Review of recent clinical studies with olanzapine.

Olanzapine is a novel antipsychotic agent displaying a unique and pleotrophic pharmacology, which distinguishes it from other existing treatments. Clinical investigations employing olanzapine have demonstrated a number of potential therapeutic advantages in reference not only to placebo but also to contemporary drug standards in the management of psychosis. This paper reviews data on the pharmacokinetics, efficacy and safety of olanzapine, its benefits for quality of life, and economic aspects to assist clinicians in determining where they can usefully employ it.

Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders.

Olanzapine and risperidone, both second-generation antipsychotic agents, represent two different pharmacologic strategies. Although they share some in vitro properties, they differ by virtue of their chemical structure, spectrum of receptor binding affinities, animal neuropharmacology, pharmacokinetics, and in vivo neuroimaging profile. Based on such differences, it was hypothesized that the two compounds would show distinct safety and/or efficacy characteristics. To test this hypothesis, an international, multicenter, double-blind, parallel-group, 28-week prospective study was conducted with 339 patients who met DSM-IV criteria for schizophrenia, schizophreniform disorder, or schizoaffective disorder. Results of the study indicated that both olanzapine and risperidone were safe and effective in the management of psychotic symptoms. However, olanzapine demonstrated significantly greater efficacy in negative symptoms (Scale for Assessment of Negative Symptoms summary score), as well as overall response rate (> or = 40% decrease in the Positive and Negative Syndrome Scale total score). Furthermore, a statistically significantly greater proportion of the olanzapine-treated than risperidone-treated patients maintained their response at 28 weeks based on Kaplan-Meier survival curves. The incidence of extrapyramidal side effects, hyperprolactinemia, and sexual dysfunction was statistically significantly lower in olanzapine-treated than risperidone-treated patients. In addition, statistically significantly fewer adverse events were reported by olanzapine-treated patients than by their risperidone-treated counterparts. Thus, the differential preclinical profiles of these two drugs were also evident in a controlled, clinical investigation. Olanzapine seemed to have a risk-versus-benefit advantage.

Mortality patterns of New York State Vietnam Veterans.

Mortality odds ratios (MORs) comparing veterans with Vietnam service who died in New York State to veterans of the Vietnam era with no Vietnam service were estimated (N = 1,496). The most elevated MORs and their confidence intervals were non-motor vehicular injuries of transport (MOR = 2.18, (1.19, 3.96)), other accidents and burns (MOR = 1.37, (0.95, 1.98)), and homicide (MOR = 1.59, (0.86, 2.94).

Racial and socioeconomic factors in cancer survival. A comparison of Veterans Administration results with selected studies.

The survival experience of 46,000 Veterans Administration (VA) male cancer patients was analyzed and compared with the results of three other studies. In the VA data, no significant differences were found between white and black patient cancer survival rates except for bladder cancer; this observation differs from those in other studies. In the VA, all patients receive the same treatment with no distinctions whereas most U. S. hospitals place their patients into categories based on ability to pay. This factor probably accounts for the lack of racial differences in survival rates in the VA and the existence of racial or socioeconomic differences in survival rates in the other studies.

Cell proliferation and cell density of mesenchyme in the maxillary process and adjacent regions during facial development in the chick embryo.

Cell proliferation, as measured by DNA labeling indices was analyzed during the early development of the maxillary process. Chick embryos were labeled with [3H]thymidine for 1 h and processed for autoradiography. The percentage of labeled mesenchymal cells was determined within delineated areas in the maxillary processes and in adjacent regions. Analysis of labeling indices in each of the areas at successive stages of development demonstrated a pattern of declining rates of cell proliferation with advancing developmental age. Cell proliferation in adjacent regions declined earlier and, in some instances, faster than it did in the maxillary process. Cell density was measured in the maxillary process and the roof of the stomodeum and was found to be higher in the maxillary process throughout the period studied. Cell density and cell proliferation data were analyzed with reference to the operation of 'density-dependent inhibition' of growth as a regulatory mechanism for the observed changes. 'Density-dependent inhibition' of growth was not a satisfactory explanation for the observed differences between the maxillary process and adjacent regions.