0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letters to the Editor   |    
Ethical Concerns Regarding Olanzapine Versus Placebo in Patients Prodromally Symptomatic for Psychosis
JERALD J. BLOCK
Am J Psychiatry 2006;163:1838-1838.

To the Editor: I am concerned that the article entitled “Randomized, Double-Blind Trial of Olanzapine Versus Placebo in Patients Prodromally Symptomatic for Psychosis” (1) lacked discussion regarding the ethics of treating young (average age=18.2 years) and nonpsychotic patients with the neuroleptic olanzapine for 1 year.

The authors anticipated this problem, and, as they point out, in prior studies 46%–80% of those labeled “prodromal” never develop schizophrenia after up to 2 years of observation and were probably false positives (p. 797). In their study, 16 of 29 participants (55%) in the placebo group never became psychotic after 2 years. We should, therefore, expect that approximately 17 of the 31 (55%) subjects who were given olanzapine were also false positives. More than one-half of the patients who were prescribed olanzapine were exposed to it unnecessarily—at doses ranging from 5 to 15 mg/day.

In addition to the patients’ average weight gain of 19 lbs, I am concerned with what other biopsychosocial repercussions there were for these young men and women after they were placed on the neuroleptic, without a clear indication, for a year. Isn’t our first and foremost obligation to “do no harm”?

1.McGlashan TH, Zipursky RB, Perkins D, Addington, J, Miller T, Woods SW, Hawkins KA, Hoffman RE, Preda A, Epstein I, Addington D, Lindborg S, Trzaskoma Q, Tohen M, Breier A: Randomized, double-blind trial of olanzapine versus placebo in patients prodromally symptomatic for psychosis. Am J Psychiatry 2006; 163:790–799
 
+

References

1.McGlashan TH, Zipursky RB, Perkins D, Addington, J, Miller T, Woods SW, Hawkins KA, Hoffman RE, Preda A, Epstein I, Addington D, Lindborg S, Trzaskoma Q, Tohen M, Breier A: Randomized, double-blind trial of olanzapine versus placebo in patients prodromally symptomatic for psychosis. Am J Psychiatry 2006; 163:790–799
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
Manual of Clinical Psychopharmacology, 7th Edition > Chapter 1.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 1.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 26.  >
The American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th Edition > Chapter 26.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 29.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
APA Guidelines
PubMed Articles