Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-27T02:01:22.208Z Has data issue: false hasContentIssue false

Efficacy of risperidone, olanzapine and clozapine in the treatment of therapy resistant schizophrenia

Published online by Cambridge University Press:  18 September 2015

M. Wardenier
Affiliation:
Arts, Psychosencluster, GGZ-Drenthe, Assen
C.J. Slooff*
Affiliation:
Psychiater, Psychosencluster, GGZ-Drenthe, Assen UHD, disciplinegroep Psychiatrie, RU Groningen
J. Arends
Affiliation:
Psychiater, Psychosencluster, GGZ-Drenthe, Assen
*
Psychosencluster, GGZ-Drenthe, Postbus 30.007, 9400 RA Assen, Nederland, Tel. 0592 334883, Fax 0592 334745, e-mail:, [email protected]

Summary

Therapy-resistance for positive symptoms is one of the most important problems that occurs with the medical treatment of schizophrenia. In the past years, clozapine has proven its effectiveness in this area and has been included in the treatment protocols and guidelines. Because of the risk of agranulocytosis with this compound and the intensive laboratory controls to be done, several studies have been performed with the new antipsychotics risperidone and olanzapine as alternative treatments. A review of the literature suggests that both drugs are as effective as the classic antipsychotics for therapy-resistant patients. A switch to risperidone or olanzapine possibly would be a alternative for those patients who have favourable effects on a low dose of clozapine. Furthermore the new antipsychotics have less side effects and ameliorating effects on negative and cognitive symptoms, so contributing to overall improvement in chronic schizophrenic disorders. However, in case of persistent positive symptopathology, clozapine remains the golden standard. The new antipsychotics should be included in treatment protocols before clozapine.

Type
Articles
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Literatuur

1.Wiersma, D. Nienhuis, FJ. Gioì, R. do Jong, A. Slooff, CJ. Natural course of schizophrenic disorders. A 15-ycar follow-up of a Dutch incidence cohort. Schizophr Bull 1998:24:7585.CrossRefGoogle ScholarPubMed
2.Kane, J. Honigfield, G, Singer, J. Clozapine for treatment resistant schizophrenia: a double blind comparison with chloropromazine. Arch Gen Psychiatry 1988:45:789796.CrossRefGoogle Scholar
3.Wahlback, K. Cheine, K. Essali, MAet al.Clozapine versus typical neuroleptic medication for Schizophrenia. Cochrane Library Oxford. 1999.CrossRefGoogle Scholar
4.Taylor, D, McConnell, D. McConell, H, Abel, K. Kerwin, R. The Bethlem & Maudslcy NHS Trust Prescribing Guidelines. 1999.Google Scholar
5.Meitzer, HY, Lee, M. Cola, P. The evolution of treatment resistance: biologic implications. J Clin Psvchopharmocol 1998:18/2:suppl 1.5S11S.CrossRefGoogle Scholar
6.Meitzer, HY. Dimensions of outcome with clozapine. Br J Psychiatry 1992:160;suppl 17:4653.CrossRefGoogle Scholar
7.Slooff, CJ. Louwerens, JW. van den Bosch, RJ. Richtlijnen en stan-daarden: een aanzet tot protocollering. In: Van den Bosch, RJ. Louwerens, JW, Slooff, CJ (eds.). Behandelingsstrategieën bij Schizofrenie. Bohn, Stafleu Van Loghum. 2e herziene druk. 1999.Google Scholar
8.Lader, M. Some adverse effects of antipsychotics: prevention and treatment. J Clin Psychiatry 1999: suppl. 12:1821.Google ScholarPubMed
9.Daniel, DG. Whitcomb, SR. Treatment of the refractory schizophrenic patient. J Clin Psychiatry 1998:59:Suppl 1.Google ScholarPubMed
10.Campbell, M, Young, PI. Baleman, DN. Smith, JM. Thomas, SHL. The use of atypical antipsychotics in the management of schizophrenia. Br J Clin Pharmacol 1999:47:1322.CrossRefGoogle ScholarPubMed
11.Marder, SR. Meibach, RC. Risperidone in the treatment of schizophrenia. Am J Psychiatry 1994:151:825835.Google ScholarPubMed
12.Möller, JH. Definition, psychopharmacological basis and clinical evaluation of novel/atypical neuroleptics: methodological issues and clinical consequences. World J Biol Psychiatry 2000:1:7591.CrossRefGoogle ScholarPubMed
13.Tollefson, GD. Beasley, CM, Tran, PV. Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schziofre-niform disorders: results of an international collaborative trial. Am J Psychiatry 1997:154:457465.Google ScholarPubMed
14.Tran, PV. Hamilton, SH. Kuntz, AJet al.Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol 1997:17:407413.CrossRefGoogle ScholarPubMed
15.Conley, RR, Mahmoud R and the Risperidone Study Group. Risperidone versus olanzapine in patients with schizophrenia and schizoaffective distorder. Presented at the US Psychiatric and Mental Health Congress. Atlanta. 11 1999.Google Scholar
16. 1 Ho, BC. Miller, D. Nopoulos, P. Andreasen, N. A comparative effective study of risperidone and olanzapine in the treatment of schizophrenia. J Clin Psychiatry 1999:60:658663.CrossRefGoogle ScholarPubMed
17.Stahl, S. Selecting an atypical antipsychotic by combining clinical experiences with guidelines from clinical trials. J Clin Psychiatry 1999:60:suppl 10:3141.Google ScholarPubMed
18.Wirshing, DA. Marshall, BD. Green, MF. Risperidone in treatment-refractory schizophrenia. Am J Psychiatry 1999:156:13741379.CrossRefGoogle ScholarPubMed
19.Conley, RR. Tamminga, CA. Baitko, JJet al.Olanzapine compared with chlorpromazine in treatment-resistant schizophrenia. Am J Psychiat ry 1998:155:914920.CrossRefGoogle ScholarPubMed
20.Bcuzcn, JN. Birkett, MA. Kiesler, GM. An investigation of subgroup effects in a study of olanzapine versus clozapine in the treatment of resistant schizophrenic patients. Eur Neuropsvchopharmacol 1998:8:226227.Google Scholar
21.Smith, RC. Chua, JW, Lipetsker, B. Bhattacharyya, A. An efficacy of risperidone in reducing positive and negative symptoms in medication-refractory schizophrenia: an open prospective study. J Clin Psychiatry 1996:57:460466.CrossRefGoogle ScholarPubMed
22.Claus, A. Bollen, J. De Cuyper, Het al.Risperidone versus haloperiodol in the treatment of chronic schizophrenic inpatients: a multicentre double-blind comparative study. Acta Psychiatr Scant! 1992:85:295305.CrossRefGoogle Scholar
23.McEvoy, JP. Efficacy of risperidone on positive features of schizophrenia. J Clin Psychiatry 1994;55:5 suppl: 1821.Google ScholarPubMed
24.Breier, A. Hamilton, SH. Compatative efficacy of olanzapine and haloperidol for patients with treatment-resistant schizophrenia. Biol Psychiatry 1999:45:403411.CrossRefGoogle Scholar
25.Klieser, E. Lehmann, E. Kinzler, E. Wurthmann, C. Heinrich, K. Randomized, double blind controlled trial of risperidone versus clozapine in patients with chronic schizophrenia. J Clin Psychopharmacol 1995:15:suppl 1:45S51S.CrossRefGoogle ScholarPubMed
26.Breier, AF. Malhotra, AK. Su, TPet al.Clozapine and risperidone in chronic schizophrenia: effects on symptoms, parkinsonian side effects, and neuroendocrine response. Am J Psychiatry 1999:156:294298.CrossRefGoogle ScholarPubMed
27.Bondolfi, G. Dufour, H, Patris, Met al.Risperidone versus clozapine in treatment-resistant chronic schizophrenia: a randomized double-blind study. Am J Psychiatry 1998:155:499504.CrossRefGoogle ScholarPubMed
28.Henderson, DC. Nasrallah, RA. Goff, DC. Switching from clozapine to olanzapine in treatment-refractory schizophrenia: safety, clinical efficacy. and predictors of response. J Clin Psychiatry 1998:59:585588.CrossRefGoogle ScholarPubMed
29.Oliemeulen, EAP. van Hoof, JJM. Jogems-Kostcrman, BJM. Hulstijn, W. Tuynman-Qua, HG. Is olanzapine a substitute for clozapine?The effects on psychomotor performance: Proceedings of the 10th Biennial Winterworkshop on schizophrenia: 2000. Feb 6-11.: Davos. Switzerland. Schizophr Res 2000:41 (1): 187.Google Scholar
30.Tuunaincn, A. Gilbody, SM. Newer Antipsychotic Medication Versus Clozapine For Schizophrenia. Oxford. Cochrane Library, 1999.Google Scholar
31.Leppig, M, Bosch, B, Naber, DHippius, H. Clozapine in the treatment of 12 Tout-patients. Psychopharmacol 1989:99:S77S79.CrossRefGoogle Scholar
32.Morera, AL. Barreiro, P. Cano-Munoz. Risperidone and clozapine combination for the treatment of refractorv schizophrenia. Acta Psychiatr Scand 1999:99:305307.CrossRefGoogle ScholarPubMed
33.McCarthy, RH, Terkelsen, KG. Risperidone augmentation of clozapine. Pharmacopsychiatr 1995:28:6163.CrossRefGoogle ScholarPubMed
34.Jones, C, Cormac, I, Mota, Jet al.Cogntive behavior therapy for schizophrenia. Oxford. Cochrane Library. Vol 1998.Google Scholar