PMID- 22339430
OWN - NLM
STAT- MEDLINE
DCOM- 20120628
LR  - 20211021
IS  - 1179-1918 (Electronic)
IS  - 1173-2563 (Linking)
VI  - 32
IP  - 4
DP  - 2012 Apr 1
TI  - Switching patients with stable schizophrenia or schizoaffective disorder from 
      olanzapine to risperidone long-acting injectable.
PG  - 267-79
LID - 10.2165/11599080-000000000-00000 [doi]
AB  - BACKGROUND: Patients with schizophrenia or related disorders often switch 
      antipsychotic therapy, most commonly due to lack of efficacy and side effects. 
      The differences in anticipated efficacy and tolerability among atypical 
      antipsychotics may drive switching behaviours. Switching to long-acting 
      antipsychotics may improve adherence. Improving adherence is essential as 
      relatively short medication gaps significantly increase the risk of schizophrenia 
      hospitalizations. Long-term treatment with risperidone long-acting injectable 
      (RLAI), the first available long-acting atypical antipsychotic, versus oral 
      atypical antipsychotics showed better adherence with RLAI. Stable patients with 
      schizophrenia or related disorders treated with a stable dose of antipsychotic 
      showed improved efficacy when switched to flexible doses of RLAI. The most common 
      reason for patients to switch from olanzapine to another antipsychotic is 
      excessive weight gain. Metabolic dysfunction also occurs more commonly with 
      olanzapine than with risperidone. Patients switching from olanzapine to 
      risperidone experienced significant decreases in body weight, body mass index and 
      triglyceride levels, whereas patients switching from risperidone to olanzapine 
      experienced significant increases in body weight and triglyceride levels. The 
      efficacy, tolerability and safety of RLAI in non-acute patients with 
      schizophrenia or schizoaffective disorder previously treated with oral olanzapine 
      needs to be explored. OBJECTIVE: The objective of this study was to evaluate the 
      efficacy, tolerability and safety of switching from oral olanzapine to RLAI. 
      METHODS: This was a six-month, prospective, multicentre, non-randomized, 
      single-arm, open-label trial. The trial evaluated non-acute adult patients with 
      psychotic disorders treated with a stable olanzapine dose who required a 
      treatment change. Three weeks after RLAI initiation, olanzapine was tapered off 
      over 1 week or 3 weeks. Efficacy and safety measures included the Positive and 
      Negative Syndrome Scale (PANSS), the Clinical Global Impression-Severity (CGI-S), 
      Global Assessment of Functioning (GAF) and treatment-emergent adverse events 
      (TEAEs). RESULTS: Among 96 patients analysed, significant endpoint efficacy 
      changes versus baseline were observed for PANSS, CGI-S and GAF (all p<0.0001). 
      PANSS total score improvement was >/=20% for 65.6% of patients and >/=50% for 31.3%. 
      TEAEs were similar in the 1- and 3-week taper groups (40.0% and 46.5%, 
      respectively). TEAEs were generally mild (34.5%) or moderate (49.0%) in 
      intensity. CONCLUSION: Switching non-acute patients with schizophrenia or 
      schizoaffective disorder requiring a treatment change from a stable dose of oral 
      olanzapine to RLAI improved psychiatric symptom control, functioning and patient 
      treatment satisfaction. RLAI was generally well tolerated. CLINICAL TRIAL 
      REGISTRATION: Clinicaltrials.gov identifier: NCT00216632.
CI  - (c) 2012 Adis Data Information BV. All rights reserved.
FAU - Rosa, Fernanda
AU  - Rosa F
AD  - Casa de Sade S. Rafael, Angra do Herosmo, Portugal. fernanda.rosa@isjd.pt
FAU - Schreiner, Andreas
AU  - Schreiner A
FAU - Thomas, Pierre
AU  - Thomas P
FAU - Sherif, Tarek
AU  - Sherif T
LA  - eng
SI  - ClinicalTrials.gov/NCT00216632
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Delayed-Action Preparations)
RN  - 12794-10-4 (Benzodiazepines)
RN  - L6UH7ZF8HC (Risperidone)
RN  - N7U69T4SZR (Olanzapine)
SB  - IM
MH  - Administration, Oral
MH  - Adult
MH  - Antipsychotic Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Benzodiazepines/administration & dosage/adverse effects/*therapeutic use
MH  - Delayed-Action Preparations
MH  - Female
MH  - Humans
MH  - Injections
MH  - Male
MH  - Middle Aged
MH  - Olanzapine
MH  - Patient Satisfaction
MH  - Psychiatric Status Rating Scales
MH  - Psychotic Disorders/drug therapy/physiopathology
MH  - Risperidone/administration & dosage/adverse effects/*therapeutic use
MH  - Schizophrenia/*drug therapy/physiopathology
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2012/02/22 06:00
MHDA- 2012/06/29 06:00
CRDT- 2012/02/21 06:00
PHST- 2012/02/21 06:00 [entrez]
PHST- 2012/02/22 06:00 [pubmed]
PHST- 2012/06/29 06:00 [medline]
AID - 10.2165/11599080-000000000-00000 [doi]
PST - ppublish
SO  - Clin Drug Investig. 2012 Apr 1;32(4):267-79. doi: 
      10.2165/11599080-000000000-00000.