OBJECTIVE: A recent 12-week controlled comparison demonstrated the superiority of clozapine to "high-dose" olanzapine in adolescents with treatment-refractory schizophrenia. In the present study, the authors conducted a 12-week, open-label, follow-up study to examine changes in lipid and glucose metabolism in youths maintained onclozapine and to determine whether patients who were previously randomized to high-dose olanzapine (up to 30 mg/day) responded to clozapine. METHOD: Thirty three (14 clozapine, 19 olanzapine) (85%) of 39 patients were available for the present 12-week, open-label extension study. Extended safety data using an intention-to-treat analysis from the 14 subjects treated withclozapine for a total of 24 weeks are presented. In addition, we report the clinical outcomes for 10 of 19 olanzapine-treated patients who were switched after 12 weeks to clozapine due to treatment nonresponse. Clinical response was defined as a decrease of 30% or more in total Brief Psychiatric Rating score from week 12 and a Clinical Global Impression-Improvement rating of 1 (very much improved) or 2 (much improved). RESULTS: The incidence of hypertriglyceridemia (defined as fasting triglycerides >125 mg/dL) (10/14 = 71%) and the incidence of "prediabetes" (defined as fasting blood glucose > or =100) (4/14 = 29%) at week 24 in the clozapine-treated subjects were notable. Seven (70%) of 10 of young patients with schizophrenia who failed treatment with "high-dose" olanzapine were found to respond to a 12-week, open-label clozapine trial. CONCLUSIONS: Clinicians and caregivers need to be aware of potential metabolic adverse events of long-term clozapine treatment. Adolescents with a poor response toolanzapine may do better on clozapine.
RCT Entities:
OBJECTIVE: A recent 12-week controlled comparison demonstrated the superiority of clozapine to "high-dose" olanzapine in adolescents with treatment-refractory schizophrenia. In the present study, the authors conducted a 12-week, open-label, follow-up study to examine changes in lipid and glucose metabolism in youths maintained on clozapine and to determine whether patients who were previously randomized to high-dose olanzapine (up to 30 mg/day) responded to clozapine. METHOD: Thirty three (14 clozapine, 19 olanzapine) (85%) of 39 patients were available for the present 12-week, open-label extension study. Extended safety data using an intention-to-treat analysis from the 14 subjects treated with clozapine for a total of 24 weeks are presented. In addition, we report the clinical outcomes for 10 of 19 olanzapine-treated patients who were switched after 12 weeks to clozapine due to treatment nonresponse. Clinical response was defined as a decrease of 30% or more in total Brief Psychiatric Rating score from week 12 and a Clinical Global Impression-Improvement rating of 1 (very much improved) or 2 (much improved). RESULTS: The incidence of hypertriglyceridemia (defined as fasting triglycerides >125 mg/dL) (10/14 = 71%) and the incidence of "prediabetes" (defined as fasting blood glucose > or =100) (4/14 = 29%) at week 24 in the clozapine-treated subjects were notable. Seven (70%) of 10 of young patients with schizophrenia who failed treatment with "high-dose" olanzapine were found to respond to a 12-week, open-label clozapine trial. CONCLUSIONS: Clinicians and caregivers need to be aware of potential metabolic adverse events of long-term clozapine treatment. Adolescents with a poor response to olanzapine may do better on clozapine.
Authors: Robert L Findling; Jean A Frazier; Ginny Gerbino-Rosen; Harvey N Kranzler; Sanjiv Kumra; Christopher J Kratochvil Journal: J Am Acad Child Adolesc Psychiatry Date: 2007-03 Impact factor: 8.829
Authors: Jon McCLELLAN; Linmarie Sikich; Robert L Findling; Jean A Frazier; Benedetto Vitiello; Stefanie A Hlastala; Emily Williams; Denisse Ambler; Tyehimba Hunt-Harrison; Ann E Maloney; Louise Ritz; Robert Anderson; Robert M Hamer; Jeffrey A Lieberman Journal: J Am Acad Child Adolesc Psychiatry Date: 2007-08 Impact factor: 8.829
Authors: Noor B Almandil; Ying Liu; Macey L Murray; Frank M C Besag; Katherine J Aitchison; Ian C K Wong Journal: Paediatr Drugs Date: 2013-04 Impact factor: 3.022