Tags

Type your tag names separated by a space and hit enter

Depressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol.
Arch Gen Psychiatry. 1998 Mar; 55(3):250-8.AG

Abstract

BACKGROUND

Depressive signs and symptoms during the course of schizophrenia are common and have been associated with impaired recovery and a higher risk of self-harm. Novel antipsychotic agents introduce new pharmacological avenues that may differentially affect schizophrenic signs and symptoms, including depression.

METHODS

This was a 17-country investigation of 1996 patients with schizophrenia or a related diagnosis randomly assigned to a blinded, comparative trial of the novel antipsychotic agent olanzapine (5-20 mg/d) or the conventional D2 antagonist haloperidol (5-20 mg/d). Patients were evaluated with the Positive and Negative Syndrome Scale, the Montgomery-Asberg Depression Rating Scale, and the Simpson-Angus Rating Scale. The trial consisted of a 6-week and a 46-week masked responder maintenance period.

RESULTS

At least moderate depressive signs and symptoms (Montgomery-Asberg Depression Rating Scale score, > or =16) were seen in slightly more than half of this sample. Although both treatments were associated with short-term baseline-to-end point improvement on the Montgomery-Asberg Depression Rating Scale, olanzapine-associated improvements were significantly superior to those observed with haloperidol (P=.001). Furthermore, the response rate for the group receiving olanzapine (> or =50% improvement on the Montgomery-Asberg Depression Rating Scale after at least 3 weeks of treatment) was also significantly higher (P=.008). Analysis demonstrated that improvement in positive, negative, and/or extrapyramidal symptoms was associated with mood improvement (indirect effect); however, most of the olanzapine treatment effect on mood was a primary direct effect (57%) that alone was significantly greater than that seen with haloperidol treatment (P<.001).

CONCLUSIONS

Depressive signs and symptoms in schizophrenia are responsive to treatment. The pleotrophic pharmacological features of olanzapine, through 1 or more non-D2-mediated pathways, likely contribute to its superior treatment effect. Better control of the mood disorders accompanying schizophrenia holds the possibility for improved patient outcomes.

Authors+Show Affiliations

Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Ind 46285, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

9510219

Citation

Tollefson, G D., et al. "Depressive Signs and Symptoms in Schizophrenia: a Prospective Blinded Trial of Olanzapine and Haloperidol." Archives of General Psychiatry, vol. 55, no. 3, 1998, pp. 250-8.
Tollefson GD, Sanger TM, Lu Y, et al. Depressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol. Arch Gen Psychiatry. 1998;55(3):250-8.
Tollefson, G. D., Sanger, T. M., Lu, Y., & Thieme, M. E. (1998). Depressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol. Archives of General Psychiatry, 55(3), 250-8.
Tollefson GD, et al. Depressive Signs and Symptoms in Schizophrenia: a Prospective Blinded Trial of Olanzapine and Haloperidol. Arch Gen Psychiatry. 1998;55(3):250-8. PubMed PMID: 9510219.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol. AU - Tollefson,G D, AU - Sanger,T M, AU - Lu,Y, AU - Thieme,M E, PY - 1998/3/24/pubmed PY - 1998/3/24/medline PY - 1998/3/24/entrez SP - 250 EP - 8 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 55 IS - 3 N2 - BACKGROUND: Depressive signs and symptoms during the course of schizophrenia are common and have been associated with impaired recovery and a higher risk of self-harm. Novel antipsychotic agents introduce new pharmacological avenues that may differentially affect schizophrenic signs and symptoms, including depression. METHODS: This was a 17-country investigation of 1996 patients with schizophrenia or a related diagnosis randomly assigned to a blinded, comparative trial of the novel antipsychotic agent olanzapine (5-20 mg/d) or the conventional D2 antagonist haloperidol (5-20 mg/d). Patients were evaluated with the Positive and Negative Syndrome Scale, the Montgomery-Asberg Depression Rating Scale, and the Simpson-Angus Rating Scale. The trial consisted of a 6-week and a 46-week masked responder maintenance period. RESULTS: At least moderate depressive signs and symptoms (Montgomery-Asberg Depression Rating Scale score, > or =16) were seen in slightly more than half of this sample. Although both treatments were associated with short-term baseline-to-end point improvement on the Montgomery-Asberg Depression Rating Scale, olanzapine-associated improvements were significantly superior to those observed with haloperidol (P=.001). Furthermore, the response rate for the group receiving olanzapine (> or =50% improvement on the Montgomery-Asberg Depression Rating Scale after at least 3 weeks of treatment) was also significantly higher (P=.008). Analysis demonstrated that improvement in positive, negative, and/or extrapyramidal symptoms was associated with mood improvement (indirect effect); however, most of the olanzapine treatment effect on mood was a primary direct effect (57%) that alone was significantly greater than that seen with haloperidol treatment (P<.001). CONCLUSIONS: Depressive signs and symptoms in schizophrenia are responsive to treatment. The pleotrophic pharmacological features of olanzapine, through 1 or more non-D2-mediated pathways, likely contribute to its superior treatment effect. Better control of the mood disorders accompanying schizophrenia holds the possibility for improved patient outcomes. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/9510219/Depressive_signs_and_symptoms_in_schizophrenia:_a_prospective_blinded_trial_of_olanzapine_and_haloperidol_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/vol/55/pg/250 DB - PRIME DP - Unbound Medicine ER -