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Very-high-dose olanzapine for treatment-resistant schizophrenia

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DOI: 10.4236/ojpsych.2012.24037    6,216 Downloads   11,085 Views   Citations

ABSTRACT

Treatment-resistant schizophrenia has an extremely negative impact on mental health and social life. If clozapine, the gold standard treatment, fails, there are very few options left. The literature suggests that high-dose olanzapine (20 - 60 mg/day) is a possible alternative. We report two cases in which very high doses of olanzapine were administered, with significant clinical improvements above 60 mg/day. Clinical, metabolic and cardiac tolerance was good. This report highlights the usefulness of very-high-dose olanzapine in treatment-resistant schizophrenia. The main hypotheses concerning the psychopharmacological mechanisms of very-high-dose olanzapine are discussed.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Batail, J. , Bleher, S. , Lozachmeur, C. , Robert, G. , Millet, B. and Drapier, D. (2012) Very-high-dose olanzapine for treatment-resistant schizophrenia. Open Journal of Psychiatry, 2, 269-271. doi: 10.4236/ojpsych.2012.24037.

References

[1] Bitter, I., Dossenbach, M., Brook, S., Feldman, P.D., Metcalfe, S., Gagiano, C.A., Füredi, J., Bartko, G., Janka, Z., Banki, C.M., Kovacs, G. and Breier, A. (2004) Olanzapine versus clozapine in treatment-resistant or treatment-intolerant schizophrenia. Progress in Neuropsycholopharmacology and Biological Psychiatry, 28, 173-180.
[2] Mcilwain, M., Harrison, J., Wheeler, A. J. and Russell, B. R. (2011) Pharmacotherapy for treatment-resistant schizophrenia. Neuropsychiatric Disease and Treatment, 7, 135-149.
[3] Kapur, S., Zipursky, R.B., Remington, G., Jones, C., Da-Silva, J., Wilson, A.A. and Houle, S. (1998) 5-HT2 and D2 receptor occupancy of olanzapine in schizophrenia: A PET investigation. American Journal of Psychiatry, 155, 921-928.
[4] Callaghan, J.T., Bergstrom, R., Ptak, L.R., and Beasley, C.M. (1999) Olanzapine: pharmacokinetic and pharmacodynamic profile. Clinical Pharmacokinetics, 37, 177-193. doi:10.2165/00003088-199937030-00001
[5] Sheitman, B., Lindgren, C., Early, J. and Sved, M. (1997) High-dose olanzapine for treatment-refractory schizophrenia. American Journal of Psychiatry, 154, 1626.
[6] Quadri, S.F., Padala, P.R., Strunk, J.C. and Boust, S.J. (2006) High-dose olanzapine orally disintegrating tablets for treatment-resistant psychosis. The Journal of Clinical Psychiatry, 8, 244-245.
[7] Reich, J. (1999) Use of high-dose olanzapine in refractory psychosis. American Journal of Psychiatry, 156, 661.
[8] Kumra, S., Kranzler, H., Gerbino-Rosen, G., Kester, H. M., DeThomas, C., Kafantaris, V., Correll, C.U. and Kane, J.M. (2008) Clozapine and “high dose” olanzapine in refractory early-onset schizophrenia: A 12-week randomized and double-blind comparison. Biological Psychiatry, 63, 524-529. doi:10.1016/j.biopsych.2007.04.043
[9] Meltzer, H., Bobo, W., Roy, A., Jayathilake, K., Chen, Y., Ertugrul, A., Anil Yagcioglu, A.E. and Small, J.G. (2008) A randomized, double-blind comparison of clozapine and high dose olanzapine in treatment-resistant patients with schizophrenia. The Journal of Clinical Psychiatry, 69, 274-285. doi:10.4088/JCP.v69n0214
[10] Baldacchino, A.M., Stubbs, J.H. and Nevison-Andrews, D. (1998) The use of olanzapine in non-compliant or treatment-resistant clozapine populations in hospital. Pharmaceutical Journal, 260, 207-209.
[11] Dursun, S., Gardner, D., Bird, D. and Flinn, J. (1999) Olanzapine for patients with treatment-resistant schizophrenia: A naturalistic case-series outcome study. Canadian Journal of Psychiatry, 44, 701-704.
[12] Martin, J., Gomez, J.C., Garcia-Bernardo, E., Cuesta, M., Alvarez, E. and Gurpegui, M. (Spanish Group for the Study of Olanzapine in Treatment-Refractory Schizophrenia Spain) (1997) Olanzapine in treatment-refractory schizophrenia: Results of an open label study. Journal of Clinical Psychiatry, 58, 479-483. doi:10.4088/JCP.v58n1103
[13] Rodriguez-Perez, V., Lopez, A., Blanco, C., Pena, C., Lopez, A., Gomez, Y., Ferreiro, M.J., Rego, C., Lopez, A., Cudeiro, F., Alvarez, V., Prieto, R. and Ciudad, A. (2002) Olanzapine for the treatment of chronic refractory schizophrenia: A 12 month follow-up naturalistic study. Progress in Neuropsycholopharmacology and Biological Psychiatry, 26, 1055-1062.
[14] Perry, P.J., Lund, B.C., Sanger, T. and Beasley, C. (2001) Olanzapine plasma concentrations and clinical response: Acute phase results of the North American Olanzapine Trial. Journal of Clinical Psychopharmacology, 21, 14-20. doi:10.1097/00004714-200102000-00004
[15] Mauri, M.C., et al. (2005) Clinical outcome and olanzapine plasma levels in acute schizophrenia. European Psychiatry, 20, 55-60. doi:10.1016/j.eurpsy.2004.09.009
[16] Lane, H.-Y., et al. (2002) Effects of olanzapine plasma concentrations on depressive symptoms in schizophrenia: A pilot study. Journal of Clinical Psychopharmacology, 22, 530-532. doi:10.1097/00004714-200210000-00019
[17] Raedler, T.J., Knable, M.B., Lafargue, T., Urbina, R.A., Egan, M.F., Pickar, D. and Weinberger, D.R. (1999) In vivo determination of striatal dopamine D2 receptor occupancy in patients treated with olanzapine. Psychiatry Research: Neuroimaging Section, 90, 81-90. doi:10.1016/S0925-4927(99)00010-4
[18] Moresco, R.M., Cavallaro, R., Messa, C., Bravi, D., Gobbo, C., Galli, L., Lucignani, G., Colombo, C., Rizzo, G., Velona, I., Smeraldi, E. and Fazio, F. (2004) Cerebral D2 and 5-HT2 receptor occupancy in schizophrenic patients treated with olanzapine or clozapine. Journal of Psycho- pharmacology, 18, 355-365.

  
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