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Risperidone and Olanzapine versus Another First Generation Antipsychotic in Patients with Schizophrenia Inadequately Responsive to First Generation Antipsychotics
Pharmacopsychiatry, 03/19/12
Chen JJ et al. – Haloperidol or trifluoperazine demonstrated similar efficacy as risperidone or olanzapine for patients with schizophrenia who had failed their first trial with a first–generation antipsychotic.

  • This study was an 8-week treatment, randomized, rater-blind, active-control study with 3 treatment arms.
  • 48 patients, who showed inadequate response to 1 FGA, were enrolled and randomized into risperidone, olanzapine, or FGA (haloperidol or trifluoperazine) groups.
  • They were blindly assessed with the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression Scale-Severity, and the Extrapyramidal Symptom Rating Scale (ESRS) at baseline and biweekly.

  • All 3 groups demonstrated a significant decrease in the PANSS total, positive, and general scores from baseline to endpoint (p-values range from 0.003 to 0.021).
  • There were no significant differences among the 3 groups in score changes.
  • The olanzapine group had significant score reductions than the risperidone and FGAs groups in terms of the ESRS subjective total score and did not experience a significant increase in the dose of anticholinergics.
  • The FGA group demonstrated that extrapyramidal syndrome (EPS) worsened under an increased dosage of anti-EPS drugs.
  • Olanzapine was associated with significant body weight gain (2.69�4.0 kg, p=0.026), but there were no significant group differences on weight gain.

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