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Pharmacopsychiatry. 2008 Sep;41(5):182-9. doi: 10.1055/s-2008-1077050. Epub 2008 Sep 1.

Treatment of severe agitation with olanzapine in 166 patients with schizophrenia, schizoaffective, or bipolar I disorder.

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  • 1Psychosis Early Detection and Intervention Centre (PEDIC), Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Centre, Hamburg-Eppendorf, Germany. lambert@uke.uni-hamburg.de

Abstract

INTRODUCTION:

Agitation is a common phenomenon in schizophrenia or acute mania. Because of the inability of patients to give informed consent in such situations, data from consenting studies are limited.

METHODS:

This observational prospective 5-day study evaluated the effectiveness of olanzapine in a sample of highly agitated patients with aggression. Primary endpoint was mean change of the PANSS-Excited Component (PANSS-EC) score.

RESULTS:

Mean PANSS-EC score at baseline was 25.5 points, 60.2% were severely agitated and 41.6% severely aggressive. A significant decrease in PANSS-EC total score (-13.3 points) was observed with rapid dose escalation and an average daily dose of 21.2 mg/day of olanzapine. 40 patients (24.1%) required treatment with another antipsychotic and 21 patients (12.7%) were not treated with olanzapine at day 5. At endpoint, 64.2% of patients were in remission of agitation. PANSS-EC reduction was not significantly different in patients with or without concurrent benzodiazepine use.

DISCUSSION:

Severe agitation with aggression may be well controlled with olanzapine in many cases, possibly by higher initial and overall doses of olanzapine. Controlled studies are needed to confirm these findings.

[PubMed - indexed for MEDLINE]
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