Psychiatr. praxi 2018; 19(1): 22-23 | DOI: 10.36290/psy.2018.005

Is there an evidence for the efficacy of high-dose olanzapine?

MUDr. Martin Hýža
Psychiatrické oddělení, Fakultní nemocnice Ostrava
Katedra neurologie a psychiatrie, Lékařská fakulta, Ostravská univerzita

High-dose olanzapine is an option in the effort to break the pharmacoresistance in the treatment of schizophrenia. This is groundedboth by the expert recommendations and a few randomized, double-blind trials that compared the efficacy of high-doseolanzapine (25–45 mg/d) with recommended-dose clozapine and found the same efficacy of both. High doses are generally welltolerated with the exception of the increase of weight. Therapeutic drug monitoring is recommended while titrating high dosesand one has to take care of potential signs of toxicity.

Keywords: olanzapine, schizophrenia, pharmacoresistance

Published: April 10, 2018  Show citation

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Hýža M. Is there an evidence for the efficacy of high-dose olanzapine? Psychiatr. praxi. 2018;19(1):22-23. doi: 10.36290/psy.2018.005.
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    References

    1. Love RC. Novel versus conventional antipsychotic drugs. Pharmacotherapy. 1996; 16(1 Pt 2): 6-10. Go to original source... Go to PubMed...
    2. SPC Zyprexa. www.sukl.cz, revize textu: 27.2.2017
    3. Kane JM, Leucht S, Carpenter D, Docherty JP. Expert Consensus Panel for Optimizing Pharmacologic Treatment of Psychotic Disorders. The expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary. J Clin Psychiatry. 2003; 64(Suppl 12): 5-19.
    4. Citrome L, Jaffe A, Levine J. Datapoints: The ups and downs of dosing second-generation antipsychotics. Psychiatr Serv. 2007; 58(1): 11. Go to original source... Go to PubMed...
    5. Lieberman JA, Stroup TS, McEvoy JP, et al. Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005; 353(12): 1209-1223. Go to original source...
    6. Tollefson GD, Birkett MA, Kiesler GM, Wood AJ; Lilly Resistant Schizophrenia Study Group. Double-blind comparison of olanzapine versus clozapine in schizophrenic patients clinically eligible for treatment with clozapine. Biol Psychiatry. 2001; 49(1): 52-63. Go to original source... Go to PubMed...
    7. Bitter I, Dossenbach MR, Brook S, et al. Olanzapine HGCK Study Group. Olanzapine versus clozapine in treatment-resistant or treatment-intolerant schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2004; 28(1): 173-180. Go to original source... Go to PubMed...
    8. Meltzer HY, Bobo WV, Roy A, et al. A randomized, double-blind comparison of clozapine and high-dose olanzapine in treatment-resistant patients with schizophrenia. J Clin Psychiatry. 2008; 69(2): 274 - 285. Go to original source... Go to PubMed...
    9. Kumra S, Kranzler H, Gerbino-Rosen G, et al. Clozapine and "high-dose" olanzapine in refractory early-onset schizophrenia: a 12-week randomized and double-blind comparison. Biol Psychiatry. 2008; 63(5): 524-529. Go to original source...
    10. Kumra S, Kranzler H, Gerbino-Rosen G, et al. Clozapine versus "high-dose" olanzapine in refractory early-onset schizophrenia: an open-label extension study. J Child Adolesc Psychopharmacol. 2008; 18(4): 307-316. Go to original source...
    11. Volavka J, Czobor P, Sheitman B, et al. Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder. Am J Psychiatry. 2002; 159(2): 255-262. Go to original source...
    12. Kelly DL, Richardson CM, Yu Y, Conley RR. Plasma concentrations of high-dose olanzapine in a double-blind crossover study. Hum Psychopharmacol. 2006; 21(6): 393-398. Go to original source...
    13. Citrome L, Stauffer VL, Chen L, et al. Olanzapine plasma concentrations after treatment with 10, 20, and 40 mg/d in patients with schizophrenia: an analysis of correlations with efficacy, weight gain, and prolactin concentration. J Clin Psychopharmacol. 2009; 29(3): 278-283. Go to original source... Go to PubMed...
    14. Kinon BJ, Volavka J, Stauffer V, et al. Standard and higher dose of olanzapine in patients with schizophrenia or schizoaffective disorder: a randomized, double-blind, fixed-dose study. J Clin Psychopharmacol. 2008; 28(4): 392-400. Go to original source... Go to PubMed...
    15. Lerner V. High-dose olanzapine for treatment-refractory schizophrenia. Clin Neuropharmacol. 2003; 26(2): 58-61. Go to original source... Go to PubMed...
    16. Qadri SF, Padala PR, Strunk JC, Boust SJ. High-dose olanzapine orally disintegrating tablets for treatment-resistant psychosis. Prim Care Companion J Clin Psychiatry. 2006; 8(4): 244-245. Go to original source...
    17. Batail J-M, Bleher S, Lozachmeur C, Robert G, Millet B, Drapier D. Very-high-dose olanzapine for treatment-resistant schizophrenia. Open J Psychiatry 2012; 2(4): 269-271. Go to original source...
    18. Petersen AB, Andersen SE, Christensen M, Larsen HL. Adverse effects associated with high-dose olanzapine therapy in patients admitted to inpatient psychiatric care. Clin Toxicol (Phila). 2014; 52(1): 39-43. Go to original source... Go to PubMed...
    19. Kelly DL, Conley RR, Richardson CM, Tamminga CA, Carpenter WT Jr. Adverse effects and laboratory parameters of high-dose olanzapine vs. clozapine in treatment-resistant schizophrenia. Ann Clin Psychiatry. 2003; 15(3-4): 181-186. Go to original source... Go to PubMed...
    20. Batail J-M, Langrée B, Robert G, et al. Use of very-high-dose olanzapine in treatment-resistant schizophrenia. Schizophr Res. 2014; 159(2-3): 411-414. Go to original source... Go to PubMed...
    21. Correll CU. Antipsychotic polypharmacy, Part 2: why use 2 antipsychotics when 1 is not good enough? J Clin Psychiatry. 2008; 69(5): 860-861. Go to original source... Go to PubMed...
    22. Hiemke C, Bergemann N, Clement HW, et al. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017. Pharmacopsychiatry. 2018; 51(1-02): 9-62. Go to original source... Go to PubMed...

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