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Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms: results of a multicenter, collaborative trial in Latin America.
J Clin Psychopharmacol. 2001 Aug; 21(4):375-81.JC

Abstract

Conventional antipsychotic agents can induce extrapyramidal symptoms (EPS) that may be alleviated by switching patients to novel agents such as olanzapine. Patients with schizophrenia and related disorders (ICD-10) who were taking haloperidol (N = 94; mean dose = 12.7 mg/day) and had EPS (Simpson-Angus Scale [SAS] > 3) were directly switched to 6 weeks of open-label olanzapine treatment (mean dose = 11.4 mg/day). There were significant mean improvements (p <0.001 for all measurements) from baseline to endpoint on the SAS (-9.69+/-5.33; percentage change, 87.2%), the Barnes Akathisia Scale (-1.00+/-1.19; percentage change, 82.5%), and the Abnormal Involuntary Movement Scale (-1.48+/-2.89; percentage change, 81.1%), and anticholinergic use decreased from 47.9% to 12.8% (mean baseline to endpoint change: -1.52+/-1.91-mg equivalents of benztropine; p < 0.001). Significant mean baseline to endpoint improvements (p < 0.001 for all measurements) were observed on the Positive and Negative Syndrome Scale (PANSS; -25.28+/-18.67; percentage change, 30.3%), the PANSS-extracted Brief Psychiatric Rating Scale (0-6 scale, -13.41+/-10.16; percentage change, 54.4%), and the Clinical Global Impressions Severity scale (-1.16+/-1.19; percentage change, 26.4%). Spontaneously reported treatment- emergent adverse events with a greater than 5% incidence were somnolence (16.0%), increased appetite (14.9%), weight gain (11.7%), headache (8.5%), anxiety (7.4%), dizziness (6.4%), and insomnia (5.3%). Criteria for a successful switch were met by 90.5% of patients. Psychotic symptom exacerbation was experienced by 30.9% of patients at any time during the study and by 11.7% of patients at endpoint. Results suggest that a direct switch to olanzapine is a therapeutic option when patients with haloperidol-induced EPS are unable to tolerate a more gradual switch.

Authors+Show Affiliations

Santa Casa de Misericórdia, Rio de Janeiro, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11476121

Citation

Costa e Silva, J A., et al. "Olanzapine as Alternative Therapy for Patients With Haloperidol-induced Extrapyramidal Symptoms: Results of a Multicenter, Collaborative Trial in Latin America." Journal of Clinical Psychopharmacology, vol. 21, no. 4, 2001, pp. 375-81.
Costa e Silva JA, Alvarez N, Mazzotti G, et al. Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms: results of a multicenter, collaborative trial in Latin America. J Clin Psychopharmacol. 2001;21(4):375-81.
Costa e Silva, J. A., Alvarez, N., Mazzotti, G., Gattaz, W. F., Ospina, J., Larach, V., Starkstein, S., Oliva, D., Cousins, L., Tohen, M., Taylor, C. C., Wang, J., & Tran, P. V. (2001). Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms: results of a multicenter, collaborative trial in Latin America. Journal of Clinical Psychopharmacology, 21(4), 375-81.
Costa e Silva JA, et al. Olanzapine as Alternative Therapy for Patients With Haloperidol-induced Extrapyramidal Symptoms: Results of a Multicenter, Collaborative Trial in Latin America. J Clin Psychopharmacol. 2001;21(4):375-81. PubMed PMID: 11476121.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms: results of a multicenter, collaborative trial in Latin America. AU - Costa e Silva,J A, AU - Alvarez,N, AU - Mazzotti,G, AU - Gattaz,W F, AU - Ospina,J, AU - Larach,V, AU - Starkstein,S, AU - Oliva,D, AU - Cousins,L, AU - Tohen,M, AU - Taylor,C C, AU - Wang,J, AU - Tran,P V, PY - 2001/7/31/pubmed PY - 2002/1/10/medline PY - 2001/7/31/entrez SP - 375 EP - 81 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 21 IS - 4 N2 - Conventional antipsychotic agents can induce extrapyramidal symptoms (EPS) that may be alleviated by switching patients to novel agents such as olanzapine. Patients with schizophrenia and related disorders (ICD-10) who were taking haloperidol (N = 94; mean dose = 12.7 mg/day) and had EPS (Simpson-Angus Scale [SAS] > 3) were directly switched to 6 weeks of open-label olanzapine treatment (mean dose = 11.4 mg/day). There were significant mean improvements (p <0.001 for all measurements) from baseline to endpoint on the SAS (-9.69+/-5.33; percentage change, 87.2%), the Barnes Akathisia Scale (-1.00+/-1.19; percentage change, 82.5%), and the Abnormal Involuntary Movement Scale (-1.48+/-2.89; percentage change, 81.1%), and anticholinergic use decreased from 47.9% to 12.8% (mean baseline to endpoint change: -1.52+/-1.91-mg equivalents of benztropine; p < 0.001). Significant mean baseline to endpoint improvements (p < 0.001 for all measurements) were observed on the Positive and Negative Syndrome Scale (PANSS; -25.28+/-18.67; percentage change, 30.3%), the PANSS-extracted Brief Psychiatric Rating Scale (0-6 scale, -13.41+/-10.16; percentage change, 54.4%), and the Clinical Global Impressions Severity scale (-1.16+/-1.19; percentage change, 26.4%). Spontaneously reported treatment- emergent adverse events with a greater than 5% incidence were somnolence (16.0%), increased appetite (14.9%), weight gain (11.7%), headache (8.5%), anxiety (7.4%), dizziness (6.4%), and insomnia (5.3%). Criteria for a successful switch were met by 90.5% of patients. Psychotic symptom exacerbation was experienced by 30.9% of patients at any time during the study and by 11.7% of patients at endpoint. Results suggest that a direct switch to olanzapine is a therapeutic option when patients with haloperidol-induced EPS are unable to tolerate a more gradual switch. SN - 0271-0749 UR - https://www.unboundmedicine.com/medline/citation/11476121/Olanzapine_as_alternative_therapy_for_patients_with_haloperidol_induced_extrapyramidal_symptoms:_results_of_a_multicenter_collaborative_trial_in_Latin_America_ L2 - https://doi.org/10.1097/00004714-200108000-00004 DB - PRIME DP - Unbound Medicine ER -