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Clinical outcome and olanzapine plasma levels in acute schizophrenia

Published online by Cambridge University Press:  16 April 2020

M.C. Mauri ,
CPC Steinhilber ,
R. Marino ,
E. Invernizzi ,
A. Fiorentini ,
G. Cerveri ,
M.L. Baldi  and
F. Barale
M.C. Mauri*
Affiliation:
Clinical Psychiatry, Clinical Neuropsychopharmacology Unit, University of Milan, IRCCS Ospedale Maggiore, Via F. Sforza 35, 20122 Milan, Italy
CPC Steinhilber
Affiliation:
Clinical Psychiatry, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy
R. Marino
Affiliation:
Clinical Psychiatry, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy
E. Invernizzi
Affiliation:
Clinical Psychiatry, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy
A. Fiorentini
Affiliation:
Clinical Psychiatry, Clinical Neuropsychopharmacology Unit, University of Milan, IRCCS Ospedale Maggiore, Via F. Sforza 35, 20122 Milan, Italy
G. Cerveri
Affiliation:
Clinical Psychiatry, Clinical Neuropsychopharmacology Unit, University of Milan, IRCCS Ospedale Maggiore, Via F. Sforza 35, 20122 Milan, Italy
M.L. Baldi
Affiliation:
Legal Medicine and Toxicology Service, IRCCS Policlinico S. Matteo, Pavia, Italy
F. Barale
Affiliation:
Clinical Psychiatry, University of Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy
*
*Corresponding author. E-mail address: maurimc@policlinico.mi.it (M.C. Mauri).
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Abstract

Purpose

This open label study was performed to evaluate the relationship between the plasma concentration of olanzapine and the response in acute schizophrenic inpatients.

Material and methods

A total of 54 inpatients, 38 males and 16 females, age ranging from 18 to 75 years, affected by Schizophrenia (DSM IV criteria) during an exacerbation phase were included in the study. Olanzapine (OLZ) was started at a dose of 5–20 mg/day and was increased to a mean dose of 15.27 mg ±5.53 S.D. Patients were evaluated at baseline, and after 2 weeks, by using BPRS, PANNS, HRS-D, EPSE, and ACS.

Results

BPRS and total PANSS showed a statistically significant improvement at the end of the study. Olanzapine plasma levels (PL) ranged from 5 to 120 ng/ml (mean 33.15 ng/ml ± 28.28 S.D.) and showed a positive correlation with OLZ dosage. A significant curvilinear correlation between OLZ PL and clinical improvement (BPRS, PANSS and HRS-D percent of amelioration) was observed.

Conclusion

Olanzapine plasma level determination seems to be a useful tool in optimizing acute treatment particularly for more problematic cases.

Keywords

Acute schizophreniaOlanzapinePlasma levels
Type
Original article
Information
European Psychiatry , Volume 20 , Issue 1 , January 2005 , pp. 55 - 60
Copyright
Copyright © Elsevier SAS 2005

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References

Altamura, ACNovel antipsychotics and the problem of clinical stabilization in schizophrenia: are they “stabilizer” rather than typical compounds?. Int Clin Psychopharmacol 1996;11:153–155.CrossRefGoogle ScholarPubMed
American Psychiatric Association DSM-IV Diagnostic and Statistical Manual of Mental Disorders. 4th e Washington, DC: APA; 1994.Google Scholar
Azorin, JMAcute phase of schizophrenia: impact of atypical antipsychotics. Int Clin Psychopharmacol 2000;15Suppl 4:5–9.Google ScholarPubMed
Beasley, CM, Tollefson, G, Tran, P, Satterlee, W, Sanger, T, Hamilton, SOlanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial. Neuropsychopharmaco 1996;14Suppl 2:111–123.CrossRefGoogle ScholarPubMed
Bernardo, M, Parellada, E, Lomena, F, Catafau, AM, Font, M, Gomez, JCet al.Double-blind olanzapine versus haloperidol D2 dopamine receptor blockade in schizophrenic patients: a baseline-endpoint. Psychiatry Res 2001;107Suppl 2:87–97.CrossRefGoogle Scholar
Birchwood, M, Mason, R, MacMillan, F, Healy, JDepression, demoralization and control over psychotic illness: a comparison of depressed and non-depressed patients with a chronic psychosis. Psychol Med 1993;23Suppl 2:387–395.CrossRefGoogle ScholarPubMed
Bymaster, FP, Rasmussen, K, Calligaro, DO, Nelson, DL, De Lapp, NW, Wong, DTet al.In vitro and in vivo biochemistry of olanzapine: a novel, atypical antipsychotic drug. J Clin Psychiatr 1997;58Suppl 10:28–36.Google ScholarPubMed
Callagan, JT, Bergstrom, RF, Ptak, LRet al.Olanzapine. Pharmacokinetic and pharmacodynamic profile. Clin Pharmacokinet 1999;37Suppl 3:77–193.Google Scholar
Davis, JM, Chen, NThe effects of olanzapine on the 5 dimensions of schizophrenia derived by factors analysis: combined results of the North American and international trials. J Clin Psychiatr 2001;62Suppl 10:757–771.CrossRefGoogle ScholarPubMed
De Vane, CLMarkowitz JS Antipsychotics. Levy, RHMetabolic Drug Interaction Philadelphia: Lippincott Williams & Wilkins; 2000. 245–257.Google Scholar
Feifel, D, Moutier, CY, Perry, WSafety and tolerability of a rapidly escalating dose-loading regimen for risperidone. J Clin Psychiatr 2000;61Suppl 12:909–911.CrossRefGoogle ScholarPubMed
Green, BFocus on olanzapine. Curr Med Res Opin 15Suppl 21999 79–85.CrossRefGoogle ScholarPubMed
Hamilton, MA rating scale for depression. J Neurol Neurosurg Psychiat 1960;23:56CrossRefGoogle ScholarPubMed
Jibson, MD, Tandon, RTreatment of acute psychotic episodes. Csernansky, JGSchizophrenia. A New Guide for Clinician New York: Marcel Dekker Inc; 2002. 107–139.Google Scholar
Kay, SR, Fiszbein, A, Opler, LAThe positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–276.CrossRefGoogle Scholar
Karangianis, JL, Dawe, IC, Thakur, A, Begin, S, Raskin, J, Roychowdhury, SMRapid tranquilization with olanzapine in acute psychosis: a case series. J Clin Psychiatr 2001;62Suppl 2:12–16.Google Scholar
Kinon, BJ, Roychowdhury, SM, Milton, DR, Hill, ALEffective resolution with olanzapine of acute presentation of behavioral agitation and positive psychotic symptoms in schizophrenia. J Clin Psychiatr 2001;62Suppl 2:17–21.Google Scholar
Mauri, MC, Laini, V, Boscati, L, Rudelli, R, Salvi, V, Orlandi, Ret al.Long-term treatment of chronic schizophrenia with risperidone: a study with plasma levels. Eur Psychiatr 2001;16:57–63.CrossRefGoogle ScholarPubMed
Nelson, EB, Rielage, E, Welge, JA, Keck, PE Jr.An open trial of olanzapine in the treatment of patients with psychotic depression. Ann Clin Psychiatr 2001;13Suppl 3:147–151.CrossRefGoogle ScholarPubMed
Nemeroff, CBDosing the antipsychotic medication olanzapine. J Clin Psychiatr 1997;58Suppl 10:45–49.Google ScholarPubMed
Overall, J, Gorham, DBrief psychiatric rating scale. Psychol Rep 1962;10:799–812.CrossRefGoogle Scholar
Perry, PJ, Sanger, T, Beasley, COlanzapine plasma concentrations and clinical response in acutely ill schizophrenic patients. J Clin Psychopharmacol 1997;17Suppl 6:472–477.CrossRefGoogle ScholarPubMed
Perry, PJ, Lund, BC, Sanger, T, Beasley, COlanzapine plasma concentration and clinical response: acute phase results of the North American olanzapine trial. J Clin Psychopharmaco 2001;21Suppl 1:14–20.CrossRefGoogle ScholarPubMed
Reus, VIOlanzapine: a novel atypical neuroleptic agent. Lance 1997;349:1264–1265.CrossRefGoogle ScholarPubMed
Roy, A, Thompson, R, Kennedy, SDepression in chronic schizophrenia. Br J Psychiatr 1983;142:465–470.CrossRefGoogle ScholarPubMed
Simpson, RM, Angus, JSWA rating scale for extrapyramidal side effects. Acta Psychiatr Scand 1970;212:11–19.CrossRefGoogle ScholarPubMed
Stockton, ME, Rasmussen, KElectrophysiological effects of olanzapine, a novel atypical antipsychotic, on A9 and A10 dopamine neurons. Neuropsychopharmaco 1996;14Suppl 2:97–105.CrossRefGoogle ScholarPubMed
Tollefson, GD, Sanger, TM, Lu, Y, Thieme, MEDepressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol. Arch Gen Psychiatr 1998;55Suppl 3:250–258.CrossRefGoogle ScholarPubMed
Xiberas, X, Martinot, JL, Mallet, L, Artiges, E, Loc’H, C, Maziere, Bet al.Extrastriatal and striatal D2 dopamine receptor blockade with haloperidol or new antipsychotic drugs in patients with schizophrenia. Br J Psychiatr 2001;179:503–508.CrossRefGoogle ScholarPubMed
Zhang, XY, Zhou, DF, Cao, LJ, Zhang, PY, Wu, GY, Shen, YCRisperidone vs haloperidol in the treatment of acute exacerbations of chronic inpatients with schizophrenia: a randomized double-blind study. Int Clin Psychopharmaco 2001;16Suppl 6:325–330.CrossRefGoogle Scholar
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