Comparison of Intramuscular Olanzapine and Intramuscular Haloperidol in Treatment of Acute Agitation in Patients of Schizophrenia.

Objectives: To determine the antipsychotic efficacy and extra pyramidal safety of intramuscular olanzapine and intramuscular haloperidol during the first 24 hours of treatment of acute agitation in schizophrenia. Methods: Patients (n = 29) with schizophrenia were randomly allocated to receive one to three injections of intramuscular olanzapine (10 mg, n =14), intramuscular haloperidol (10 mg, n = 14) over a 24-hour period. Agitation was measured with the excited component of the positive and negative symptom scale (PANSS) and agitation behavior scale (ABS). Results: After the first injection, IM olanzapine was comparable to IM haloperidol for reducing mean changes in scores from baseline on excited component of PANSS at 2 hours to ( -13.08 olanzapine, -8.07 haloperidol ) and at 24 hours (-9.86 olanzapine, -8.07 haloperidol ). Mean changes in the scores of ABS scale from baseline was at 2 hours (-9.78 olanzapine, -8.54 haloperidol) and at 24 hours (-6.14 olanzapine, -6.6 haloperidol). Patients treated with IM olanzapine had significantly fewer incidence of treatment emergent Parkinsonism (0% olanzapine versus 6.66% haloperidol, p = 4.55), no patient had akathisia with olanzapine as compared to 13.33% of patients with haloperidol, p = 2.03. No patient developed acute dystonia compared to 6.66% of patients with haloperidol, p = 2.59. Conclusion: IM olanzapine was comparable to IM haloperidol in reduction of symptoms of acute agitation in schizophrenia during first 24 hours of treatment, the efficacy of both being evident within 2 hours after first injection. More Extra pyramidal symptoms were observed during treatment with IM haloperidol than with IM olanzapine.

Comparison of the Clinical Efficacy and Safety between Intramuscular Olanzapine and Intramuscular Haloperidol Injection in the Treatment of Delirium / 대한정신약물학회지

OBJECTIVE: The present study aimed to provide preliminary data on the effectiveness and tolerability of intramuscular (IM) olanzapine and IM haloperidol for patients with delirium. METHODS: Sixty-two patients with delirium were randomly assigned to either olanzapine IM or haloperidol IM groups, with a flexible dosing schedule for 7 days. The Delirium Rating Scale-revised-98 (DRS-R-98), clinical global impression-severity (CGI-S) were assessed daily. The Simpson-Angus Rating Scale (SAS), the Barnes Akathisia Rating Scale (BARS) and the Abnormal Involuntary Movement Scale (AIMS) were used for the assessments of side effects. RESULTS: The DRS-R-98 scores were significantly decreased over time (F=26.02, P<0.0001), without any significant group differences (F=0.048, P=0.829), and time by treatment group interaction (F=5.64, P=0.725). There were no serious adverse events in both groups. The scores on the SAS, BARS, and AIMS were not changed significantly during the study. CONCLUSIONS: This study showed that olanzapine IM did not show any superior efficay and safety compared with haloperidol IM in treatment delirium. However our study suggested that either olanzapine IM or haloperidol IM would be effective and tolerable. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.

Comparison of the Clinical Efficacy and Safety between Intramuscular Olanzapine and Intramuscular Haloperidol Injection in the Treatment of Delirium / 대한정신약물학회지

OBJECTIVE: The present study aimed to provide preliminary data on the effectiveness and tolerability of intramuscular (IM) olanzapine and IM haloperidol for patients with delirium. METHODS: Sixty-two patients with delirium were randomly assigned to either olanzapine IM or haloperidol IM groups, with a flexible dosing schedule for 7 days. The Delirium Rating Scale-revised-98 (DRS-R-98), clinical global impression-severity (CGI-S) were assessed daily. The Simpson-Angus Rating Scale (SAS), the Barnes Akathisia Rating Scale (BARS) and the Abnormal Involuntary Movement Scale (AIMS) were used for the assessments of side effects. RESULTS: The DRS-R-98 scores were significantly decreased over time (F=26.02, P<0.0001), without any significant group differences (F=0.048, P=0.829), and time by treatment group interaction (F=5.64, P=0.725). There were no serious adverse events in both groups. The scores on the SAS, BARS, and AIMS were not changed significantly during the study. CONCLUSIONS: This study showed that olanzapine IM did not show any superior efficay and safety compared with haloperidol IM in treatment delirium. However our study suggested that either olanzapine IM or haloperidol IM would be effective and tolerable. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.