Switching From Depot Antipsychotic Drugs to Olanzapine in Patients With Chronic Schizophrenia
J Clin Psychiatry 2003;64(2):119-122
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Patients with chronic
schizophrenia (DSM-IV criteria) often receive depot antipsychotic
medications to assure longer administration and better compliance
with their treatment regimen. This study evaluated whether
patients stabilized on depot antipsychotic medication could be
successfully transitioned to oral olanzapine.
Method: In a 3-month open-label study, 26
clinically stable patients with schizophrenia taking depot
antipsychotics for over 3 years were randomly assigned to
continue on their current depot dose or to switch to oral
olanzapine. Clinical ratings (Positive and Negative Syndrome
Scale [PANSS], Global Assessment of Functioning [GAF] scale, and
Clinical Global Impressions [CGI] scale) and side effect
parameters (Abnormal Involuntary Movement Scale [AIMS], Barnes
Akathisia Scale, AMDP-5 scale, vital signs, and weight) were
Results: Oral olanzapine patients (N =
13) demonstrated significant clinical improvement over the depot
control group (N = 13) from baseline to 3-month endpoint (PANSS
total, p = .012; PANSS general, p = .068; PANSS negative, p =
.098; CGI-Improvement, p = .007; CGI-Severity, p = .026; GAF, p =
.015). Side effect rating scales showed no statistical
differences between the 2 groups (AIMS, Barnes Akathisia Scale,
AMDP-5, vital signs). The depot control group showed no
statistical superiority in any measure except weight change (p =
.0005). After 3 months, all olanzapine patients preferred
olanzapine to their previous depot medications and chose to
continue on olanzapine treatment.
Conclusion: Clinicians may expect clinical
improvement when switching chronically psychotic patients from
traditional depot antipsychotic drugs to oral olanzapine.
Switching may be completed within a 4-week period with relative
compliance being maintained and patients preferring oral
olanzapine to their previous depot medications.