Olanzapine Versus Risperidone in Newly Admitted Acutely Ill Psychotic Patients
John E. Kraus, MD. PhD; Brian B. Sheitman, MD; Alan Cook, MD; Robert Reviere, PhD; and Jeffrey A. Lieberman, MD
J Clin Psychiatry 2005;66(12):1564-1568
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objective: Risperidone and olanzapine are
the 2 most widely prescribed second-generation
antipsychotics. The purpose of this study was to
compare the efficacy of risperidone and olanzapine using duration of hospitalization as the
primary outcome measure. This outcome was selected
as it is an indirect measure of how well patients
are responding to the medication and represents a "real world" endpoint relevant to practicing
hospital psychiatrists.
Method: The study was done at a large
state psychiatric hospital in North Carolina from
2001 to 2003. Subjects were eligible for inclusion
if they required treatment with an antipsychotic (e.g., positive symptoms) and were able to
provide informed consent. Eighty-five patients entered the study and were randomly assigned
to risperidone (N = 40) or olanzapine (N = 45) as
their initial antipsychotic. Treatment was
naturalistic, and dosing was based on the discretion of
the treating physician.
Results: There was no significant difference
in the mean durations of hospitalization for the
risperidone group (7.9 days) as compared to the olanzapine group (8.1 days). There were no
significant differences in the demographics of
either treatment group, but, during the study,
risperidone-treated patients used more
antihistamines (chi2 = 4.0, p = .05). Eighty percent of each
group (N = 36, olanzapine; N = 32, risperidone)
remained on the study medication at discharge.
Conclusions: Risperidone and
olanzapine were equally efficacious, suggesting that
measures other than "efficacy" (e.g., side
effects, cost) should be considered when
determining overall "effectiveness" of treatment.