Quality of life in schizophrenia

A multicenter, randomized, naturalistic, controlled trial comparing olanzapine to first-generation antipsychotics

Maurício Silva De Lima, Jair De Jesus Mari, Alan Breier, Anna Maria Costa, Eduardo Pondé De Sena, Matthew Hotopf

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: To assess the effectiveness of olanzapine for treating schizophrenia and to assess if olanzapine promotes a better quality of life than first-generation antipsychotics (FGAs). Method: Multicenter, naturalistic, randomized controlled study, comparing olanzapine with FGAs, at hospitalization and during a 9-month follow-up. Outcome assessors were blind to the allocated drug. The dose of antipsychotic was determined by doctors according to their clinical practice routines. Data collection was performed from April 1999 to August 2001. Results: 197 patients with DSM-IV-diagnosed schizophrenia were allocated to olanzapine (N = 104) and FGA (N = 93). Patients taking olanzapine showed greater improvements in Positive and Negative Syndrome Scale (PANSS) negative symptoms (mean difference = 2.3, 95% CI = 0.6 to 4.1) and general psychopathology (mean difference = 4.0, 95% CI = 0.8 to 7.2) subscales and fewer incidences of tardive dyskinesia (RR = 2.4, 95% CI = 1.4 to 4.2, p <.0001). Olanzapine was also associated with greater improvement in a number of health-related quality-of-life outcomes on the Medical Outcomes Study 36-item Short-Form Health Survey, including physical functioning (mean difference = 6.6, 95% CI = 1.2 to 11.9), physical role limitations (mean difference = 13.7, 95% CI = 3.0 to 24.3), and emotional role limitations (mean difference = 12.1, 95% CI = 0.7 to 23.5). Patients taking olanzapine gained significantly more weight during the trial than patients taking FGAs, with a correspondent endpoint increase in the body mass index (BMI) of 28.7 versus 25.3 (p <.001). Conclusion: Compared with FGAs, olanzapine has advantages in terms of improvements of negative symptoms and quality of life. It is also associated with fewer incidences of tardive dyskinesia and greater increases in weight and BMI. These findings are highlighted by the naturalistic approach adopted in this trial.

Original languageEnglish (US)
Pages (from-to)831-838
Number of pages8
JournalJournal of Clinical Psychiatry
Volume66
Issue number7
StatePublished - Jul 2005

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olanzapine
Antipsychotic Agents
Schizophrenia
Randomized Controlled Trials
Quality of Life
Body Mass Index
Weights and Measures
Incidence
Health Surveys
Psychopathology
Diagnostic and Statistical Manual of Mental Disorders

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Quality of life in schizophrenia : A multicenter, randomized, naturalistic, controlled trial comparing olanzapine to first-generation antipsychotics. / De Lima, Maurício Silva; De Jesus Mari, Jair; Breier, Alan; Costa, Anna Maria; De Sena, Eduardo Pondé; Hotopf, Matthew.

In: Journal of Clinical Psychiatry, Vol. 66, No. 7, 07.2005, p. 831-838.

Research output: Contribution to journalArticle

De Lima, Maurício Silva ; De Jesus Mari, Jair ; Breier, Alan ; Costa, Anna Maria ; De Sena, Eduardo Pondé ; Hotopf, Matthew. / Quality of life in schizophrenia : A multicenter, randomized, naturalistic, controlled trial comparing olanzapine to first-generation antipsychotics. In: Journal of Clinical Psychiatry. 2005 ; Vol. 66, No. 7. pp. 831-838.
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abstract = "Objective: To assess the effectiveness of olanzapine for treating schizophrenia and to assess if olanzapine promotes a better quality of life than first-generation antipsychotics (FGAs). Method: Multicenter, naturalistic, randomized controlled study, comparing olanzapine with FGAs, at hospitalization and during a 9-month follow-up. Outcome assessors were blind to the allocated drug. The dose of antipsychotic was determined by doctors according to their clinical practice routines. Data collection was performed from April 1999 to August 2001. Results: 197 patients with DSM-IV-diagnosed schizophrenia were allocated to olanzapine (N = 104) and FGA (N = 93). Patients taking olanzapine showed greater improvements in Positive and Negative Syndrome Scale (PANSS) negative symptoms (mean difference = 2.3, 95{\%} CI = 0.6 to 4.1) and general psychopathology (mean difference = 4.0, 95{\%} CI = 0.8 to 7.2) subscales and fewer incidences of tardive dyskinesia (RR = 2.4, 95{\%} CI = 1.4 to 4.2, p <.0001). Olanzapine was also associated with greater improvement in a number of health-related quality-of-life outcomes on the Medical Outcomes Study 36-item Short-Form Health Survey, including physical functioning (mean difference = 6.6, 95{\%} CI = 1.2 to 11.9), physical role limitations (mean difference = 13.7, 95{\%} CI = 3.0 to 24.3), and emotional role limitations (mean difference = 12.1, 95{\%} CI = 0.7 to 23.5). Patients taking olanzapine gained significantly more weight during the trial than patients taking FGAs, with a correspondent endpoint increase in the body mass index (BMI) of 28.7 versus 25.3 (p <.001). Conclusion: Compared with FGAs, olanzapine has advantages in terms of improvements of negative symptoms and quality of life. It is also associated with fewer incidences of tardive dyskinesia and greater increases in weight and BMI. These findings are highlighted by the naturalistic approach adopted in this trial.",
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