Literature DB >> 19210948

The safety of olanzapine in adolescents with schizophrenia or bipolar I disorder: a pooled analysis of 4 clinical trials.

Ludmila A Kryzhanovskaya1, Carol K Robertson-Plouch, Wen Xu, Janice L Carlson, Karen M Merida, Ralf W Dittmann.   

Abstract

OBJECTIVE: To describe the safety of olanzapine treatment in adolescents (aged 13-17 years) with schizophrenia or bipolar I disorder, and to compare these data with those of olanzapine-treated adults. DATA SOURCES AND STUDY SELECTION: Placebo-controlled database, adolescents: acute phase of 2 double-blind, placebo-controlled trials (3-6 weeks; olanzapine, N = 179, mean age = 15.5 years; placebo, N = 89, mean age = 15.7 years); overall adolescent olanzapine exposure database, adolescents: 4 trials (e.g., the 2 aforementioned studies, each with a 26-week open-label extension phase, and 2 open-label, 4.5- and 24-week trials; N = 454, mean age = 15.9 years); and adult database: 84 clinical trials of up to 32 weeks. DATA SYNTHESIS: The mean daily dosage of olanzapine was 10.6 mg/day (exposure = 48,946 patient days). In the overall adolescent olanzapine exposure database, the most common adverse events included increased weight (31.7%), somnolence (19.8%), and increased appetite (17.4%). In up to 32 weeks of treatment, when compared with adults, adolescents from the overall adolescent olanzapine exposure database gained statistically significantly more weight (7.4 kg vs. 3.2 kg, p < .001); statistically significantly more adolescents gained > or = 7% of their baseline weight (65.1% vs. 35.6%, p < .001). Adolescents experienced statistically significant within-group baseline-to-endpoint changes in fasting glucose (p < .001), total cholesterol (p = .002), triglycerides (p = .007), and alanine aminotransferase (p < .001). Two patients from the overall adolescent olanzapine exposure database (0.4%) attempted suicide; 13 (2.9%) had suicidal ideation. In the placebo-controlled database, adolescents had statistically significant baseline-to-endpoint increases in prolactin (11.4 micrograms/L, p < .001); 47.4% had high prolactin levels.
CONCLUSIONS: The types of adverse events in olanzapine-treated adolescents appear to be similar to those of adults. The magnitude and incidence of weight and prolactin changes were greater in adolescents. TRIAL REGISTRATION: clinicaltrials.gov Identifiers: NCT00051298, NCT00050206, and NCT00113594. Copyright 2009 Physicians Postgraduate Press, Inc.

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Year:  2009        PMID: 19210948     DOI: 10.4088/jcp.08m03538

Source DB:  PubMed          Journal:  J Clin Psychiatry        ISSN: 0160-6689            Impact factor:   4.384


  11 in total

1.  Associations among obesity, acute weight gain, and response to treatment with olanzapine in adolescent schizophrenia.

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Review 9.  Olanzapine in pregnancy and breastfeeding: a review of data from global safety surveillance.

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Review 10.  Dilemma of treating schizophrenia during pregnancy: a Case series and a review of literature.

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Journal:  BMC Psychiatry       Date:  2017-08-29       Impact factor: 3.630

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