Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms: Results of a multicenter, collaborative trial in Latin America

Jorge A. Costa E Silva, Nelson Alvarez, Guido Mazzotti, Wagner Farid Gattaz, Jorge Ospina, Veronica Larach, Sergio Starkstein, Daniel Oliva, Lynne Cousins, Mauricio Tohen, Cindy C. Taylor, Jeff Wang, Pierre V. Tran

Resultado de la investigación: Article

33 Citas (Scopus)

Resumen

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.

Idioma originalEnglish
Páginas (desde-hasta)375-381
Número de páginas7
PublicaciónJournal of Clinical Psychopharmacology
Volumen21
N.º4
DOI
EstadoPublished - 2001

Huella dactilar

olanzapine
Latin America
Haloperidol
Complementary Therapies
Multicenter Studies
Benztropine
Brief Psychiatric Rating Scale
Psychomotor Agitation
Cholinergic Antagonists
Sleep Initiation and Maintenance Disorders
Dizziness
International Classification of Diseases
Appetite
Antipsychotic Agents
Weight Gain
Headache
Schizophrenia
Therapeutics
Anxiety

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Citar esto

Costa E Silva, Jorge A. ; Alvarez, Nelson ; Mazzotti, Guido ; Gattaz, Wagner Farid ; Ospina, Jorge ; Larach, Veronica ; Starkstein, Sergio ; Oliva, Daniel ; Cousins, Lynne ; Tohen, Mauricio ; Taylor, Cindy C. ; Wang, Jeff ; Tran, Pierre V. / Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms : Results of a multicenter, collaborative trial in Latin America. En: Journal of Clinical Psychopharmacology. 2001 ; Vol. 21, N.º 4. pp. 375-381.
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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.",
author = "{Costa E Silva}, {Jorge A.} and Nelson Alvarez and Guido Mazzotti and Gattaz, {Wagner Farid} and Jorge Ospina and Veronica Larach and Sergio Starkstein and Daniel Oliva and Lynne Cousins and Mauricio Tohen and Taylor, {Cindy C.} and Jeff Wang and Tran, {Pierre V.}",
year = "2001",
doi = "10.1097/00004714-200108000-00004",
language = "English",
volume = "21",
pages = "375--381",
journal = "Journal of Clinical Psychopharmacology",
issn = "0271-0749",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

Costa E Silva, JA, Alvarez, N, Mazzotti, G, Gattaz, WF, Ospina, J, Larach, V, Starkstein, S, Oliva, D, Cousins, L, Tohen, M, Taylor, CC, Wang, J & Tran, PV 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, vol. 21, n.º 4, pp. 375-381. https://doi.org/10.1097/00004714-200108000-00004

Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms : Results of a multicenter, collaborative trial in Latin America. / Costa E Silva, Jorge A.; Alvarez, Nelson; Mazzotti, Guido; Gattaz, Wagner Farid; Ospina, Jorge; Larach, Veronica; Starkstein, Sergio; Oliva, Daniel; Cousins, Lynne; Tohen, Mauricio; Taylor, Cindy C.; Wang, Jeff; Tran, Pierre V.

En: Journal of Clinical Psychopharmacology, Vol. 21, N.º 4, 2001, p. 375-381.

Resultado de la investigación: Article

TY - JOUR

T1 - Olanzapine as alternative therapy for patients with haloperidol-induced extrapyramidal symptoms

T2 - Results of a multicenter, collaborative trial in Latin America

AU - Costa E Silva, Jorge A.

AU - Alvarez, Nelson

AU - Mazzotti, Guido

AU - Gattaz, Wagner Farid

AU - Ospina, Jorge

AU - Larach, Veronica

AU - Starkstein, Sergio

AU - Oliva, Daniel

AU - Cousins, Lynne

AU - Tohen, Mauricio

AU - Taylor, Cindy C.

AU - Wang, Jeff

AU - Tran, Pierre V.

PY - 2001

Y1 - 2001

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.

AB - 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.

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