Olanzapine compared to quetiapine in adolescents with a first psychotic episode
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To compare the efficacy, safety, and tolerability of olanzapine and quetiapine in adolescents with first episode psychosis.
Fifty adolescents (age 16 ± 1.25) with a first episode of psychosis were randomized to quetiapine or olanzapine in a 6-month open label study. Efficacy and side effect scales, as well as vital signs and laboratory data were recorded at baseline, 7, 15, 30, 90, and 180 days (end of study).
Out of the total sample included in the study, 32 patients completed the trial (quetiapine n = 16, olanzapine n = 16). Patients in both treatment groups had a significant reduction in all clinical scales with the exception of the negative scale of the Positive and Negative Symptom Scale (PANSS) for olanzapine and the general psychopathology scale of the PANSS for quetiapine. The only difference between treatment arms on the clinical scales was observed on the patients’ strength and difficulties questionnaire (SDQ) scale, with greater improvement for olanzapine. Patients on olanzapine gained 15.5 kg and patients on quetiapine gained 5.5 kg.
Olanzapine and quetiapine reduced psychotic symptoms in this adolescent sample. Patients on olanzapine gained significantly more weight. Side effects with both drugs seemed to be more prevalent than those reported in adult studies.
Keywordsolanzapine quetiapine safety tolerability adolescent first episode psychosis
- 14.Guy W (1976) Clinical Global Impression. ECDEU Assessment Manual for Psychopharmacology revised. National Institute of Mental Health, RockvilleGoogle Scholar
- 16.Jones PB, Barnes TR, Davies L, Dunn G, Lloyd H, Hayhurst KP, Murray RM, Markwick A, Lewis SW (2006) Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1). Arch Gen Psychiatry 63:1079–1087PubMedCrossRefGoogle Scholar
- 17.Kahn RS, Fleischhacker WW, Boter H, Davidson M, Vergouwe Y, Keet IP, Gheorghe MD, Rybakowski JK, Galderisi S, Libiger J, Hummer M, Dollfus S, Lopez-Ibor JJ, Hranov LG, Gaebel W, Peuskens J, Lindefors N, Riecher-Rossler A, Grobbee DE (2008) Effectiveness of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: an open randomised clinical trial. Lancet 371:1085–1097PubMedCrossRefGoogle Scholar
- 18.Kay SR, Opler LA, Lindenmayer JP (1989) The positive and negative syndrome scale (PANSS): rationale and standardisation. Br J Psychiatry Suppl, pp 59–67Google Scholar
- 22.Laita P, Cifuentes A, Doll A, Llorente C, Cortes I, Parellada M, Moreno D, Ruiz-Sancho A, Graell M, Arango C (2007) Antipsychotic-related abnormal involuntary movements and metabolic and endocrine side effects in children and adolescents. J Child Adolesc Psychopharmacol 17:487–502PubMedCrossRefGoogle Scholar
- 24.Lieberman JA, Tollefson G, Tohen M, Green AI, Gur RE, Kahn R, McEvoy J, Perkins D, Sharma T, Zipursky R, Wei H, Hamer RM (2003) Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trial of olanzapine versus haloperidol. Am J Psychiatry 160:1396–1404PubMedCrossRefGoogle Scholar
- 27.McConville BJ, Arvanitis LA, Thyrum PT, Yeh C, Wilkinson LA, Chaney RO, Foster KD, Sorter MT, Friedman LM, Brown KL, Heubi JE (2000) Pharmacokinetics, tolerability, and clinical effectiveness of quetiapine fumarate: an open-label trial in adolescents with psychotic disorders. J Clin Psychiatry 61:252–260PubMedGoogle Scholar
- 30.Naber D, Karow A, Lambert M (2005) Subjective well-being under the neuroleptic treatment and its relevance for compliance. Acta Psychiatr Scand Suppl, pp 29–34Google Scholar