Childhood-onset schizophrenia: an open-label study of olanzapine in adolescents
Authors
Kumra, SanjivJacobsen, Leslie K.
Lenane, Marge C.
Karp, Barbara I.
Frazier, Jean A.
Smith, A. K.
Bedwell, Jeffrey
Lee, Paul H.
Malanga, C. J.
Hamburger, Susan D.
Rapoport, Judith L.
UMass Chan Affiliations
Department of PsychiatryDocument Type
Journal ArticlePublication Date
1998-04-29Keywords
AdolescentAge of Onset
Antipsychotic Agents
Benzodiazepines
Child
Clozapine
Female
Humans
Male
Pilot Projects
Pirenzepine
Schizophrenia
United States
Psychiatry
Metadata
Show full item recordAbstract
OBJECTIVE: Olanzapine, a potent 5-HT2a/2c, dopamine D1D2D4 antagonist with anticholinergic activity, has a profile of known receptor affinity similar to that of clozapine. This pilot study examined the efficacy of olanzapine for treatment-refractory childhood-onset schizophrenia in eight patients who had received 8-week open-label trials. For comparison, data are included from 15 patients who had received 6-week open-label clozapine trials using identical rating instruments (largely by the same raters) in the same treatment setting. METHOD: Twenty-three children and adolescents with an onset of DSM-III-R schizophrenia by age 12 for whom at least two different typical neuroleptics had been ineffective participated in the two separate studies. Some of the patients were intolerant of clozapine, although it had been effective (n = 4). Patients receiving olanzapine were evaluated over 8 weeks with the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Clinical Global Impressions Scale for Improvement. RESULTS: For the eight patients who received olanzapine trials, at week 8 there was a 17% improvement in the BPRS total score, a 27% improvement in the Scale for the Assessment of Negative Symptoms, and a 1% improvement in the Scale for the Assessment of Positive Symptoms, relative to "ideal" admission status on typical neuroleptics. In contrast, the magnitude of the effect sizes for each of the clinical ratings was larger at week 6 of the previous clozapine trial than for an 8-week olanzapine trial, relative to admission status on typical neuroleptics. For the four children who had received both clozapine and olanzapine, BPRS total scores were significantly lower at week 6 of clozapine treatment compared with week 6 of olanzapine treatment (p = .03). CONCLUSION: These data provide preliminary evidence for the efficacy of olanzapine for some children and adolescents with treatment-refractory schizophrenia, but they also suggest the need for a more rigorous double-blind comparison of these two atypical antipsychotics.Source
J Am Acad Child Adolesc Psychiatry. 1998 Apr;37(4):377-85. Link to article on publisher's siteDOI
10.1097/00004583-199804000-00015Permanent Link to this Item
http://hdl.handle.net/20.500.14038/45850PubMed ID
9549958Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/00004583-199804000-00015