Standard and higher dose of olanzapine in patients with schizophrenia or schizoaffective disorder

A randomized, double-blind, fixed-dose study

Bruce J. Kinon, Jan Volavka, Virginia Stauffer, Sara E. Edwards, Hong Liu-Seifert, Lei Chen, David H. Adams, Jean Pierre Lindenmayer, Joseph Patrick McEvoy, Peter F Buckley, Jeffrey A. Lieberman, Herbert Y. Meltzer, Daniel R. Wilson, Leslie Citrome

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

The objective of this study was to assess the dose-response relationship of standard and higher doses of olanzapine in a randomized, double-blind, 8-week, fixed-dose study comparing olanzapine 10 (n = 199), 20 (n = 200), and 40 mg/d (n = 200) for patients with schizophrenia or schizoaffective disorder and suboptimal response to current treatment. Patients meeting criteria for antipsychotic treatment resistance were excluded. Dose-response relationship was assessed by linear regression analysis with log-transformed dose (independent variable) and Positive and Negative Syndrome Scale (PANSS) total score (dependent variable). There were no significant dose group differences in patients completing the study (overall, 67.8%). All dose groups showed statistically significant improvement in PANSS total scores from baseline to end point without significant dose-response relationship (P = 0.295). Post hoc analysis of response showed significant interaction between baseline PANSS and dose (P = 0.023), indicating better response at higher doses for patients with higher baseline PANSS. There was a significant dose response for mean change in weight (P = 0.003) with significant difference between the 10- and 40-mg-dose groups (P = 0.002; 1.9 [10 mg/d], 2.3 [20 mg/d], and 3.0 kg [40 mg/d]). There was a significant dose response for change in prolactin (P < 0.001) with a significant difference between each group (-10.5 [10 mg/d], -1.7 [20 mg/d], and 4.9 ng/mL [40 mg/d]; P ≤ 0.018). Over 8 weeks, non-treatment-resistant patients with schizophrenia or schizoaffective disorder responded to all 3 doses of olanzapine, without a statistically significant dose-response relationship, suggesting that for many patients with schizophrenia or schizoaffective disorder, particularly those who are mildly or moderately ill, 10 mg/d should be the initial dose of choice.

Original languageEnglish (US)
Pages (from-to)392-400
Number of pages9
JournalJournal of Clinical Psychopharmacology
Volume28
Issue number4
DOIs
StatePublished - Aug 1 2008

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olanzapine
Psychotic Disorders
Schizophrenia
Prolactin
Antipsychotic Agents
Linear Models
Regression Analysis
Weights and Measures

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Standard and higher dose of olanzapine in patients with schizophrenia or schizoaffective disorder : A randomized, double-blind, fixed-dose study. / Kinon, Bruce J.; Volavka, Jan; Stauffer, Virginia; Edwards, Sara E.; Liu-Seifert, Hong; Chen, Lei; Adams, David H.; Lindenmayer, Jean Pierre; McEvoy, Joseph Patrick; Buckley, Peter F; Lieberman, Jeffrey A.; Meltzer, Herbert Y.; Wilson, Daniel R.; Citrome, Leslie.

In: Journal of Clinical Psychopharmacology, Vol. 28, No. 4, 01.08.2008, p. 392-400.

Research output: Contribution to journalArticle

Kinon, BJ, Volavka, J, Stauffer, V, Edwards, SE, Liu-Seifert, H, Chen, L, Adams, DH, Lindenmayer, JP, McEvoy, JP, Buckley, PF, Lieberman, JA, Meltzer, HY, Wilson, DR & Citrome, L 2008, 'Standard and higher dose of olanzapine in patients with schizophrenia or schizoaffective disorder: A randomized, double-blind, fixed-dose study', Journal of Clinical Psychopharmacology, vol. 28, no. 4, pp. 392-400. https://doi.org/10.1097/JCP.0b013e31817e63a5
Kinon, Bruce J. ; Volavka, Jan ; Stauffer, Virginia ; Edwards, Sara E. ; Liu-Seifert, Hong ; Chen, Lei ; Adams, David H. ; Lindenmayer, Jean Pierre ; McEvoy, Joseph Patrick ; Buckley, Peter F ; Lieberman, Jeffrey A. ; Meltzer, Herbert Y. ; Wilson, Daniel R. ; Citrome, Leslie. / Standard and higher dose of olanzapine in patients with schizophrenia or schizoaffective disorder : A randomized, double-blind, fixed-dose study. In: Journal of Clinical Psychopharmacology. 2008 ; Vol. 28, No. 4. pp. 392-400.
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