A 4-week, double-blind comparison of olanzapine with haloperidol in the treatment of amphetamine psychosis.

OBJECTIVE: To compare the efficacy and tolerability of olanzapines and haloperidol in treating patients with amphetamine psychosis. MATERIAL AND METHOD: Fifty-eight patients experiencing episode of amphetamine psychosis were randomly assigned to olanzapine (N=29) or haloperidol (N=29) in 1:1 (olanzapine: haloperidol) ratio. All patients started with 5-10 mg/day of the study drug; after each 7-day period, the study drug could be adjusted in 5-mg increments or decrements within the allowed dose range of 5-20 mg/day during the 4-week double-blind period. RESULTS: Clinical response was seen in both treatment groups since the first week. Ninety three percent of the olanzapine patients (N=27 of 29) and 79.3% of the haloperidol patients (N=23 of 27) were clinically improved at endpoint. These differences were not statistically significant (p=0.25). The Simpson-Angus total score change from baseline to endpoint reflected no extrapyramidal symptoms among the olanzapine-treated patients (median=0.0, range=0.0). In contrast, worsening occurred among the haloperidol-treated patients (median=0.2, range=0.0-3.1). The differences of mean change in Simpson Angus Scale significantly favored olanzapine (p<0.01). Change to endpoint on the Barnes Akathisia Scale showed that olanzapine-treated patients' scores were close to the baseline (median=0.0, range=-1.0-0.0), whereas haloperidol-treated patients' scores worsened from the baseline (median=0.0, range=-1.0-3.0). This difference was statistically significant (p=0.02). CONCLUSION: Both olanzapine and haloperidol were efficacious in the treatment of patients with amphetamine psychosis. Olanzapine was superior to conventional neuroleptic haloperidol in treatment safety with lower frequency and severity of extrapyramidal symptoms.

Cost analysis of the treatment of schizophrenia in Thailand: a simulation model comparing olanzapine, risperidone, quetiapine, ziprasidone and haloperidol.

OBJECTIVES: To compare the annual costs of treating schizophrenia with four atypical antipsychotics-olanzapine, risperidone, quetiapine and ziprasidone and one typical antipsychotic: haloperidol in Thailand MATERIAL AND METHOD: The present study used a cost analysis model. The model simulated treatment of schizophrenics for 12 months with the data from international literature review. A comprehensive search of pharmacoeconomic literature was carried out in order to identify studies to be included in the present review. Model parameter used data from the searches of 1175 publications but merely 31 of them were relevant to the objectives of the present study. Costs associated with olanzapine, risperidone, quetiapine, ziprasidone and haloperidol therapy were calculated over a period of 12-months. This analysis included health care costs and costs associated with productivity losses. RESULTS: The total cost from the cost analysis was as follows: Haloperidol gives the lowest annual cost of THB 86,004, within the atypical antipsychotics, Olanzapine produces an annual cost of THB 103,225 compared to THB 104,564 with risperidone, 118,314 with ziprazidone. The cost ranges up to THB 146,526 for quetiapine therapy. CONCLUSION: Treatment with olanzapine appears to be more cost-effective than that with the other atypical antipsychotics in Thai schizophrenic patients.