Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Sanger, T. M. Articles by Tollefson, G. D. Search for Related Content PubMed Citation Articles by Sanger, T. M. Articles by Tollefson, G. D. Schizophrenia Spectrum Disorders Other Neuroleptics

Olanzapine Versus Haloperidol Treatment in First-Episode Psychosis

OBJECTIVE: It has been hypothesized that the morbidity and mortality associated with schizophrenia can be prevented by providing effective treatment during the first episode of psychosis. Hence, the authors examined patients with first-episode psychosis to determine the efficacy and safety of olanzapine and haloperidol treatment. METHOD: A subpopulation of first-episode patients (N=83) from a large prospective, multicenter, international, double-blind, 6-week acute treatment study was evaluated. These patients were selected from a pool of 1,996 patients who had a DSM-III-R diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder and who also met the following criteria: 1) the length of their current psychotic episode had to be 5 or fewer years, and 2) patients had to be 45 years of age or younger at onset of first psychotic symptoms. RESULTS: Compared to haloperidol, olanzapine showed a statistically significantly greater reduction in the Brief Psychiatric Rating Scale (BPRS) total and negative scores and in the Positive and Negative Syndrome Scale total and positive scores. Clinical response (defined as 40% or greater improvement in BPRS total score from baseline) was also statistically significantly higher in olanzapine-treated patients (67.2%) than in haloperidol-treated patients (29.2%). Olanzapine-treated patients further showed statistically significant improvements in the Simpson-Angus scale and Barnes Akathisia Scale scores, while haloperidol-treated patients showed a worsening on both measures. Compared to olanzapine-treated multiple-episode patients in the parent study, olanzapine-treated first-episode patients achieved an even statistically significantly higher response. Haloperidol-treated first-episode patients experienced statistically significantly more extrapyramidal symptoms than haloperidol-treated multiple-episode patients. CONCLUSIONS: In patients experiencing first-episode psychosis, olanzapine had a risk-benefit profile significantly superior to that of haloperidol. The study results suggest that novel antipsychotic agents such as olanzapine should be considered as a preferred option in first-episode psychosis, on the basis of both safety and efficacy advantages.

This article has been cited by other articles:

				J. Rabinowitz, S. Z. Levine, O. Barkai, and O. Davidov Dropout Rates in Randomized Clinical Trials of Antipsychotics: A Meta-analysis Comparing First- and Second-Generation Drugs and an Examination of the Role of Trial Design Features Schizophr Bull, February 26, 2008; (2008) sbn005v1. [Abstract] [Full Text] [PDF]

				J. P. McEvoy, J. A. Lieberman, D. O. Perkins, R. M. Hamer, H. Gu, A. Lazarus, D. Sweitzer, C. Olexy, P. Weiden, and S. D. Strakowski Efficacy and Tolerability of Olanzapine, Quetiapine, and Risperidone in the Treatment of Early Psychosis: A Randomized, Double-Blind 52-Week Comparison Am J Psychiatry, July 1, 2007; 164(7): 1050 - 1060. [Abstract] [Full Text] [PDF]

				D. L. Penn, E. J. Waldheter, D. O. Perkins, K. T. Mueser, and J. A. Lieberman Psychosocial Treatment for First-Episode Psychosis: A Research Update Am J Psychiatry, December 1, 2005; 162(12): 2220 - 2220. [Abstract] [Full Text] [PDF]

				P. Haddad Weight change with atypical antipsychotics in the treatment of schizophrenia J Psychopharmacol, November 1, 2005; 19(6_suppl): 16 - 27. [Abstract] [PDF]

				G. REMINGTON Rational pharmacotherapy in early psychosis The British Journal of Psychiatry, August 1, 2005; 187(48): s77 - s84. [Abstract] [Full Text] [PDF]

				D. G Robinson, M. G Woerner, H. M Delman, and J. M Kane Pharmacological Treatments for First-Episode Schizophrenia Schizophr Bull, July 1, 2005; 31(3): 705 - 722. [Abstract] [Full Text] [PDF]

				N. Schooler, J. Rabinowitz, M. Davidson, R. Emsley, P. D. Harvey, L. Kopala, P. D. McGorry, I. Van Hove, M. Eerdekens, W. Swyzen, et al. Risperidone and Haloperidol in First-Episode Psychosis: A Long-Term Randomized Trial Am J Psychiatry, May 1, 2005; 162(5): 947 - 953. [Abstract] [Full Text] [PDF]

				J. A. Lieberman, G. Tollefson, M. Tohen, A. I. Green, R. E. Gur, R. Kahn, J. McEvoy, D. Perkins, T. Sharma, R. Zipursky, et al. Comparative Efficacy and Safety of Atypical and Conventional Antipsychotic Drugs in First-Episode Psychosis: A Randomized, Double-Blind Trial of Olanzapine Versus Haloperidol Am J Psychiatry, August 1, 2003; 160(8): 1396 - 1404. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 1999 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us