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Long-Term Olanzapine Treatment in Schizophrenic Outpatients: Its Effects on Their Quality of Life and Clinical Outcome

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Comprehensive Treatment of Schizophrenia

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Summary

This multicenter, open-label study was designed to evaluate the long-term effects of olanzapine on the quality of life (QOL) of persons with schizophrenia. A total of 29 outpatients diagnosed with schizophrenia, schizotypal disorder, or schizoaffective disorder, including 18 day-care patients, were enrolled in 10 treatment facilities. The study period lasted 24 weeks and was extended to 48 to 52 weeks where possible. The patients’ QOL was assessed with the Quality of Life Scale (QLS) established by Heinrichs et al. The Mean change from baseline to endpoint showed significant improvement in the total score and in all subscales of the QLS (P ≦ 0.005). Some patients also showed improvement in real world psychosocial functioning domains. In addition, there was a noticeable decrease in hospitalization rates. Significant improvement from baseline to 24 weeks was observed in the Brief Psychiatric Rating Scale (BPRS) total and all BPRS subscores (P ≦ 0.028) except hostility. According to the Final Global Improvement Rating (FGIR), 22 patients (75.9%) were assessed as slightly improved or better, with moderate or remarkable improvement observed in 13 patients (44.8%). In terms of extrapyramidal symptoms, significant improvement from baseline to 48/52 weeks was observed for Drug-Induced Extra-Pyramidal Symptoms Scale (DIEPSS) total, overall severity, parkinsonism, and akathisia (P ≦ 0.008). The results of this study suggest that long-term treatment with olanzapine has beneficial effects not only in the clinical domain, but also on functional status and QOL for Japanese patients with schizophrenia living in the community.

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References

  1. Carpenter WTJ (1996) Maintenance therapy of persons with schizophrenia. J Clin Psychiatry 57(Suppl 9):10–18

    PubMed  Google Scholar 

  2. Hogarty GE, Goldberg SC, Schooler NR, et al (1974) Drug and sociotherapy in the aftercare of schizophrenic patients. Arch Gen Psychiatry 31:603–608

    Article  PubMed  CAS  Google Scholar 

  3. Kane JM, Rifkin A, Woerner M (1983) Low-dose neuroleptic treatment of outpatient schizophrenics I. Preliminary results for relapse rates. Arch Gen Psychiatry 40:893–896

    Article  PubMed  CAS  Google Scholar 

  4. Kissling W (1992) Ideal and reality of neuroleptic relapse prevention. Br J Psychiatry 161(Suppl 18):133–139

    Google Scholar 

  5. Awad AG (1994) Subjective response to neuroleptics and the quality of life: implications for treatment outcome. Acta Psychiatr Scand 89(Suppl 380):27–32

    Article  Google Scholar 

  6. Awad AG, Hogan TP, Voruganti LNP, et al (1995) Patients’ subjective experiences on antipsychotic medications: implications for outcome and quality of life. Int Clin Psy-chopharmacol 10(Suppl 3):123–132

    Article  Google Scholar 

  7. Kane JM (1994) Clozapine: negative symptoms and extrapyramidal side effects. J Clin Psychiatry 55(Suppl B):74–77

    PubMed  Google Scholar 

  8. Lewander T (1994) Neuroleptics and the neuroleptic-induced deficit syndrome. Acta Psychiatr Scand 89(Suppl 380):8–13

    Article  Google Scholar 

  9. Van Putten T, May PRA (1978) “Akinetic depression” in schizophrenia. Arch Gen Psychiatry 35:1101–1107

    Article  PubMed  Google Scholar 

  10. Van Putten T, Marder SR (1987) Behavioral toxicity of antipsychotic drugs. J Clin Psychiatry 48(suppl):13–19

    PubMed  Google Scholar 

  11. Kane JM, Honigfeld G, Singer J, et al (1988) Clozapine for the treatment-resistant schizophrenic. Arch Gen Psychiatry 45:789–796

    Article  PubMed  CAS  Google Scholar 

  12. Franz M, Lis S, Pluddemann K, et al (1997) Conventional versus atypical neuroleptics: subjective quality of life in schizophrenic patients. Br J Psychiatry 170:422–425

    Article  PubMed  CAS  Google Scholar 

  13. Green MF (1996) What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 153:321–330

    PubMed  CAS  Google Scholar 

  14. Meltzer HY (1992) Dimensions of outcome with clozapine Brit J Psychiatry 160(suppl 17):46–53

    Google Scholar 

  15. Meltzer HY, Thompson PA, Lee MA, et al (1996) Neuropsychological deficits in schizophrenia: relation to social function and effect of antipsychotic drug treatment. Neuropsychopharmacoly 14(Suppl 3):27S–33S

    Article  CAS  Google Scholar 

  16. Sullivan G, Wells KB, Leake B (1992) Clinical factors associated with better quality of life in a seriously mentally ill population. Hosp Commun Psychiatry 43:794–798

    CAS  Google Scholar 

  17. Heinrichs DW, Hanlon TE, Carpenter WT Jr (1984) The quality of life scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 10:388–398

    PubMed  CAS  Google Scholar 

  18. Kirkpatrick B, Buchanan RW, Mckenney PD, et al (1989) The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatr Res 30:119–123

    Article  CAS  Google Scholar 

  19. Miyata R, Fujii Y (1995) Quality of Life Scale (QLS): guide to its usage. Seiwa Shoten, Tokyo

    Google Scholar 

  20. Miyata R, Fujii Y, Inagaki A, et al (1995) Reliability of the Japanese version of Quality of Life Scale (QLS). 91st Annual Meeting of the Japanese Society of Psychiatry and Neurology, Nagasaki

    Google Scholar 

  21. Overall LE, Gorham DR (1962) The Brief Psychiatric Rating Scale. Psychol Rep 10:799–812

    Google Scholar 

  22. Miyata R, Fujii Y, Inagaki A, et al (1995) Reliability of the Japanese version of Brief Psychiatric Rating Scale (BPRS). Clin Eval 23:357–367

    Google Scholar 

  23. Inada T (1996) Evaluation and diagnosis of drug-induced extrapyramidal symptoms: commentary on DIEPSS and guide to its usage. Seiwa Shoten, Tokyo

    Google Scholar 

  24. Foster RH, Goa KL (1998) Risperidone: a pharmacoeconomic review of its use in schizophrenia. Pharmacoeconomics 14:97–133

    Article  PubMed  CAS  Google Scholar 

  25. Hamilton SH, Revicki DA, Edgell ET, et al (1999) Clinical and economic outcomes of olanzapine compared with haloperidol for schizophrenia. Results of a randomized clinical trial. Pharmacoeconomics 15:469–480

    Article  PubMed  CAS  Google Scholar 

  26. Lehman AF (1996) Evaluating outcomes of treatments for persons with psychotic disorders. J Clin Psychiatry 57(Suppl ll):61–67

    PubMed  Google Scholar 

  27. Meltzer HY, Burnett S, Bastani B, et al (1990) Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hosp Commun Psychiatry 41:892–897

    CAS  Google Scholar 

  28. Breier A, Buchanan RW, Irish D, et al (1993) Clozapine treatment of outpatients with schizophrenia: outcome and long-term response patterns. Hosp Commun Psychiatry 44:1145–1149

    CAS  Google Scholar 

  29. Revicki DA, Genduso LA, Hamilton SH, et al (1999) Olanzapine versus Haloperidol in the treatment of schizophrenia and other psychotic disorders: Quality of life and clinical outcomes of a randomized clinical trial. Qual Life Res 8:417–426

    Article  PubMed  CAS  Google Scholar 

  30. Hamilton SH, Revicki DA, Genduso LA, et al (1998) Olanzapine versus placebo and haloperidol: Quality of life and efficacy results of the North American double-blind trial. Neuropsychopharmacology 18:41–49

    Article  PubMed  CAS  Google Scholar 

  31. Addington DE, Jones B, Bloom D, et al (1993) Reduction of hospital days in chronic schizophrenic patients treated with risperidone: a retrospective study. Clin Therapeut 15:917–926

    CAS  Google Scholar 

  32. Albright PS, Livingstone S, Keegan D, et al (1996) Reduction of healthcare resouce utilisation and costs following the use of risperidone for patients with schizophrenia previously treated with standard antipsychotic therapy. Clin Drug Invest 11:289–299

    Article  Google Scholar 

  33. Csernansky J, Okamoto A, Brecher M (1999) Risperidone vs haloperidol for prevention of relapse in schizophrenia and schizoaffective disorders: a long-term double-blind comparison. Biological Psychiatry Annual Meeting, Washington, DC

    Google Scholar 

  34. Lindstrom LH, Eriksson B, Hellgren A, et al (1995) Efficacy and safety of risperidone in the long-term treatment of patients with schizophrenia. Clin Ther 151:825–835

    Google Scholar 

  35. Viale G, Mechling L, Durkin M, et al (1997) Impact of risperidone on the use of mental health care resources. Psychiatr Serv 48:1153–1159

    PubMed  CAS  Google Scholar 

  36. Tran PV, Dellva MA, Tollefson GD, et al (1998) Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychosis. Br J Psychiatry 172:499–505

    Article  PubMed  CAS  Google Scholar 

  37. Beasley CMJ, Tollefson GD, Tran PV (1997) Efficacy of olanzapine: an overview of pivotal clinical trials. J Clin Psychiatry 58(Suppl 10):7–12

    PubMed  CAS  Google Scholar 

  38. Beasley CMJ, Tollefson GD, Tran PV (1997) Safety of olanzapine. J Clin Psychiatry 58(Suppl 10):13–17

    PubMed  CAS  Google Scholar 

  39. Fulton B, Goa KL (1997) Olanzapine: a review of its pharmacological properties and therapeutic efficacy in the management of schizophrenia and related psychoses. Drugs 53:281–298

    Article  PubMed  CAS  Google Scholar 

  40. Allebeck P (1989) Schizophrenia: a life shortening disease. Schizophr Bull 15:81–89

    PubMed  CAS  Google Scholar 

  41. Cooper H, Klewe J (1995) Insight and acceptance of the need for medication. Primary Care Psychiatry 2(Suppl 1):1–3

    Google Scholar 

  42. Larsen P, Ashleigh EA (1996) Response to risperidone: a two edged sword? J Calif Alliance Mentally Ill 7:17–18

    Google Scholar 

  43. Weiden P, Aquila R, Standard J (1996) Atypical antipsychotic drugs and long-term outcome in schizophrenia. J Clin Psychiatry 57(Suppl 11):53–60

    PubMed  CAS  Google Scholar 

  44. Fujii Y, Hayama T, Inagaki A, et al (1998) Switching from conventional antipsychotics to risperidone for schizophrenic patients and one year follow-up. Jpn J Psychopharmacol 1:527–541

    Google Scholar 

  45. Meltzer HY, Okayli G (1995) Reduction of suicidality during clozapine treatment of neuroleptic-resistant schizophrenia: impact on risk-benefit assessment. Am J Psychiatry 152:183–190

    PubMed  CAS  Google Scholar 

  46. Allison DB, Mentore JL, Heo M, et al (1998) Weight gain associated with conventional and newer antipsychotics: a meta-analysis. 21th CINP, Glasgow

    Google Scholar 

  47. Wirshing DA, Wirshing WC, Kysar L, et al (1999) Novel antipsychotics: comparison of weight gain liabilities. J Clin Psychiatry 60:358–363

    Article  PubMed  CAS  Google Scholar 

  48. Crawford AMK, Beasley CMJ, Tollefson GD (1997) The acute and long-term effect of olanzapine compared with placebo and haloperidol on serum prolactin concentrations. Schizophr Res 26:41–54

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Yamanashi Prefectural Kita Hospital, 3314-13 Kamijominamiwari, Asahimachi, Nirasaki, Yamanashi, 407-0046, Japan

    Yasuo Fujii & Ryoji Miyata

  2. Department of Psychiatry, School of Medicine, Kitasato University, 2-1-1 Asamizodai, Sagamihara, Kanagawa, 228-8520, Japan

    Mitsukuni Murasaki

  3. Department of Psychiatry, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawaku, Tokyo, 142-8666, Japan

    Kunitoshi Kamijima

  4. Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Gohei Yagi

Authors
  1. Yasuo Fujii
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  2. Ryoji Miyata
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  3. Mitsukuni Murasaki
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  4. Kunitoshi Kamijima
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  5. Gohei Yagi
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Editors and Affiliations

  1. Department of Neuropsychiatry, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Haruo Kashima M.D. (Professor), Masafumi Mizuno M.D. (Instructor) & Masahiro Asai M.D. (Guest Professor) (Professor),  (Instructor) &  (Guest Professor)

  2. School of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand

    Ian R. H. Falloon M.D. (Professor of Psychiatry & Behavioural Science) (Professor of Psychiatry & Behavioural Science)

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© 2002 Springer-Verlag Tokyo

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Fujii, Y., Miyata, R., Murasaki, M., Kamijima, K., Yagi, G. (2002). Long-Term Olanzapine Treatment in Schizophrenic Outpatients: Its Effects on Their Quality of Life and Clinical Outcome. In: Kashima, H., Falloon, I.R.H., Mizuno, M., Asai, M. (eds) Comprehensive Treatment of Schizophrenia. Keio University International Symposia for Life Sciences and Medicine, vol 8. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68514-2_15

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  • DOI: https://doi.org/10.1007/978-4-431-68514-2_15

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68516-6

  • Online ISBN: 978-4-431-68514-2

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