Quality of Life in Schizophrenia: A Multicenter, Randomized, Naturalistic, Controlled Trial Comparing Olanzapine to First-Generation Antipsychotics
J Clin Psychiatry 2005;66(7):831-838
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objective: To assess the effectiveness of
olanzapine for treating schizophrenia and to assess if olanzapine
promotes a better quality of life than first-generation
Method: Multicenter, naturalistic, randomized
controlled study, comparing olanzapine with FGAs, at
hospitalization and during a 9-month follow-up. Outcome assessors
were blind to the allocated drug. The dose of antipsychotic was
determined by doctors according to their clinical practice
routines. Data collection was performed from April 1999 to August
Results: 197 patients with DSM-IV-diagnosed
schizophrenia were allocated to olanzapine (N = 104) and FGA
(N = 93). Patients taking olanzapine showed greater improvements in
Positive and Negative Syndrome Scale (PANSS) negative symptoms
(mean difference = 2.3, 95% CI = 0.6 to 4.1) and general
psychopathology (mean difference = 4.0, 95% CI = 0.8 to 7.2)
subscales and fewer incidences of tardive dyskinesia (RR = 2.4, 95%
CI = 1.4 to 4.2, p < .0001). Olanzapine was also associated with
greater improvement in a number of health-related quality-of-life
outcomes on the Medical Outcomes Study 36-item Short-Form Health
Survey, including physical functioning (mean difference = 6.6, 95%
CI = 1.2 to 11.9), physical role limitations (mean difference = 13.7,
95% CI = 3.0 to 24.3), and emotional role limitations (mean
difference = 12.1, 95% CI = 0.7 to 23.5). Patients taking olanzapine
gained significantly more weight during the trial than patients
taking FGAs, with a correspondent endpoint increase in the body
mass index (BMI) of 28.7 versus 25.3 (p < .001).
Conclusion: Compared with FGAs, olanzapine has
advantages in terms of improvements of negative symptoms and
quality of life. It is also associated with fewer incidences of
tardive dyskinesia and greater increases in weight and BMI. These
findings are highlighted by the naturalistic approach adopted in