BACKGROUND: Treatment-resistance in schizophrenia remains a public health problem. Clozapine has been shown to be effective in about one third of this population, but carries with it medical risks and weekly blood draws. As olanzapine is a drug with a very similar biochemical profile to clozapine, it is important to evaluate whether non-response to olanzapine predicts clozapine non-response. METHODS: Forty-four treatment-resistant patients received eight weeks of olanzapine, either in a double-blind trial or subsequent open treatment at a mean daily dose of 25 mg/day. Two of 44 patients (5%) responded to olanzapine treatment. Patients who did not respond could then receiveclozapine. Twenty-seven subsequently received an 8-week open trial ofclozapine. RESULTS: Patients who did and did not receive clozapine did not differ demographically or in psychopathology. Eleven of 27 (41%) met a priori response criteria during clozapine treatment (mean dose 693 mg/day) after failing to respond to olanzapine. CONCLUSIONS: This study demonstrates that failure to respond to olanzapine treatment does not predict failure to clozapine. Treatment-resistant patients who fail on olanzapine may benefit from a subsequent trial of clozapine.
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BACKGROUND: Treatment-resistance in schizophrenia remains a public health problem. Clozapine has been shown to be effective in about one third of this population, but carries with it medical risks and weekly blood draws. As olanzapine is a drug with a very similar biochemical profile to clozapine, it is important to evaluate whether non-response to olanzapine predicts clozapine non-response. METHODS: Forty-four treatment-resistant patients received eight weeks of olanzapine, either in a double-blind trial or subsequent open treatment at a mean daily dose of 25 mg/day. Two of 44 patients (5%) responded to olanzapine treatment. Patients who did not respond could then receive clozapine. Twenty-seven subsequently received an 8-week open trial of clozapine. RESULTS:Patients who did and did not receive clozapine did not differ demographically or in psychopathology. Eleven of 27 (41%) met a priori response criteria during clozapine treatment (mean dose 693 mg/day) after failing to respond to olanzapine. CONCLUSIONS: This study demonstrates that failure to respond to olanzapine treatment does not predict failure to clozapine. Treatment-resistant patients who fail on olanzapine may benefit from a subsequent trial of clozapine.
Authors: Thomas E Winkler; Sarah L Lederer; Eunkyoung Kim; Hadar Ben-Yoav; Deanna L Kelly; Gregory F Payne; Reza Ghodssi Journal: Biointerphases Date: 2017-05-01 Impact factor: 2.456
Authors: Johan Fernø; Audun O Vik-Mo; Goran Jassim; Bjarte Håvik; Kjetil Berge; Silje Skrede; Oddrun A Gudbrandsen; Jo Waage; Niclas Lunder; Sverre Mørk; Rolf K Berge; Hugo A Jørgensen; Vidar M Steen Journal: Psychopharmacology (Berl) Date: 2008-10-30 Impact factor: 4.530
Authors: Sarah M Norman; Kelli M Sullivan; Fang Liu; Bethany A DiPaula; Pedro A Jose; Christopher A Kitchen; Stephanie M Feldman; Deanna L Kelly Journal: Psychiatr Q Date: 2017-09