was concluded that for patients...... receiving high-dose chemotherapy with stem cell transplant, a combination of a 5-HT3 receptor antagonist with dexamethasone and aprepitant (125 mg orally on day 1 and 80 mg orally on days 2 to 4) is recommended before chemotherapy. For patients undergoing multiple-day chemotherapy-induced nausea...

  17. A schizophrenic patient with cerebral infarctions after hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    Youichi Yanagawa

    2013-01-01

    Full Text Available We herein report the fourth case of cerebral infarction, concomitant with hemorrhagic shock, in English literature. A 33-year-old male, who had been diagnosed with schizophrenia and given a prescription for Olanzapine, was discovered with multiple self-inflicted bleeding cuts on his wrist. On arrival, he was in hemorrhagic shock without verbal responsiveness, but his vital signs were normalized following infusion of Lactate Ringer′s solution. The neuroradiological studies revealed multiple cerebral ischemic lesions without any vascular abnormality. He was diagnosed with speech apraxia, motor aphasia, and dysgraphia, due to multiple cerebral infarctions. As there was no obvious causative factor with regard to the occurrence of cerebral infarction in the patient, the hypoperfusion due to hemorrhagic shock, and the thromboembolic tendency due to Olanzapine, might have acted together to lead to the patient′s cerebral ischemia.

  18. Pharmacological interventions for borderline personality disorder

    Science.gov (United States)

    Stoffers, Jutta; Völlm, Birgit A; Rücker, Gerta; Timmer, Antje; Huband, Nick; Lieb, Klaus

    2014-01-01

    Background Drugs are widely used in borderline personality disorder (BPD) treatment, chosen because of properties known from other psychiatric disorders (“off-label use”), mostly targeting affective or impulsive symptom clusters. Objectives To assess the effects of drug treatment in BPD patients. Search methods We searched bibliographic databases according to the Cochrane Developmental, Psychosocial and Learning Problems Group strategy up to September 2009, reference lists of articles, and contacted researchers in the field. Selection criteria Randomised studies comparing drug versus placebo, or drug versus drug(s) in BPD patients. Outcomes included total BPD severity, distinct BPD symptom facets according to DSM-IV criteria, associated psychopathology not specific to BPD, attrition and adverse effects. Data collection and analysis Two authors selected trials, assessed quality and extracted data, independently. Main results Twenty-eight trials involving a total of 1742 trial participants were included. First-generation antipsychotics (flupenthixol decanoate, haloperidol, thiothixene); second-generation antipsychotics (aripirazole, olanzapine, ziprasidone), mood stabilisers (carbamazepine, valproate semisodium, lamotrigine, topiramate), antidepressants (amitriptyline, fluoxetine, fluvoxamine, phenelzine sulfate, mianserin), and dietary supplementation (omega-3 fatty acid) were tested. First-generation antipsychotics were subject to older trials, whereas recent studies focussed on second-generation antipsychotics and mood stabilisers. Data were sparse for individual comparisons, indicating marginal effects for first-generation antipsychotics and antidepressants. The findings were suggestive in supporting the use of second-generation antipsychotics, mood stabilisers, and omega-3 fatty acids, but require replication, since most effect estimates were based on single studies. The long-term use of these drugs has not been assessed. Adverse event data were scarce

  19. Treatment of refractory catatonic schizophrenia with low dose aripiprazole

    Directory of Open Access Journals (Sweden)

    Sasaki Tsuyoshi

    2012-05-01

    Full Text Available Abstract This case is of 54-year-old female with catatonic schizophrenia, characterized by treatment resistance to the pharmacotherapy with olanzapine, risperidone, flunitrazepam, and ECT. Olanzapine and risperidone and flunitrazepam did not improve her catatonic and psychotic symptoms, and induced the extrapyramidal symptoms. The effects of ECT did not continue even for a month. However, the treatment with low-dose aripiprazole dramatically improved the patient’s psychotic symptoms and extrapyramidal symptoms. The mechanisms underlying the effects of low-dose aripiprazole in this case remain unclear, but unlike other antipsychotics, aripiprazole is a dopamine D2 partial agonist. In this regard, our results suggest that aripiprazole has numerous advantages, especially in cases of stuporous catatonia and a defective general status.

  20. Switch to quetiapine in antipsychotic agent-related hyperprolactinemia.

    Science.gov (United States)

    Keller, R; Mongini, F

    2002-12-01

    Novel antipsychotics (clozapine, risperidone, olanzapine, quetiapine) are effective in treating psychotic symptoms, also in neurological disease. Hyperprolactinemia is a side effect related to antipsychotics that can cause galactorrhea, gynecomastia, amenorrhea, anovulation, impaired spermatogenesis, decreased libido and sexual arousal, impotence, and anorgasmia, consequent to removal of tonic dopaminergic inhibition of prolactin secretion via hypothalamic dopaminergic receptor blockade in the tuberoinfundibolar tract. Hyperprolactinemia occurs more frequently during treatment with risperidone and olanzapine compared with clozapine and quetiapine. The therapeutic algorithm to antipsychotic-relatedhyperprolactinemia is the following: reduction in antipsychotic dose, addition of cabergoline, bromocriptine, amantadine, and/or switch to another antipsychotic. We propose switching to quetiapine in symptomatic hyperprolactinemia related to antipsychotics and describe five cases.

  1. Il trattamento dei disturbi psicotici con olanzapina, risperidone e neurolettici tipici: una valutazione comparativa di costo/efficacia in una realtà psichiatrica locale

    Directory of Open Access Journals (Sweden)

    Egidio Filippelli

    2005-09-01

    Full Text Available BACKGROUND: Several clinical trials demonstrated that atypical antipsychotics are more effective but also more expensive (as drug cost compared with the typical neuroleptics by treating psychotic disorders. The present study aimed to evaluate this result using an observational approach which better reflects the real clinical practice. OBJECTIVE: To evaluate clinical effectiveness (including work and social functioning and overall direct costs in a group of patients affected by psychotic disorders (schizophrenia and bipolar and treated with typical and atypical (olanzapine and risperidone antipsychotics. METHODS: With a multicentre observational design - two years long - 89 patients (in charge by Psychiatric Centers of Regione Campania - Italy were assessed using CGI (Clinical Global Impression and GAF (Global Assessment of Functioning scales. Moreover economic data were collected with reference to pharmacological and non-pharmacological (hospitalization, medical/nurse visits, etc. resources consumption. The pharmacoeconomic analysis were conducted choosing the perspective of the local Psychiatric Services for costs attribution. RESULTS: Considering the treatment outcomes, the use of the atypical drugs provided better performances with reference to the patients quality of life. The results in terms of work and social functioning indicated an advantage in the olanzapine group of patients. Overall direct costs of treatment (drugs and healthcare resources didn’t generate significant differences among the groups of therapy despite the pharmacological cost evidentiated an economic advantage (p<0,05 in the typical group due to the cheaper cost of these drugs. The use of olanzapine was associated to a lower number of hospitalizations and showed a general reduction (- 16% of total treatment costs between 1st and 2nd year of observation. CONCLUSIONS: The lack of side effects, the improvement in work and social functioning, associated to a more efficient

  2. Differential RNA expression between schizophrenic patients and controls of the dystrobrevin binding protein 1 and neuregulin 1 genes in immortalized lymphocytes.

    Science.gov (United States)

    Chagnon, Y C; Roy, M-A; Bureau, A; Mérette, C; Maziade, M

    2008-03-01

    The dystrobrevin binding protein 1 (DTNBP1) and neuregulin 1 (NRG1) genes have been related to schizophrenia (SZ) and bipolar disorder (BP) by several whole-genome linkage and associations studies. Few expression studies in post-mortem brains have also reported a lower or a higher expression of DTNBP1 and NRG1, respectively, in SZ. Since the difficulty to access post-mortem brains, we evaluated RNA expression of DTNBP1 and NRG1 in immortalized lymphocytes of SZ patients and unrelated-family controls. An antipsychotic stimulation was also used to challenge the genetic background of the subjects and enhance differential expression. Immortalized lymphocytes of twelve SZ and twelve controls were grown individually in the presence or not of the antipsychotic olanzapine (Zyprexa; EliLilly). RNA was extracted and pooled in four groups of three SZ and four groups of three controls, and used to probe Agilent 18K microchips. Mean gene expression values were contrasted between SZ and control groups using a T-test. For DTNBP1, RNA expression was lower in SZ than in controls before (-28%; p=0.02) and after (-30%; p=0.01) olanzapine stimulation. Similarly, NRG1 GGF2 isoform showed a lower expression in SZ before (-29%; p=0.04) and after (-33%; p=0.02) olanzapine stimulation. In contrast, NRG1 GGF isoform showed no significant difference between SZ and controls (-7%; p=0.61, +3%; p=0.86, respectively), but was slightly repressed by olanzapine in controls (-8%; p=0.008) but not in SZ (+1%; p=0.91). These results are in agreement with those observed in post-mortem brain when the isoforms involved are considered.

  3. REPEATED CONFUSIONAL STATES FOLLOWING DISCONTINUATION OF PROXETINE IN A 51-YEAR-OLD WOMEN SUFFERING FROM PSYCHOTIC DEPRESSION

    Directory of Open Access Journals (Sweden)

    Horst J. Koch

    2015-09-01

    Full Text Available A 51-year-old women suffering from depression with psychotic symptoms including a history of meningitis and epilepsy since childhood was treated with paroxetine, olanzapine and lamotrigine for years. In the periods she interrupted paroxetine administration, she developed each time a confusional state requiring intensive psychiatric care. She recovered in a few days after re-administration of paroxetine. Clinicians should be aware of severe withdrawal reactions after discontinuation of SSRI, particularly in patients with neurological history.

  4. Switching to aripiprazole for the treatment of residual mutism resulted in distinct clinical courses in two catatonic schizophrenia cases

    OpenAIRE

    Katsumasa Muneoka; Nobuhisa Kanahara; Shou Kimura

    2017-01-01

    Objectives: The efficacy of a partial agonist for the dopamine D2 receptor, aripiprazole, for catatonia in schizophrenia has been reported. Methods: We report distinct clinical courses in challenging aripiprazole to treat residual mutism after severe catatonic symptoms improved. Results: In the first case, mutism was successfully treated when the patient was switched from olanzapine to aripiprazole. In contract, switching to aripiprazole from risperidone aggravated auditory hallucinations in ...

  5. Psychosis and Silent Celiac Disease in a Down Syndrome Adolescent: A Case Report

    Directory of Open Access Journals (Sweden)

    Amparo Morant

    2011-01-01

    Full Text Available Celiac disease is an autoimmune systemic disorder. It presents gastrointestinal and nongastrointestinal manifestations as well as associated conditions. We report a 16-year-old Down syndrome girl who presented psychosis symptomatology, and she was diagnosed as having silent celiac disease. Olanzapine treatment and gluten-free diet were satisfactory. It is necessary to consider celiac disease in Down syndrome patients with psychiatric symptoms, mainly psychotic symptomatology.

  6. The orexin-1 receptor antagonist SB-334867 blocks the effects of antipsychotics on the activity of A9 and A10 dopamine neurons: implications for antipsychotic therapy.

    Science.gov (United States)

    Rasmussen, Kurt; Hsu, Mei-Ann; Yang, Yili

    2007-04-01

    Antipsychotic drugs alter the activity of dopamine neurons in the ventral tegmental area (A10) and substantia nigra pars compacta (A9). As there is a dense projection of orexin neurons from the lateral hypothalamus to A10 dopaminergic neurons, and some antipsychotics have been shown to increase the expression of c-fos in orexin-containing cells in the hypothalamus, we hypothesized that stimulation of orexin receptors plays a role in the effects of antipsychotics on the activity of A9 and A10 dopamine cells. Single-unit recordings in anesthetized rats demonstrated the central effects of the selective orexin-1 receptor antagonist SB-334867 (2 mg/kg, intravenous), as it reversed the excitatory effects of orexin-A administration (6 microg, intracerebroventricular) on the activity of locus coeruleus (LC) cells. Recordings from midbrain dopamine neurons showed that acute administration of SB-334867 alone did not alter the number of spontaneously active A9 or A10 cells, but did reverse: (1) the increase in the number of spontaneously active A9 and/or A10 dopamine cells caused by the acute administration of haloperidol (1 mg/kg, subcutaneous) or olanzapine (10 mg/kg, s.c.) and (2) the decrease in the number of spontaneously active A9 and/or A10 dopamine cells caused by the chronic administration of haloperidol (1 mg/kg/day x 21 days, s.c.) or olanzapine (10 mg/kg/day x 21 days, s.c.). However, SB-334867 did not block a different electrophysiological effect of olanzapine, as it did not block the olanzapine-induced activation of LC cells. These results indicate that activation of orexin-1 receptors plays an important role on the effects of antipsychotic drugs on dopamine neuronal activity and may play an important role in the clinical effects of antipsychotic drugs.

  7. L’impatto farmacoeconomico del trattamento della schizofrenia con antipsicotici tipici ed atipici: l’esperienza di un DSM della Regione Sicilia

    Directory of Open Access Journals (Sweden)

    Tommaso Federico

    2005-12-01

    Full Text Available Il presente lavoro è stato realizzato con il patrocinio del Dipartimento Ispettorato Regionale Sanitario dell.Assessorato per la Sanità della Regione Sicilia, nella persona del Dirigente Generale Dott. Saverio Ciriminna BACKGROUND: The comparatively high acquisition costs of the new antipsychotic drugs have induced the mental health community to look closely at their potential benefits. OBJECTIVE: To compare the clinical and economic outcomes associated with olanzapine, risperidone and typical neuroleptics treatment for schizophrenia. METHODS:Amulticenter, observational, two-years long, retrospective and prospective study was conducted with 229 psychotic patients (in charge by psychiatric Centers of Regione Sicilia - Italy. Clinical outcomes were assessed using changes in CGI (Clinical Global Impression and PANSS (Positive and Negative Syndrome Scale scores. The economic data collection included pharmacological and non-pharmacological resources consumption (hospitalizations, medical/nurse visits, etc.. The economic evaluation was conducted in the perspective of the Local Psychiatric Services. RESULTS: The results in terms of clinical performance indicated an advantage (statistically significant in the olanzapine group of patients. The pharmacological costs were significantly lower (p0,05. Treatment with olanzapine was associated with a lower non-pharmacological resources consumption and showed a general reduction (p<0,05 vs. risperidone of total treatment costs between 1st and 2nd year of observation. CONCLUSIONS:Within the context of the local health care Services, olanzapine appears to be the “dominant” therapeutic option compared with risperidone and typical neuroleptics. Treatment with risperidone appears to be “cost-neutral” compared with typical neuroleptics.

  8. Detecting Potential Adverse Reactions of Sulpiride in Schizophrenic Patients by Prescription Sequence Symmetry Analysis

    OpenAIRE

    2014-01-01

    PURPOSE: Previous studies have demonstrated sulpiride to be significantly more effective than haloperidol, risperidone and olanzapine in schizophrenic treatment; however, only limited information is available on the potential risks associated with sulpiride treatment. This study attempts to provide information on the potential risks of sulpiride treatment of schizophrenia, especially with regard to unexpected adverse effects. MATERIALS AND METHODS: Patients with schizophrenia aged 18 and olde...

  9. Effectiveness of Sulpiride in Adult Patients With Schizophrenia

    OpenAIRE

    2012-01-01

    The objective of this study is to compare the effectiveness among sulpiride, risperidone, olanzapine, and haloperidol by evaluating the persistence of drug use. A retrospective cohort study was conducted by analyzing the National Health Insurance Research Database of Taiwan. Patients with schizophrenia aged 18–65 years and newly prescribed with a single oral antipsychotic medication between years 2003 and 2008 were included. The primary outcome was the persistence of antipsychotic agents by c...

  10. A Case of Very-late-onset Schizophrenia-like Psychosis

    OpenAIRE

    Son, Ji Hyun; Kee, Baik Seok

    2011-01-01

    This paper presents the case of a 67-year-old woman who visited the Psychiatry Department complaining of persecutory ideas and auditory hallucinations after a buccal cancer operation. On neuropsychological testing, she demonstrated paranoid psychosis and bizarre thoughts. Hospital admission was recommended for supportive care and treatment with antipsychotics. She was initially treated with olanzapine, but this medication had little effect and was replaced with amisulpride, which reduced the ...

  11. Second generation antipsychotic-induced obsessive-compulsive symptoms in schizophrenia: a review of the experimental literature.

    Science.gov (United States)

    Fonseka, Trehani M; Richter, Margaret A; Müller, Daniel J

    2014-11-01

    Second generation antipsychotics (SGAs) have been implicated in the de novo emergence and exacerbation of obsessive-compulsive symptoms (OCS) in patients with schizophrenia. Among SGAs, clozapine, olanzapine, and risperidone are the most prominent agents associated with these sequelae, according to case reports. Comorbid OCS can impede recovery by compromising treatment benefits, medication compliance, and clinical prognoses. Previous reviews of SGA-induced OCS have predominantly focused on descriptive case reports, with limited attention paid toward experimental findings. To address this paucity of data, we sought to review the effects of SGAs on OCS in schizophrenia in the experimental literature, while addressing the role of different treatment (duration, dose, serum levels) and pharmacogenetic factors. Our findings suggest that clozapine confers the greatest risk of OCS in schizophrenia, with 20 to 28% of clozapine-treated patients experiencing de novo OCS, in addition to 10 to 18% incurring an exacerbation of pre-existing OCS. Clozapine can also yield full threshold obsessive-compulsive disorder (OCD), in some cases. Olanzapine is another high risk drug for secondary OCS which occurs in 11 to 20% of schizophrenic patients receiving olanzapine therapy. At this time, there is insufficient experimental evidence to characterize the effects of other SGAs on OCS. Despite some experimental support for the involvement of longer treatment duration and genetic factors in mediating drug-induced OCS, more research is needed to clearly elucidate these associations. Based on these results, schizophrenic patients should be routinely monitored for OCS throughout the course of SGA treatment, particularly when clozapine or olanzapine is administered.

  12. A case of catatonia in a 14-year-old girl with schizophrenia treated with electroconvulsive therapy.

    Science.gov (United States)

    Häßler, Frank; Reis, Olaf; Weirich, Steffen; Höppner, Jacqueline; Pohl, Birgit; Buchmann, Johannes

    2013-01-01

    This article presents a case of a 14-year-old female twin with schizophrenia who developed severe catatonia following treatment with olanzapine. Under a combined treatment with amantadine, electroconvulsive therapy (ECT), and (currently) ziprasidone alone she improved markedly. Severity and course of catatonia including treatment response were evaluated with the Bush-Francis Catatonia Rating Scale (BFCRS). This case report emphasizes the benefit of ECT in the treatment of catatonic symptoms in an adolescent patient with schizophrenic illness.

  13. Diabetes mellitus and impaired glucose tolerance in patients with schizophrenia, before and after antipsychotic treatment

    Directory of Open Access Journals (Sweden)

    Rayees Ahmad Wani

    2015-01-01

    Full Text Available Background: Treatment with antipsychotics increases the risk of developing diabetes in patients of schizophrenia but this diabetogenic potential of different antipsychotics seems to be different. Moreover, there may be an independent link between schizophrenia and diabetes. So we plan to study the prevalence of glucose dysregulation in patients of schizophrenia before and after treatment with various antipsychotics. Materials and Methods: Fifty patients (32 males and 18 females diagnosed with schizophrenia were evaluated for glucose dysregulation using oral glucose tolerance test, initially (drug naive and after antipsychotic treatment. Age- and sex-matched healthy volunteer group of 50 subjects (35 males and 15 females was taken for comparison. Results were interpreted using American Diabetic Association criteria. Results: Though the glycemic status of the patient group was comparable with healthy controls initially but antipsychotic treatment was associated with glucose dysregulation. For first 6 weeks the antipsychotic (olanzapine, risperidone, haloperidol and aripiprazole-induced glucose dysregulation was comparable, which was seen to be maximum with the olanzapine-treated group at the end of this study, 14 weeks. Conclusion: We conclude that antipsychotic treatment of nondiabetic drug naive schizophrenia patients was associated with adverse effects on glucose regulation. For initial 6 weeks the antipsychotic-induced glucose dysregulation was comparable, which was seen to be maximum with olanzapine at the end of study, i.e. 14 weeks. Keeping this at the back of mind we can stabilize a patient initially with a more effective drug, olanzapine, and later on shift to one with less metabolic side effects.

  14. Antipsychotic medication in children and adolescents: a descriptive review of the effects on prolactin level and associated side effects.

    OpenAIRE

    Roke, Y.; van Harten, P. N.; Boot, A M; Buitelaar, J K

    2009-01-01

    OBJECTIVE: This review reports the incidence of hyperprolactinemia, its relationship with genotype, and prolactin-related side effects in children and adolescents treated with antipsychotics. METHOD: Data on prolactin levels were available for haloperidol, pimozide, risperidone, olanzapine, clozapine, ziprasidone, and quetiapine. Twenty-nine studies were selected after a literature search in the English Medline/Embase/Psychinfo/EBM databases (1965 to August, 2008). RESULTS: All antipsychotics...

  15. 氨磺必利与奥氮平治疗女性精神分裂症患者的对照研究

    Institute of Scientific and Technical Information of China (English)

    张大文; 曹青; 黄月花; 童容容

    2015-01-01

    Objective To compare the clinical effi cacy and safety of Amisulpride with olanzapine in the treatment of female schizophenia. Methods 100 cases with female schizophrenia were divided randomly into two groups, by single blind contrast. Each group with 50 cases, compare the use of Amisulpride with olanzapine in the treatment for 8 weeks. Positive and Negative syndrome scale (PANSS) was used to assess the effi cacy, side effects scale(TESS) was used to assess adverse reactions.Results After 8 weeks of treatment, amisulpride group and olanzapine group markedly effective rate were 72% and 70%, had no signifi cant difference between the two groups ; after 4 weeks treatment amisulpride group negative scores than olanzapine group decreased signifi cantly (P0.05);但治疗4周末氨磺必利组阴性症状分较奥氮平组减少更显著(P<0.05).而氨磺必利和奥氮平组的不良反应发生率分别为38.3%和45.8%,差异无统计学意义,但奥氮平组嗜睡和体质量增加指标显著高于氨磺必利组,差异具有统计学意义(P<0.05),其他不良反应发生率差异无统计学意义.结论 氨磺必利是一种安全有效的抗精神病药,较适合女性精神分裂症患者的临床治疗.

  16. Comparative efficacy and safety of antipsychotics in the treatment of schizophrenia: a network meta-analysis in a Japanese population.

    Science.gov (United States)

    Kishi, Taro; Ikuta, Toshikazu; Matsunaga, Shinji; Matsuda, Yuki; Oya, Kazuto; Iwata, Nakao

    2017-01-01

    The relative efficacy and tolerability of antipsychotics for schizophrenia are considerably well studied. This study aimed to examine whether previous findings could be replicated in a genetically distinct and homogenous group (ie, Japanese patients with schizophrenia) and whether previous findings could be extended to a broader range of antipsychotics with previously unclear relative efficacy and tolerability. Bayesian network meta-analysis was performed in which randomized trials comparing any of the following interventions were included: second-generation antipsychotics, haloperidol, or placebo. The primary outcomes for efficacy and acceptability were the response rate and all-cause discontinuation. The secondary outcomes included the improvement of Positive and Negative Syndrome Scale scores, discontinuation because of adverse events, and individual adverse events. Eighteen relevant studies were identified (total n=3,446; aripiprazole =267, blonanserin =285, clozapine =47, clocapramine =295, haloperidol =857, mosapramine =493, olanzapine =179, paliperidone =136, perospirone =146, placebo =138, quetiapine =212, and risperidone =338; mean study duration =8.33±1.41 weeks). In primary outcomes, olanzapine and paliperidone showed efficacy than placebo, and olanzapine and paliperidone showed superior acceptability compared with placebo. There were differences in the incidences of individual adverse events (the best antipsychotic: extrapyramidal symptoms = olanzapine, hyperprolactinemia- related symptoms = quetiapine, sedation = paliperidone, and weight change = blonanserin) among antipsychotics. Although the current analysis exclusively included Japanese patients with schizophrenia, no remarkable differences were observed in efficacy and safety compared with previous meta-analyses. Diverse hierarchies in safety outcomes also support the implication that individual risk expectations for adverse events can guide clinical decisions. However, the sample size was

  17. Danish register-based study on the association between specific antipsychotic drugs and fractures in elderly individuals