Intramuscular Olanzapine and Intramuscular Haloperidol in Acute Schizophrenia: Antipsychotic Efficacy and Extrapyramidal Safety during the First 24 Hours of Treatment

Padraig Wright, Stacy R. Lindborg, Martin Birkett, Karena Meehan, Barry Jones, Karla Alaka, Iris Ferchland-Howe, Anne Pickard, Cindy C. Taylor, John Roth, John Battaglia, István Bitter, Guy Chouinard, Philip L P Morris, Alan Breier

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objective: To determine the antipsychotic efficacy and extrapyramidal safety of intramuscular (IM) olanzapine and IM haloperidol during the first 24 hours of treatment of acute schizophrenia. Method: Patients (n = 311) with acute schizophrenia were randomly allocated (2:2: 1) to receive IM olanzapine (10.0 mg, n = 131), IM haloperidol (7.5 mg, n = 126), or IM placebo (n = 54). Results: After the first injection, IM olanzapine was comparable to IM haloperidol and superior to IM placebo for reducing mean change scores from baseline on the Brief Psychiatric Rating Scale (BRPS) Positive at 2 hours (-2.9 olanzapine, -2.7 haloperidol, and -1.5 placebo) and 24 hours (-2.8 olanzapine, -3.2 haloperidol, and -1.3 placebo); the BPRS Total at 2 hours (-14.2 olanzapine,-13.1 haloperidol, and -7.1 placebo) and 24 hours (-12.8 olanzapine, -12.9 haloperidol, and -6.2 placebo); and the Clinical Global Impressions (CGI) scale at 24 hours (-0.5 olanzapine, -0.5 haloperidol, and -0.1 placebo). Patients treated with IM olanzapine had significantly fewer incidences of treatment-emergent parkinsonism (4.3% olanzapine vs 13.3% haloperidol, P = 0.036), but not akathisia (1.1% olanzapine vs 6.5% haloperidol, P = 0.065), than did patients treated with IM haloperidol; they also required significantly less anticholinergic treatment (4.6% olanzapine vs 20.6% haloperidol, P <0.001). Mean extrapyramidal symptoms (EPS) safety scores improved significantly from baseline during IM olanzapine treatment, compared with a general worsening during IM haloperidol treatment (Simpson-Angus Scale total score mean change: -0.61 olanzapine vs 0.70 haloperidol; P <0.001; Barnes Akathisia Scale global score mean change: -0.27 olanzapine vs 0.01 haloperidol; P <0.05). Conclusion: IM olanzapine was comparable to IM haloperidol for reducing the symptoms of acute schizophrenia during the first 24 hours of treatment, the efficacy of both being evident within 2 hours after the first injection. In general, more EPS were observed during treatment with IM haloperidol than with IM olanzapine.

Original languageEnglish (US)
Pages (from-to)716-721
Number of pages6
JournalCanadian Journal of Psychiatry
Volume48
Issue number11
StatePublished - Dec 2003

Fingerprint

olanzapine
Haloperidol
Antipsychotic Agents
Schizophrenia
Safety
Placebos
Therapeutics
Psychomotor Agitation

Keywords

  • Agitation
  • Antipsychotic agent
  • EPS
  • Extrapyramidal safety measures
  • Extrapyramidal symptoms
  • Haloperidol
  • Intramuscular
  • Olanzapine
  • Positive symptoms
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Intramuscular Olanzapine and Intramuscular Haloperidol in Acute Schizophrenia : Antipsychotic Efficacy and Extrapyramidal Safety during the First 24 Hours of Treatment. / Wright, Padraig; Lindborg, Stacy R.; Birkett, Martin; Meehan, Karena; Jones, Barry; Alaka, Karla; Ferchland-Howe, Iris; Pickard, Anne; Taylor, Cindy C.; Roth, John; Battaglia, John; Bitter, István; Chouinard, Guy; Morris, Philip L P; Breier, Alan.

In: Canadian Journal of Psychiatry, Vol. 48, No. 11, 12.2003, p. 716-721.

Research output: Contribution to journalArticle

Wright, P, Lindborg, SR, Birkett, M, Meehan, K, Jones, B, Alaka, K, Ferchland-Howe, I, Pickard, A, Taylor, CC, Roth, J, Battaglia, J, Bitter, I, Chouinard, G, Morris, PLP & Breier, A 2003, 'Intramuscular Olanzapine and Intramuscular Haloperidol in Acute Schizophrenia: Antipsychotic Efficacy and Extrapyramidal Safety during the First 24 Hours of Treatment', Canadian Journal of Psychiatry, vol. 48, no. 11, pp. 716-721.
Wright, Padraig ; Lindborg, Stacy R. ; Birkett, Martin ; Meehan, Karena ; Jones, Barry ; Alaka, Karla ; Ferchland-Howe, Iris ; Pickard, Anne ; Taylor, Cindy C. ; Roth, John ; Battaglia, John ; Bitter, István ; Chouinard, Guy ; Morris, Philip L P ; Breier, Alan. / Intramuscular Olanzapine and Intramuscular Haloperidol in Acute Schizophrenia : Antipsychotic Efficacy and Extrapyramidal Safety during the First 24 Hours of Treatment. In: Canadian Journal of Psychiatry. 2003 ; Vol. 48, No. 11. pp. 716-721.
@article{18ee47a6bdfc4db0856c38e53d60367a,
title = "Intramuscular Olanzapine and Intramuscular Haloperidol in Acute Schizophrenia: Antipsychotic Efficacy and Extrapyramidal Safety during the First 24 Hours of Treatment",
abstract = "Objective: To determine the antipsychotic efficacy and extrapyramidal safety of intramuscular (IM) olanzapine and IM haloperidol during the first 24 hours of treatment of acute schizophrenia. Method: Patients (n = 311) with acute schizophrenia were randomly allocated (2:2: 1) to receive IM olanzapine (10.0 mg, n = 131), IM haloperidol (7.5 mg, n = 126), or IM placebo (n = 54). Results: After the first injection, IM olanzapine was comparable to IM haloperidol and superior to IM placebo for reducing mean change scores from baseline on the Brief Psychiatric Rating Scale (BRPS) Positive at 2 hours (-2.9 olanzapine, -2.7 haloperidol, and -1.5 placebo) and 24 hours (-2.8 olanzapine, -3.2 haloperidol, and -1.3 placebo); the BPRS Total at 2 hours (-14.2 olanzapine,-13.1 haloperidol, and -7.1 placebo) and 24 hours (-12.8 olanzapine, -12.9 haloperidol, and -6.2 placebo); and the Clinical Global Impressions (CGI) scale at 24 hours (-0.5 olanzapine, -0.5 haloperidol, and -0.1 placebo). Patients treated with IM olanzapine had significantly fewer incidences of treatment-emergent parkinsonism (4.3{\%} olanzapine vs 13.3{\%} haloperidol, P = 0.036), but not akathisia (1.1{\%} olanzapine vs 6.5{\%} haloperidol, P = 0.065), than did patients treated with IM haloperidol; they also required significantly less anticholinergic treatment (4.6{\%} olanzapine vs 20.6{\%} haloperidol, P <0.001). Mean extrapyramidal symptoms (EPS) safety scores improved significantly from baseline during IM olanzapine treatment, compared with a general worsening during IM haloperidol treatment (Simpson-Angus Scale total score mean change: -0.61 olanzapine vs 0.70 haloperidol; P <0.001; Barnes Akathisia Scale global score mean change: -0.27 olanzapine vs 0.01 haloperidol; P <0.05). Conclusion: IM olanzapine was comparable to IM haloperidol for reducing the symptoms of acute schizophrenia during the first 24 hours of treatment, the efficacy of both being evident within 2 hours after the first injection. In general, more EPS were observed during treatment with IM haloperidol than with IM olanzapine.",
keywords = "Agitation, Antipsychotic agent, EPS, Extrapyramidal safety measures, Extrapyramidal symptoms, Haloperidol, Intramuscular, Olanzapine, Positive symptoms, Schizophrenia",
author = "Padraig Wright and Lindborg, {Stacy R.} and Martin Birkett and Karena Meehan and Barry Jones and Karla Alaka and Iris Ferchland-Howe and Anne Pickard and Taylor, {Cindy C.} and John Roth and John Battaglia and Istv{\'a}n Bitter and Guy Chouinard and Morris, {Philip L P} and Alan Breier",
year = "2003",
month = "12",
language = "English (US)",
volume = "48",
pages = "716--721",
journal = "Canadian Journal of Psychiatry",
issn = "0706-7437",
publisher = "Canadian Psychiatric Association",
number = "11",

}

TY - JOUR

T1 - Intramuscular Olanzapine and Intramuscular Haloperidol in Acute Schizophrenia

T2 - Antipsychotic Efficacy and Extrapyramidal Safety during the First 24 Hours of Treatment

AU - Wright, Padraig

AU - Lindborg, Stacy R.

AU - Birkett, Martin

AU - Meehan, Karena

AU - Jones, Barry

AU - Alaka, Karla

AU - Ferchland-Howe, Iris

AU - Pickard, Anne

AU - Taylor, Cindy C.

AU - Roth, John

AU - Battaglia, John

AU - Bitter, István

AU - Chouinard, Guy

AU - Morris, Philip L P

AU - Breier, Alan

PY - 2003/12

Y1 - 2003/12

N2 - Objective: To determine the antipsychotic efficacy and extrapyramidal safety of intramuscular (IM) olanzapine and IM haloperidol during the first 24 hours of treatment of acute schizophrenia. Method: Patients (n = 311) with acute schizophrenia were randomly allocated (2:2: 1) to receive IM olanzapine (10.0 mg, n = 131), IM haloperidol (7.5 mg, n = 126), or IM placebo (n = 54). Results: After the first injection, IM olanzapine was comparable to IM haloperidol and superior to IM placebo for reducing mean change scores from baseline on the Brief Psychiatric Rating Scale (BRPS) Positive at 2 hours (-2.9 olanzapine, -2.7 haloperidol, and -1.5 placebo) and 24 hours (-2.8 olanzapine, -3.2 haloperidol, and -1.3 placebo); the BPRS Total at 2 hours (-14.2 olanzapine,-13.1 haloperidol, and -7.1 placebo) and 24 hours (-12.8 olanzapine, -12.9 haloperidol, and -6.2 placebo); and the Clinical Global Impressions (CGI) scale at 24 hours (-0.5 olanzapine, -0.5 haloperidol, and -0.1 placebo). Patients treated with IM olanzapine had significantly fewer incidences of treatment-emergent parkinsonism (4.3% olanzapine vs 13.3% haloperidol, P = 0.036), but not akathisia (1.1% olanzapine vs 6.5% haloperidol, P = 0.065), than did patients treated with IM haloperidol; they also required significantly less anticholinergic treatment (4.6% olanzapine vs 20.6% haloperidol, P <0.001). Mean extrapyramidal symptoms (EPS) safety scores improved significantly from baseline during IM olanzapine treatment, compared with a general worsening during IM haloperidol treatment (Simpson-Angus Scale total score mean change: -0.61 olanzapine vs 0.70 haloperidol; P <0.001; Barnes Akathisia Scale global score mean change: -0.27 olanzapine vs 0.01 haloperidol; P <0.05). Conclusion: IM olanzapine was comparable to IM haloperidol for reducing the symptoms of acute schizophrenia during the first 24 hours of treatment, the efficacy of both being evident within 2 hours after the first injection. In general, more EPS were observed during treatment with IM haloperidol than with IM olanzapine.

AB - Objective: To determine the antipsychotic efficacy and extrapyramidal safety of intramuscular (IM) olanzapine and IM haloperidol during the first 24 hours of treatment of acute schizophrenia. Method: Patients (n = 311) with acute schizophrenia were randomly allocated (2:2: 1) to receive IM olanzapine (10.0 mg, n = 131), IM haloperidol (7.5 mg, n = 126), or IM placebo (n = 54). Results: After the first injection, IM olanzapine was comparable to IM haloperidol and superior to IM placebo for reducing mean change scores from baseline on the Brief Psychiatric Rating Scale (BRPS) Positive at 2 hours (-2.9 olanzapine, -2.7 haloperidol, and -1.5 placebo) and 24 hours (-2.8 olanzapine, -3.2 haloperidol, and -1.3 placebo); the BPRS Total at 2 hours (-14.2 olanzapine,-13.1 haloperidol, and -7.1 placebo) and 24 hours (-12.8 olanzapine, -12.9 haloperidol, and -6.2 placebo); and the Clinical Global Impressions (CGI) scale at 24 hours (-0.5 olanzapine, -0.5 haloperidol, and -0.1 placebo). Patients treated with IM olanzapine had significantly fewer incidences of treatment-emergent parkinsonism (4.3% olanzapine vs 13.3% haloperidol, P = 0.036), but not akathisia (1.1% olanzapine vs 6.5% haloperidol, P = 0.065), than did patients treated with IM haloperidol; they also required significantly less anticholinergic treatment (4.6% olanzapine vs 20.6% haloperidol, P <0.001). Mean extrapyramidal symptoms (EPS) safety scores improved significantly from baseline during IM olanzapine treatment, compared with a general worsening during IM haloperidol treatment (Simpson-Angus Scale total score mean change: -0.61 olanzapine vs 0.70 haloperidol; P <0.001; Barnes Akathisia Scale global score mean change: -0.27 olanzapine vs 0.01 haloperidol; P <0.05). Conclusion: IM olanzapine was comparable to IM haloperidol for reducing the symptoms of acute schizophrenia during the first 24 hours of treatment, the efficacy of both being evident within 2 hours after the first injection. In general, more EPS were observed during treatment with IM haloperidol than with IM olanzapine.

KW - Agitation

KW - Antipsychotic agent

KW - EPS

KW - Extrapyramidal safety measures

KW - Extrapyramidal symptoms

KW - Haloperidol

KW - Intramuscular

KW - Olanzapine

KW - Positive symptoms

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=10744226266&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744226266&partnerID=8YFLogxK

M3 - Article

C2 - 14733451

AN - SCOPUS:10744226266

VL - 48

SP - 716

EP - 721

JO - Canadian Journal of Psychiatry

JF - Canadian Journal of Psychiatry

SN - 0706-7437

IS - 11

ER -