Search

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: La esquizofrenia es una condición crónica que afecta a 1% de la población. Una de las principales teorías sobre su etiología señala que la hipofunción en los receptores de glutamato N-metil-D-aspartato (NMDA) induce la pérdida del equilibrio entre la producción de especies oxidantes generadas en el metabolismo celular y los sistemas de defensa antioxidante, lo que genera un estado de estrés oxidante. Se ha propuesto a la N-acetilcisteína (NAC) como un agente adyuvante para potencializar la eficacia de antipsicóticos atípicos como la olanzapina (OLZ), mejorando los procesos de oxidación propios de la enfermedad. Métodos: Se utilizaron 30 ratones divididos en cinco grupos experimentales, a los cuales se administró MK-801 (un antagonista de NMDA) como modelo de esquizofrenia. Se evalúo la participación del estrés oxidante al medir la peroxidación lipídica y la concentración de glutatión reducido a nivel de la corteza frontal. Resultados: La administración de MK-801 produjo aumento en la peroxidación lipídica y disminución en la concentración de glutatión reducido a nivel de la corteza frontal. Tanto los tratamientos de OLZ y NAC, administrados solos o en combinación, disminuyeron la peroxidación lipídica y aumentaron el glutatión reducido en la corteza frontal. Discusión: Estos datos sugieren que el tratamiento con OLZ y NAC, administradas solas o en combinación, regulan el daño oxidante propio de la enfermedad y podrían ser una opción para pacientes con psicosis crónica o con poca respuesta a los esquemas actuales de tratamiento. Sin embargo, se requieren más estudios para demostrar su eficacia y seguridad. [ABSTRACT FROM AUTHOR]

Copyright of State & Society / Państwo i Społeczeństwo is the property of Andrzej Frycz Modrzewski Krakow University, AFM Publishing Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Over the past few decades, drug abuse has become a significant health problem. The reason for this situation is multifaceted; one should take into account both the greater health awareness in the society and faster pace of life associated with increased stress, but also the increasingly common tendency to medicalise everyday problems. This phenomenon, so far associated mainly with analgesics, sedatives and hypnotics, has begun to affect also other groups of drugs in recent years. The article addresses the phenomenon of abuse and misuse of olanzapine -- an increasingly popular drug with a well-established clinical status, used primarily in the treatment of psychotic, affective and behavioural disorders. The epidemiology, pathophysiological background and clinical picture of the abuse and misuse of this drug are described. Moreover, the issues of insufficient social awareness of this problem and the lack of guidelines both for the diagnosis and treatment are highlighted. Undoubtedly, the phenomenon requires further study, with a particular focus on its specific clinical presentations characteristic for the populations of different countries and groups of patients with specific medical diagnoses. [ABSTRACT FROM AUTHOR]

Purpose: Pulmonary embolism (PE) is the most serious clinical manifestation of venous thromboembolism (VTE) and a common cause of death in psychiatric patients. Patients diagnosed with mental illness have additional thromboembolic risk factors. These factors are not included in scores used to assess VTE risk. The goal of this elaboration is to take notice of the increased thromboembolic risk in psychiatric patients, with a particular focus on patients with catatonic symptoms. Case description: Two cases of young men with catatonic symptoms who suffered from cardiac arrest during psychiatric hospitalization are reported on. Autopsy showed pulmonary embolism as the main cause of death. Based on the Padua Prediction Score the two patients had no indications for thromboprophylaxis. Both men were mostly treated with olanzapine. Comment: PE should be always taken into account in differential diagnosis, even if patients do not present with its typical risk factors. [ABSTRACT FROM AUTHOR]

Introduction:olanzapine is one of the most used antipsychotic drugs in the world. Although it is efficient, it may be toxic in excess. Therefore, in this work the possibility of olanzapine electrochemical determination over an electrode, modified by the cobalt (III) oxyhydroxide in pair with its dioxide in a composite with squaraine dye. Methods: the trivariant correspondent mathematical model includes two scenarios of the drug oxidation, possible for the case, including the indirect electropolymerization of the condensed benzodiazepine molecule, like also its oxidation by sulfur atom. This model has been developed and analyzed by means of stability theory and bifurcation analysis. Results and discussion: the analysis of the model has shown that the mechanism hybridity of the electroanalytical process, alongside with the formation and decomposition of ionic compounds during its realization, augments the possibility for the oscillatory behavior realization, relatively to the simplest and commonest case. Nevertheless, the oscillatory instability is realized in parameter values far beyond the detection limit. On the other hand, the stable steady-state is easy to obtain and maintain, indicating an efficient electroanalytical process, controlled by the analyte diffusion. Conclusions: the electroanalytical process is efficient. The cobalt compound is acting as an active substance, and the dye is the mediator. [ABSTRACT FROM AUTHOR]

La Enfermedad de Huntington (EH) es una afección hereditaria que produce disfunción del núcleo estriado y sus conexiones, caracterizándose clínicamente por la triada de demencia de patrón subcortical sin afasia, movimientos anormales (coreicos) y síntomas psiquiátricos no cognitivos. Estos últimos presentan una prevalencia que oscila entre el 35-70% de los casos, siendo habitual su insuficiente exploración por parte de los clínicos. Presentamos el caso de una paciente de 55 años diagnosticada de EH tras estudio genético a los 47 años, que previamente se encontraba diagnosticada de esquizofrenia desde los 32 años, siendo los síntomas psiquiátricos la posible forma de comienzo, precediendo en años al inicio de los movimientos coreicos y el deterioro cognitivo. Se discuten, a la luz del caso presentado, aspectos epidemiológicos, fisiopatológicos, de diagnóstico, tratamiento y síntomas psicopatológicos más habituales que se presentan en la EH.

Os xantomas eruptivos resultam de uma deposição rápida intracelular e dérmica de lípidos e constituem um importante sinal de risco cardiovascular, com impacto prognóstico. Os autores descrevem o caso de um homem de 47 anos com múltiplas pápulas distribuídas nas nádegas, região lombar, parede abdominal, cotovelos e pescoço com dois meses de evolução, cupuliformes, amareladas, firmes e pouco pruriginosas. Os antecedentes pessoais incluíam abuso etílico, diabetes mellitus tipo 2 e dislipidemia não medicadas, além de início recente de terapêutica com olanzapina por síndrome depressivo. Os exames complementares mostraram hipertrigliceridemia (7474 mg/dL), hipercolesterolemia (1054 mg/dL) e hemoglobina A1c de 12,1%. O estudo histopatológico de uma pápula do flanco esquerdo revelou numerosos histiócitos xantomizados na derme confirmando o diagnóstico de xantomas eruptivos. No nosso caso, a introdução da olanzapina poderá ter agravado os antecedentes de doença metabólica, contribuindo assim para o rápido aparecimento das lesões cutâneas. O reconhecimento atempado dos xantomas eruptivos pode ter um profundo impacto no diagnóstico, tratamento e prognóstico, por conduzir à pesquisa de causas secundárias.

To report the case of a patient with bipolar affective disorder (BPD) in psychiatric care, who was diagnosed three times with Neuroleptic Malignant Syndrome by different antipsychotics (NMS). A 57-year-old female patient with previous diagnosis of BD was admitted to the hospital with fever, muscle stiffness, tremors, behavioral changes, lowering of consciousness level, increased CPK and leukocytosis, which were not clarified by another medical condition, then suspected of Neuroleptic Malignant Syndrome. The use of antipsychotics is essential for several psychiatric disorders, such as mania, personality disorders and dementia in general, and the onset of NMS is unpredictable. It is concluded that a depth knowledge of the disease is necessary for early diagnosis and treatment, which will result a better prognosis. [ABSTRACT FROM AUTHOR]

Dispersible tablet form (ODT) of drugs is convenient for patients to take; the effectiveness of its use increases significantly with non-compliance treatment of mental disorders. Upon the expiration of the patent for the original drug, the production of generics with the same pharmacologically active ingredient often starts. Due to differences in fillers and manufacturing techniques, even high-quality copies of the original product may not be equivalent to it. Therefore, the aim of this study was to evaluate the bioequivalence of the ODT form of the original drug and generic with 10 mg olanzapine. After taking the original drug and generic in two stages, on an empty stomach from healthy volunteers, from the vein were sampled bloods into vacuum heparin tubes. The washout period between doses of the drugs was 21 days. The extraction (LLE) of olanzapine was carried with a mixture of n-hexane:isopropanol (3:1) at pH 8.0, and analyzed by liquid chromatography-tandem mass spectrometry (quadrupole-linear ion trap). The degree of extraction olanzapine from bloods (model samples, 20 ng/ml) was 75.2% (CV 4.6%). The quantitative limit for olanzapine by HPLC-MS/MS (LLOQ) was 0.50 ng/ml (CV 2.0%, accuracy 17.6%). Conducted on an open randomized cross scheme studies showed a satisfactory bioavailability and bioequivalence profile of the original drug and generic containing olanzapine. The calculated pharmacokinetic parameters for the logarithmically converted mean values verified with a 90% confidence interval were: Сmax - 95.93-99.80% (average value 97.64%); AUC0 - t - 95.43-100.35% (average value 97.75%); Сmax/AUC0 - t - 94.44-101.73% (average value 97.87%). [ABSTRACT FROM AUTHOR]

Wprowadzony ze względów czysto akademickich podział na leki przeciwdepresyjne, przeciwpsychotyczne i normotymiczne jest mylący. W praktyce klinicznej z pewnością nie każdy rodzaj depresji należy leczyć lekami określanymi jako przeciwdepresyjne, a działanie leków przeciwpsychotycznych z pewnością nie ogranicza się do leczenia tzw. psychoz (rozumianych jako choroby psychiczne, którym towarzyszą objawy wytwórcze). Bardzo dobrym przykładem jest tutaj terapia choroby afektywnej dwubiegunowej. W chorobie afektywnej dwubiegunowej typu pierwszego często w ogóle odradza się stosowanie leków przeciwdepresyjnych (także w okresach depresji), z kolei w chorobie afektywnej dwubiegunowej typu drugiego przydatność leków przeciwdepresyjnych ocenia się najczęściej jako „ograniczoną”. Z jednej strony występuje tu ryzyko zmiany fazy depresyjnej na hipomaniakalną, z drugiej często spotkać się można z lekoopornością. W tej sytuacji warto zadać pytanie o pozycję atypowych leków przeciwpsychotycznych w leczeniu choroby afektywnej dwubiegunowej. W artykule przedstawiono aktualne wyniki badań dotyczących stosowania olanzapiny, kwetiapiny i amisulprydu w terapii depresji i manii w przebiegu tej choroby. Wspomniano również o roli leków z omawianej grupy w terapii zapobiegawczej (normotymicznej). Wyniki wielu poprawnych metodologicznie badań, przeprowadzonych z wykorzystaniem metody podwójnie ślepej próby oraz grupy kontrolnej placebo, wskazują na skuteczność olanzapiny w leczeniu zarówno depresji, jak i manii w przebiegu choroby afektywnej dwubiegunowej. Można także wykorzystać olanzapinę, choć raczej w kuracjach skojarzonych, jako lek normotymiczny. Podstawowym problemem związanym ze stosowaniem tego leku jest częste występowanie zespołu metabolicznego. W przypadku kwetiapiny również istnieją dane dotyczące możliwości jej użycia w terapii depresji i manii. Autorzy badań nad kwetiapiną zwracają uwagę na to, że działanie zależy od dawki. W dawkach do 300 mg na dobę lek wykazuje głównie skuteczność przeciwdepresyjną. W leczeniu manii konieczne są dawki większe – zwykle powyżej 500 mg na dobę. Kluczowy problem związany z tym lekiem dotyczy występowania nadmiernej sedacji. W przypadku amisulprydu brakuje wystarczającej liczby badań, by stwierdzić przydatność leku w terapii choroby afektywnej dwubiegunowej. Bardzo interesujące są doniesienia kazuistyczne wskazujące na możliwość profilaktycznego działania amisulprydu u osób z istotnymi zaburzeniami metabolicznymi.

Objectives: To describe haematological adverse effects in adolescents with anorexia nervosa who are taking olanzapine., Methods: Case series report., Case Report: The reported cases (two female patients and one male) were found to have blood test abnormalities after starting olanzapine and to rapidly recover their platelet and neutrophil values after the drug was discontinued. Low haemoglobin values persisted longer than observed in other series. These abnormalities became more noticeable when the dose of olanzapine was increased to 5 mg/day (initial dose 2.5 mg/day). It should be noted that two of the patients already had values indicative of mild neutropenia before they started the antipsychotic drug, and that these worsened as they continued taking the drug. In one of the patients there was only a decrease in neutrophil values, as well as mild anaemia., Conclusions: This first case series of haematological abnormalities in adolescents with anorexia nervosa who are taking olanzapine found values corresponding to pancytopenia in two of the three cases reported. It would be worthwhile to consider heightening haematological surveillance in this population when starting treatment with olanzapine and rethinking our knowledge regarding the frequency of these side effects., (Copyright © 2021 Asociación Colombiana de Psiquiatría. Published by Elsevier España, S.L.U. All rights reserved.)

OBJECTIVES: Olanzapine, an atypical antipsychotic drug with affinities for dopamine, serotonin, and histamine binding sites appears to be associated with substantial weight gain and metabolic alterations. The aim of this study was to evaluate weight gain and metabolic alterations in rats treated with olanzapine on a hypercaloric diet. METHODS: We used 40 rats divided into 4 groups: Group 1, standard food and water conditions (control); Group 2, standard diet plus olanzapine; Group 3, cafeteria diet (hypercaloric); and Group 4, olanzapine plus cafeteria diet. Olanzapine was administered by gavage at a dose of 3 mg/kg for 9 weeks. RESULTS There were no significant changes in the cholesterol levels in any group. Glucose levels increased in Group 3 by the fourth week. Triglyceride levels were altered in group 2 toward the end of the experiment. Leptin levels decreased in Groups 2 and 4. Complex II activity in the muscles and liver was altered in Group 2 (muscle), and Groups 2, 3, and 4 (liver). Complex IV activity was altered only in the liver in Group 2, without significant alterations within the muscles. CONCLUSION: These results suggest that olanzapine is correlated with weight gain and the risks associated with obesity.OBJETIVOS: A olanzapina, uma droga antipsicótica atípica com afinidade por locais de ligação de dopamina, serotonina e histamina, parece se associar a um ganho de peso e a alterações metabólicas consideráveis. O objetivo desse estudo foi avaliar o ganho de peso e as alterações metabólicas em ratos tratados com olanzapina numa dieta hipercalórica. MÉTODOS: Usamos 40 ratos divididos em 4 grupos: Grupo 1, condições padrão de alimento e água (controle); Grupo 2, dieta padrão mais olanzapina; Grupo 3, dieta hipercalórica; e Grupo 4, olanzapina mais dieta hipercalórica. Olanzapina foi administrada por gavagem a uma dose de 3 mg/kg por 9 semanas. RESULTADOS: Não houve alterações significativas nos níveis de colesterol em qualquer um dos grupos. Os níveis de glicose aumentaram no Grupo 3 por volta da quarta semana. Os níveis de triglicerídeos estavam alterados no Grupo 2 ao final do experimento. Os níveis de leptina diminuíram nos Grupos 2 e 4. A atividade do complexo II nos músculos e no fígado se alterou no Grupo 2 (músculos) e nos Grupos 2, 3 e 4 (fígado). A atividade do complexo IV se alterou apenas no fígado no Grupo 2, sem alterações significativas nos músculos. CONCLUSÃO: Esses resultados sugerem que olanzapina se correlaciona ao ganho de peso e aos riscos associados à obesidade.

The objective of the present work is to study the dissolution behavior of olanzapine from its solid dispersions with mannitol. Solid dispersions were prepared by melt dispersion method and characterized by phase solubility studies, drug content and in vitro dissolution studies. The best releasing dispersions were selected from release data, dissolution parameters and their release profiles. Solid state characterization techniques like Fourier transform infrared (FT-IR) spectroscopy, X-ray diffractometry, differential scanning calorimetry, near-infrared and Raman spectroscopy were used to characterize the drug in selected dispersions. The dispersions were also evaluated by wettability studies and permeation studies. The results of phase solubility studies and the thermodynamic parameters indicated the spontaneity and solubilization effect of the carrier. The release study results showed greater improvement of drug release from solid dispersions compared to pure drug, and the release was found to increase with an increase in carrier content. The possible mechanism for increased release rate from dispersions may be attributed to solubilization effect of the carrier, change in crystal quality, phase transition from crystalline to amorphous state, prevention of agglomeration or aggregation of drug particles, change in surface hydrophobicity of the drug, and increased wettability and dispersability of the drug in dissolution medium. The suggested reasons for increased release rate from dispersions were found to be well supported by results of solid state characterization, wettability and permeation studies. The absence of any interaction between the drug and the carrier was also proved by FT-IR analysis.O objetivo do presente trabalho é estudar o comportamento de dissolução da olanzapina a partir de suas dispersões sólidas de manitol. As dispersões sólidas foram preparadas por dispersão por fusão e caracterizadas por estudos de solubilidade de fase, conteúdo de fármaco e dissolução in vitro. As melhores dispersões quanto à liberação foram selecionadas a partir dos dados de liberação, parâmetros de dissolução e perfis de liberação. Técnicas de caracterização de estado sólido como espectroscopia no infravermelho pela transformada de Fourier (FTIR), difratometria de raios X, calorimetria de varredura diferencial, infravermelho próximo e espectroscopia Raman foram utilizadas para caracterizar os fármacos a partir das dispersões selecionadas. As dispersões foram, também, avaliadas pelos estudos de capacidade de umedecimento e permeação. Os resultados dos estudos de solubilidade de fase e os parâmetros termodinâmicos indicaram a espontaneidade e o efeito de solubilização do transportador. Os resultados dos estudos de liberação mostraram maior aperfeiçoamento da liberação do fármaco das dispersões sólidas, comparativamente à do fármaco puro, e descobriu-se que a liberação aumenta com o aumento do conteúdo de transportador. O mecanismo possível para o aumento da taxa de liberação das dispersões pode ser atribuído ao efeito de solubilização do transportador, mudança da qualidade do cristal, transição de fase cristalina para estado amorfo, prevenção da aglomeração ou agregação das partículas do fármaco, mudança na superfície de hidrofobicidade do fármaco e aumento da capacidade de umedecimento e dispersividade do fármaco no meio de dissolução. As razões sugeridas para o aumento da taxa de liberação a partir das dispersões foram apoiadas pelos resultados da caracterização do estado sólido, capacidade de umedecimento e pelos estudos de permeação. A ausência de qualquer interação entre o fármaco e o transportador foi, também, comprovada pela análise no FTIR.

The aim of the present study was to develop an olanzapine freeze-dried tablet (FDT). The solubility and dissolution rate of poorly water-soluble olanzapine was improved by preparing a freeze-dried tablet of olanzapine using the freeze-drying technique . The FDT was prepared by dispersing the drug in an aqueous solution of highly water-soluble carrier materials consisting of gelatin, glycine, and sorbitol. The mixture was poured in to the pockets of blister packs and then was subjected to freezing and lyophilisation. The FDT was characterised by DSC, XRD and SEM and was evaluated for saturation solubility and dissolution. The samples were stored in a stability chamber to investigate their physical stability. Results obtained by DSC and X-ray were analysed and showed the crystalline state of olanzapine in FDT transformation to the amorphous state during the formation of FDT. Scanning electron microscope (SEM) results suggest reduction in olanzapine particle size. The solubility of olanzapine from the FDT was observed to be nearly four and a half times greater than the pure drug. Results obtained from dissolution studies showed that olanzapine FDT significantly improved the dissolution rate of the drug compared with the physical mixture (PM) and the pure drug. More than 90% of olanzapine in FDT dissolved within 5 minutes, compared to only 19.78% of olanzapine pure drug dissolved over the course of 60 minutes. In a stability test, the release profile of the FDT was unchanged, as compared to the freshly prepared FDT after 90 days of storing.O objetivo do presente estudo foi desenvolver comprimidos liofilizados de olanzapina (FDT). A solubilidade e a taxa de dissolução da olanzapina, fracamente solúvel em água, foram melhoradas com a preparação de comprimidos liofilizados de olanzapina usando a técnica de liofilização. O FDT foi preparado por dispersão do fármaco em solução aquosa de materiais altamente solúveis em água, como gelatina, glicina e sorbitol. A mistura foi colocada em blisters e, então, submetida ao congelamento e liofilização. O FDT foi caracterizado por DSC, Difração de Raios X e microscopia eletrônica de varredura(SEM) e avaliaram-se a solubilidade de saturação e a dissolução. As amostras for5am armazenadas em câmara de estabilidade para investigar a estabilidade física. Os resultados obtidos com DSC e Raios X foram analisados e mostraram a transformação do estado cristalino da olanzepina em FDT no estado amorfo durante a formação do FDT. Os resultados da SEM sugerem a redução do tamanho das partículas de olanzapina. A solubilidade da olanzapina do FDT melhorou significativamente a taxa de dissolução do fármaco comparativamente à mistura física (PM) e ao fármaco puro. Mais do que 90% da olanzepina no FDT dissolveu em 5 minutos, comparativamente aos 19,78% do fármaco puro dissolvido em 60 minutos. No teste de estabilidade, o perfil de liberação da FDT mostrou-se inalterado, quando comparado com o FDT recém-preparado, após 90 dias de armazenamento.

Two new spectrophotometric methods using permanganate as the oxidimetric reagent for the determination of olanzapine (OLP) were developed and validated as per the current ICH guidelines. The methods involved the addition of known excess of permanganate to OLP in either acid or alkaline medium followed by the determination of unreacted permanganate at 550 nm (method A) or bluish-green color of manganate at 610 nm (method B). The decrease in absorbance in method A or increase in absorbance in method B as a function of concentration of OLP was measured and related to OLP concentration. Under optimized conditions, Beer's law was obeyed over the ranges 2.0 to 20 and 1.0 to 10 μg mL-1 in method A and method B, respectively. The calculated molar absorptivity values were 1.34 x 10(4) and 2.54 x 10(4) l mol-1cm-1 for method A and method B respectively, and the respective Sandell sensitivities were 0.0233 and 0.0123 μg cm-2. The LOD and LOQ for method A were calculated to be 0.37 and 1.13 μg mL-1and the corresponding values for method B were 0.16 and 0.48 μg mL-1. Intermediate precision, expressed as RSD was in the range 0.51 to 2.66 %, and accuracy, expressed as relative error ranged from 0.79 to 2.24 %. The proposed methods were successfully applied to the assay of OLP in commercial tablets with mean percentage recoveries of 102 ±1.59 % (method A) and 101 ±1.53 % (method B). The accuracy and reliability of the methods were further confirmed by performing recovery tests via standard addition procedure.Dois métodos espectrofotométricos novos, usando o permanganato como o reagente oxidimétrico para a determinação da olanzapina (OLP) foram utilizados e validados de acordo com as diretrizes atuais do ICH. Os métodos envolveram a adição de excesso conhecido de permanganato à OLP em meio ácido ou alcalino, determinando-se o permanganato que não reagiu em 550 nm (método A), ou pela cor verde-azulada do manganato a 610 nm (método B). A diminuição da absorbância no método A ou o aumento da absorbância no método B, em função da concentração de OLP, foi medida e relacionada à concentração de OLP. Sob condições otimizadas, a lei de Beer foi obedecida, nas faixas de concentração de 2,0 a 20 e 1,0 a 10 ao μg mL-1, no método A e no método B, respectivamente. Os valores de absortividade molar foram de 1,34 x 104 e 2,54 x 104 l mol-1cm-1 para o método A e para o método B, respectivamente, e as sensibilidades respectivas de Sandell foram de 0,0233 e 0,0123 μg cm-2. Os LOD e os LOQ para o método A calculados foram 0,37 e 1,13 μg mL-1e os valores correspondentes para o método B foram 0,16 e 0,48 μg mL-1. A precisão intermediária, expressa como RSD, encontrou-se na faixa de 0,51 a 2,66%, e a exatidão, expressa como o erro relativo, variou de 0,79 a 2,24%. Os métodos propostos foram aplicados com sucesso ao ensaio de OLP em comprimidos comerciais, com porcentagens médias de recuperação de 102± 1,59% (método A) e de 101± 1,53% (método B). A exatidão e a confiabilidade dos métodos foram confirmadas executando testes de recuperação através de procedimento padrão de adição.

Objetivo: Hacer un estudio de la utilización de psicofármacos del grupo de antipsicóticos atípicos dentro del Centro Penitenciario de Málaga durante los años 2003/2004 y compararlo con el Distrito de Atención Primaria de referencia (Distrito Guadalhorce). Material y Métodos: Se ha realizado un estudio retrospectivo sobre la utilización de antipsicóticos atípicos en el Centro penitenciario de Málaga durante los años 2003/04 y se ha comparado con la utilización que de estos fármacos se hace en el Distrito de Atención Primaria (A.P.) de referencia. La información sobre consumo de medicación se obtuvo a partir de las ordenes médicas recibidas en el centro durante los años de estudio. Para la clasificación de principios activos se usó la clasificación ATC (Anatomical Therapeutic and Chemical Classifying System) y para el cálculo de envases, la base de datos propia del centro (SANIT 3.0). Para el cálculo de DDD se utilizó la DDD/1000 habitantes día. Resultados: Se ha incrementado la utilización de antipsicóticos atípicos a nivel del C.P. Existe una tendencia hacia la mayor utilización de quetiapina a dosis bajas mientras que ha disminuido la utilización de risperidona en el año 2004 respecto a 2003, aunque continúa siendo el de mayor utilización tanto en DDD como en envases consumidos. La situación en Atención Primaria es exactamente la contraria. Conclusión: El uso de este grupo de medicamentos en estudio ha disminuido a nivel de Atención Primaria (A.P.), posiblemente debido a medidas especiales de control médico (visado). En nuestro Centro Penitenciario se ha incrementado el uso, aunque se desconocen los motivos de dichas diferencias.Aim: we studied the use of psychotropic drugs belonging to the group of atypical neuroleptics in Malaga State Prison (Centro Penitenciario de Málaga) from 2003 to 2004. We also compared the results of this study with references taken from the Primary Health Care District of Guadalhorce. Materials and Methods: A retrospective study was carried out on the use of antipsychotic drugs from 2003 to 2004 in Malaga State Prison. A comparison was then made with the use of this type of medication in the Primary Health Care District of Guadalhorce. Data on medication consumption was taken from medical orders received at the prison during this study. The ATC (Anatomical Therapeutic and Chemical Classifying System) was used for classifying the active principles. The prison"s own data base (SANIT) was used for calculating the number of containers. For calculating the DDD, the ratio DDD/1000 inmates/day was utilised. Results: The use of atypical antipsychotic medication in the prison increased. There is an increasing trend towards the use of quetiapine in small doses. The use of risperidone went down during the period of this study, although it is still the most commonly used drug in DDD and in consumed containers. The Primary Health care results indicate a trend in the opposite direction. Conclusion: The use of the group of drugs in this study has decreased in the Primary Health Care area, possibly because of special medical control measures such as the control stamp. In Malaga Prison use of these drugs has increased. The reasons for this difference are as yet unknown.

Copyright of Journal of Psychiatry & Clinical Psychology / Psychiatria i Psychologia Kliniczna is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Long-acting injectable antipsychotics constitute a valuable alternative for the treatment of psychotic disorders, mainly schizophrenia. They assure a more stable drug level, improve treatment compliance, and increase the chances for favorable and long-lasting improvement. Additionally, the long-acting second-generation antipsychotics combine the values of long-acting injectable drugs with the values of atypical antipsychotics. Four second generation long-acting antipsychotics have been described: risperidone, olanzapine, aripiprazole and paliperidone. The indications for their use, treatment strategy, tolerance, and potential interactions are discussed. [ABSTRACT FROM AUTHOR]

A síndrome neuroléptica maligna (SNM) é uma reação idiossincrásica rara, extremamente grave e potencialmente fatal ao uso de antipsicóticos, tanto típicos quanto atípicos, bem como drogas de ação dopaminérgica. O diagnóstico fundamenta-se em critérios clínicos e laboratoriais e exclusão de outras condições médicas gerais ou psiquiátricas que melhor expliquem os sintomas. Segundo o DSM-IV, os principais critérios são rigidez muscular grave e temperatura elevada, associadas ao uso de medicação antipsicótica. Foi relatado um caso de paciente com 30 anos manifestando história de transtorno afetivo bipolar, que apresentou sinais e sintomas consistentes com SNM, após três semanas de tratamento com olanzapina. Esse relato visa a discutir o risco da SNM ao uso de antipsicóticos atípicos, bem como a importância de diagnóstico precoce e intervenção imediata.Neuroleptic malignant syndrome (NMS) is an idiosyncratic, serious and potentially fatal disorder observed in patients who receive treatment with neuroleptics, typical and atypical, as well as medications with dopaminergic effects. The diagnosis is based on clinical and laboratory criteria and the exclusion of other general medical or psychiatric conditions that could best explain the symptoms. The main criteria according to DSM-IV are severe rigidity and fever associated with the use of antipsychotic medication. We present a case of a 30-year-old female with history of bipolar affective disorder that developed signs and symptoms consistent with NMS after three weeks of treatment with Olanzapine. This case aims to address the risk of NMS associated atypical antipsychotic, as well as the importance of an early diagnosis and immediate intervention.

A síndrome neuroléptica maligna (SNM) consiste em reação idiossincrática a neurolépticos, provavelmente relacionada a bloqueio dos receptores dopaminérgicos nos gânglios da base, sendo por isso também conhecida como síndrome da deficiência aguda de dopamina.A SNM é caracterizada por hiperpirexia, alteração do nível de consciência, hipertonia, disfunção autonômica e insuficiência respiratória, podendo ainda ser encontrados rabdomiólise e leucocitose. O haloperidol é a droga mais frequentemente associada à síndrome. Relatamos o caso de um paciente de 30 anos que apresentou SNM em duas ocasiões diferentes, a primeira delas relacionada ao uso de haloperidol e clorpromazina e a segunda relacionada ao uso de olanzapina, fato este sem menção anterior na literatura indexada.

Previous reports on the use of olanzapine in Huntington's disease (HD) used doses ranging from 10-30 mg. We report a case of HD with marked delusions and behavioral impairment assessed by the Unified Huntington's Disease Rating Scale at baseline and four months later treated with a low dose of olanzapine. The patient improved in motor, psychiatric and activity of daily living symptoms after four months of treatment. The response to a low dose of olanzapine in HD may be an indicator of efficacy in similar cases. Further randomized controlled trials can properly assess these findings.Relatos de casos sobre o uso de olanzapina na doença de Huntington (DH) usaram doses variando de 10-30 mg. Este é um relato de caso de DH avaliado pela Unified Huntington Rating Scale no início e quatro meses depois com uma dose baixa de olanzapina. A paciente melhorou dos sintomas motores, psiquiátricos e nas atividades de vida diária após os quatro meses de tratamento. A resposta a baixas doses de olanzapina na DH pode ser um indicador de eficácia em casos similares. Mais estudos controlados randomizados podem avaliar apropriadamente esses achados.

Objectives. The objective of the study was to assess the prevalence and incidence of tardive dyskinesia in patients treated with olanzapine during the follow-up period of 20 months. Methods. It was a prospective, observational, non-interventional study under naturalistic conditions, without a control group. The evaluation of the severity and presence of tardive dyskinesia was performed with the Abnormal Involuntary Movement Scale and research criteria by Schooler and Kane. Results. The study included 573 patients (woman 43,3%) with the diagnosis of schizophrenia (ICD-10), the mean age of41.8 (± 12) years. The mean dose of olanzapine was 15.9 (±4.2) mg. The prevalence of tardive dyskinesia was 16.4%. The cumulative incidence assessed in the group of 479 patients was 6.47%. The annual incidence was 3.9%. An increased risk of tardive dyskinesia was observed in smokers - RR of 1.99 (Cl 0.88-4.49), those taking higher doses of olanzapine 1.57 (Cl 0.91-2.7) and in those who used polytherapy: 3.55 (Cl 1.43-8.82). Only in the case of polytherapy a multidimensional analysis confirmed that this factor had a significant influence on the risk of tardive dyskinesia (p=0.006) Conclusions. The study demonstrated high (16,4%) prevalence of tardive dyskinesia, and the annual incidence (3,9%) comparable to the results of a meta-analysis by Corell et al. In the case of olanzapine in monotherapy the annual incidence was lower (1.96%) but the use of antipsychotics in polytherapy more than tripled the risk of tardive dyskinesia [ABSTRACT FROM AUTHOR]

Objective. This study investigates the healthcare costs of adverse events (AE) associated with treatment of bipolar disorder with two atypical oral antipsychotics (AOA): aripiprazole (ARI) and olanzapine (OLA). Methods. A cost analysis using a Markov model considering the following health states was performed: no existence of adverse events (NAE); extrapyramidal symptoms (EPS); weight gain (WG); and sexual dysfunction (SD). Transition probabilities amongst health states were estimated from meta-analyses of clinical trials and from a retrospective Spanish study. The healthcare costs associated to each health state were obtained from a published Spanish study. The minimum acquisition cost per mg of the mean daily dose for each AOA was used. This is considered to be a relevant efficiency criterion in Hospital Pharmacy Departments. The time horizon applied in the analysis was 12 months. A probabilistic sensitivity analysis was performed for all the variables involved in the analysis with Monte Carlo simulations. All costs were updated to 2013 costs using the Spanish Health System price index. Results. In comparison with OLA, treatment with ARI generates annual average cost savings per patient of €289 (CI95% €271; €308). In the hypothetical scenario in which we assume that ARI may have a similar rate of sexual dysfunction as that of quetiapine (i.e. the lowest rate amongst AOAs), the additional cost per patient would be €323 (CI95% €330; €317). Conclusion. The results of this analysis show that patients treated with aripiprazole demonstrate lower adverse events costs in comparison to olanzapine. This difference may generate significant cost savings in the Spanish health system in the treatment of patients affected by bipolar disorders. The robustness of the results was tested via a probabilistic analysis. [ABSTRACT FROM AUTHOR]

Copyright of Psychiatria Polska is the property of Editorial Committee of Polish Psychiatric Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Some antipsychotics drugs are associated with blood dyscrasias. The psychotro-pic medication most frequently associated with agranulocytosis is clozapine (0,5-2% of patients). Olanzapine is a second-generation antipsychotic with a chemical structure similar to clozapine, with a risk of neutropenic reactions of 1/10.000 treated patients. We report the case of a 32-year-old man without medical or psychiatric records, who was admitted due to a first psychotic episode. In a blood test previous to hospitalization, complete blood cell count was normal (white blood cell count 8,92x10³/ul, neutrophilic count 6,99x10³/ul). Three days after initiation of olanzapine 20mg/day, WBC count had fallen to 2,46x10³/ul (neutrophilic count 0,64x10³/ul). After replacing olanzapine, initially for risperidone and later for intramuscular zuclopentixol, WBC count gradually increased. On the twelfth day of olanzapine withdrawal, complete blood cell count had normalized (WBC count 5,73x10³/ul). [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. Cuantification blood glucose and weight caused for olanzapine diabetic rats. The study was experimental, in group, prospective, incidental. Material and methods. We made measuring of blood glucose in 20 health rats and 20 diabetic rats, selected in 4 groups with 10 rats each, group 1: health rats, group 2: health rats with olanzapine, group 3: diabetic rats, and, group 4: diabetic rats with olanzapine. The medicine was continuous 4 weeks. We recorded 5 weight and 5 glucose measures, started with baselines and weekly for 4 weeks. Results. We recorded data set variables were analyzed using tables the values representing mean and standard deviation. With T student find significative diferences betwen experimental groups. In diabetic rats hyperglycemia occur in the fourth week and in these groups, obtained statistical differences in the weight at the end of the first week (p = 0.0001). The diabetic rats group with olanzapine was weekly die since first week and. in the fourth week only three survived whitout relation meausuring of hyperglycemia. Conclusion. In diabetic rat with olanzapine cause hyperglycemia and it´s neccessary absolut contraindication in diabetic because they have probabylity for complications with diabetes conducing at dead. [ABSTRACT FROM AUTHOR]

Serotonin syndrome is an acute neurologic picture due to serotonergic hyperactivity, due to the interaction of drugs that enhance or mimic the action of the serotonin. The incidence of serotonin syndrome is rising because of the growing availability of serotonergic drugs such as antidepressants. It is therefore important that clinicians recognize and manage appropriately this syndrome. This case report refers to an accidental poisoning by the atypical neuroleptic olanzapine in a 2 year old boy who developed clinical manifestations such as agitation, sweating, myoclonus, spontaneous clonus and hyperthermia, considered as diagnostic criteria for the syndrome. Therapy consisted of internal decontamination with gastric lavage, activated charcoal and sodium sulfate, cyproheptadine, propranolol and furosemide. The clinical outcome was satisfactory. In our country the majority of the causal drugs are easily available and widely employed, for which reason it is probable that this syndrome is under registered. Hence the importance of this case report. [ABSTRACT FROM AUTHOR]

Objective: this study assessed treatment outcomes of Latin American patients with bipolar I disorder (manic or mixed episodes) who included olanzapine in their treatment regimen compared with patients who did not. Materials and methods: patients from seven Latin American countries participated in this prospective, observational, noninterventional, open-label study were: (i) time to remission of manic symptoms (Young Mania Rating Scale (YMRS) ≤ 12), (ii) time to hospitalisation after remission, and (iii) time to relapse with a manic (YMRS ≥ 15) or depressive (Montgomery-Åsberg Depression Rating Scale (MADRS) ≥ 15) episode. Comparisons of clinical outcomes only included data from visits where patients continued to use their baseline treatment. Results: at baseline, 516 patients included olanzapine in their treatment and 246 did not; 67.5% of all patients had a manic episode and 31.9% had a mixed episode. Time to remission of manic symptoms was similar between groups (log-rank P-value = 0.133). Time to hospitalisation (log-rank P-value < 0.0001) and relapse with a manic (log-rank P value = 0.0002), but not a depressive (log-rank P-value = 0.363) episode was significantly longer in the olanzapine group compared with the non-olanzapine group. Similar rates of treatment-emergent adverse events and statistically significant improvements in quality of life (12-Item Short Form Health Survey) were observed in both groups. Conclusions: inclusion of olanzapine in bipolar I disorder therapy may allow patients from Latin America to maintain clinically effective and long-term responses to treatment. [ABSTRACT FROM AUTHOR]

Objective: to describe the clinical outcomes of the Schizophrenia Outpatients Health Outcomes (SOHO) study in Argentina. Methods: naturalistic, observational, prospective and 3-year study that compared outpatients who started or changed to oral olanzapine or to any other antipsychotic (other AP). The effectiveness was measured using the Global Clinical Impression Schizophrenia Scale. Other effectiveness measures and emergent adverse events were recorded. Results: Argentina enrolled 186 patients on Olanzapine and 175 on other APs. Patients on olanzapine improved more and faster than patients in Other AP group with a statistical difference at the first and second year. Rates of clinical response were statistically greater on olanzapine vs other AP (92.4, 75.4%, respectively, p =0.0001) and rates of relapse were similar between groups (25.9, 28%, respectively, p = 0.7436). Rates of extrapyramidal symptoms and tardive dyskinesia were statistically lower in the olanzapine group and weight gain was statistically greater during the first but not at the third year. More patients discontinued their prescribed antipsychotic due to lack of or incomplete response than due to intolerability. Conclusions: these results support the observations of faster and greater clinical improvement with olanzapine than other AP in real-world settings. A greater proportion of patients in the olanzapine group gained weight ≥ 7% from baseline to the first year and second years without statistical difference. At the third year a greater proportion of patients in other AP group gained weight ≥ 7% from baseline without statistical difference vs olanzapine. Some limitations in the design and heterogeneity of the other AP group and the nature of observational studies must be taken in account to interpret these results. [ABSTRACT FROM AUTHOR]

Introduction. Patterns of use of antipsychotics are not well described in emergency units. The objective of this study was to describe the effectiveness and safety of use of olanzapine in patients with acute psychosis and agitation in the emergency rooms. Methods. In this prospective observational study 278 patients with acute psychosis and agitation were consecutively admitted in 16 psychiatric emergency wards and treated with any oral psychopharmacology treatment, including olanzapine, according to investigators clinical criteria. Data were collected prospectively including demographics, diagnosis, concomitant medications, utilization of mechanical restraints, and severity of agitation. Clinical evolution during emergency room stay was assessed with PANSS-Excitement Component, CGI-S, and Agitation and Calmness Evaluation Scale (ACES) at baseline, before any re-intervention (if needed) and at discharge from the emergency room. Safety was also evaluated. Results. Olanzapine alone was used in 148 (53.2%) patients. Most of them (77.7 %) were diagnosed of schizophrenia and related psychoses. Up to 38 patients (25.7%) required mechanical restraints. Mean change (confidence interval [CI] 95%) from baseline to discharge was significant in all rating scales; PANSS-EC: -7.46 (-8.2, -6.7); CGI-S: -1.82 (-2, -1.6); ACES: 1.28 (1.1, 1.5). At discharge 70.3% of patients went to inpatient units. Five patients (3.4 %) reported adverse events including: bradycardia, dry mouth, sedation, hypertension, hypotension, and orthostatic hypotension. None of them was serious. Conclusions. The utilization of olanzapine alone decreased agitation in psychotic patients in emergency room settings. Incidence of adverse events was low and it was well tolerated. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the health results and the related costs of the antipsychotic medications available on the market, with emphasis on olanzapine, in outpatients with schizophrenia in naturalistic settings. Methods: 572 outpatients with schizophrenia (CIE-10 or DSM-IV) who began or changed to an oral antipsychotic medication were enrolled in blocks of 10 patients: 5 for olanzapine and 5 for other antipsychotics (AP) different to Olanzapine, according to the prescription at that time. The risk behaviors, the level of functioning, and the quality of life were analyzed with the EUROQOL-EQ-D5 scale and the Visual Analogue Scale. The use of health resources was also evaluated. The analysis compared the group that received olanzapine with the subgroups which received risperidone and typical antipsychotics (AT) in monotherapy. Results: similar percentages of suicide attempts, alcohol abuse/dependence and arrests were found in the three treatment groups. The rates of hostile and aggressive behavior were statistically lower with olanzapine vs TA (p = 0.0003). Olanzapine and risperidone proved superior in improving/ maintaining a high level of social, work and housing status vs. TA. Olanzapine and risperidone showed better results in the 5 items of EQ-5D vs. TA but only olanzapine achieved a statistical difference vs. TA in self-care, daily activities and absence of anxiety/ depression. A higher percentage of patients on olanzapine continued with the medication up to the three year endpoint (p < 0.0001 olanzapine vs TA); discontinued treatment less due to problems of efficacy or intolerability (p = 0.0005 olanzapine vs TA and p < 0.0001 olanzapine vs. TA respectively); had the lowest rates of hospitalization. Conclusions: olanzapine and risperidone were superior to the typical antipsychotics in improving the overall functioning of the patients which can be interpreted as greater and better social reintegration. The state of health and the quality of life improved with both atypicals but only olanzapine was statistically superior to the typicals. The patients on olanzapine remained in treatment for the longest period and abandoned treatment less due to problems of efficacy or intolerability. Less patients on olanzapine needed hospitalization and outpatient consultations versus typical medications which could mean savings in direct costs of the illness. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the health results and the costs related to the available antipsychotics, with emphasis on olanzapine, in naturalistic outpatient settings. Methods: 572 patients with schizophrenia (ICD-10 or DSM-IV) who began or changed to an oral, antipsychotic were enrolled in blocks of ten: 5 patients for olanzapine and 5 for another antipsychotic, according to the prescription at that time. The effectiveness was measured by the mean change in score on the Global Clinical Impression of Severity of illness Scale (GCI-S). "Clinical response" was defined as the decrease ≥" 2 points on the GCI-S if the baseline score was ≥" 4 and the decrease ≥" 1 if the baseline was ≤" 3. "Minimally symptomatic" was defined as reaching a score of 1 or 2 on the GCI-S after the baseline. Adverse events resulting from the treatment were recorded, along with the use of any concomitant medication and the causes of discontinuation of the medication. Results: The SOHO Andean Region enrolled 272, 97 and 65 patients in monotherapy with olanzapine, typical antipsychotics (TA) and risperidone respectively. Both olanzapine and risperidone were more effective than the TA in improving the general, positive and negative symptoms at 12, 24, and 36 months, but only olanzapine showed a statistically significant difference vs TA in depressive and cognitive symptoms. Less patients on olanzapine developed extrapyramidal symptoms (EPS) and adverse sexual events. The patients on olanzapine demonstrated the lowest rate of tardive dyskinesia at 3 years. More patients on olanzapine gained weight with a statistically significant difference vs risperidone and TA. The mean weight gain with olanzapine was 5 kg and the greatest increase was recorded in the first 12 months of treatment. Conclusions: olanzapine, but not risperidone, was more effective than typicals improving depressive and cognitive symptoms with statistical difference. Olanzapine was better tolerated in terms of EPS, tardive dyskinesia and sexual function impairment. A greater weight gain was recorded with olanzapine; however, the discontinuation rate due to intolerability was the lowest. These results support the greater benefits of Atypicals in terms of effectiveness and tolerability. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the safety and tolerability of long-term treatment with olanzapine versus risperidone in schizophrenic outpatients with prominent negative symptoms. Methods. This was a multi-center, randomised, open-label, parallel, dose-flexible, 1 year study of outpatients with schizophrenia (DSM-IV criteria) with prominent negative symptoms (SANS global score ≥10). Safety was evaluated by recording treatment-emergent adverse events, vital signs, body weight and, when available, laboratory parameters. Extrapyramidal symptoms (EPS) were evaluated by a questionnaire based on the UKU scale, and sexual dysfunction by the Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ). Results. The mean (±SD) modal dose throughout the study was 12.3 (± 6.3) mg/day for olanzapine and 5.2 (± 2.5) mg/day for risperidone. EPS were significantly more frequent in the risperidone-treated patients 50.4% versus 28.9% for olanzapine (p=0.0006). Olanzapine patients showed significantly greater reductions (improvement) from baseline in the PRSexDQ score (p=0.0292) and risperidone patients reported significantly more sexual adverse events (21.1% versus 7.3% for olanzapine, p=0.0018). Mean body weight gain was not significantly different at endpoint (3.5 kg gained with olanzapine versus 1.9 kg gained with risperidone; p=0.3522), but the proportion of patients showing a body weight increase ≥7% was higher among the olanzapine-treated patients (37.8% versus 16.8%; p=0.0012). Conclusions. Significantly less treatment-emergent extrapyramidal and sexual adverse events were observed in patients treated with olanzapine compared to those treated with risperidone. Mean body weight increases with both drugs were not significantly different after one year. Olanzapine patients presented a significantly higher incidence of clinically important body weight increase when compared with patients treated with risperidone. [ABSTRACT FROM AUTHOR]

Introduction. This study was conducted to determine effectiveness and safety of olanzapine in patients with severe agitation. Method. A naturalistic, open-label study in 80 acutely agitated psychotic patients visited in our psychiatric emergency department. Patients received either a 20-mg olanzapine orally-disintegrating tablet or conventional treatment depending on attending psychiatrist's preference. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC), the Agitation-Calmness Evaluation Scale (ACES) and pragmatic variables (second pharmacological intervention and need for physical restraints). Results: 60 % patients completed a 6 hour trial. Both groups showed a significant reduction in mean PANSS-EC score. The olanzapine-treated group showed statistically significant improvements: PANSS-EC (F=122.9; df=2.4; p=0.000), ACES (F=68.2; df=2.8; p=0.000). Treatment was well-tolerated and no serious side-effects were observed. Conclusions. In this naturalistic study in patients with severe agitation, 20-mg oral olanzapine was effective, rapid and safe. [ABSTRACT FROM AUTHOR]

Temperament and character are terms utilized to delineate the participation of biologic and psychosocial factors in the development of normal and disordered personality. At times, biological factors, and in others rearing, education, psychological and social events at an early age are the main determinants. The American Psychiatric Association describes Borderline Personality Disorder (BPD) as characterized by a pattern of interpersonal, self-image and affective instability, as well as notable impulsivity. In this disorder, temperament as an inherited factor plays an important role, as demonstrated by familial studies in which the disorder is more frequently present in the families of probands than non-probands. Other disorders where impulsivity is an outstanding feature, such as antisocial personality disorder and substance abuse, are also frequent in first degree relatives of patients with BPD. [ABSTRACT FROM AUTHOR]

The IC-SOHO study was designed to supply information on antipsychotic treatments in the real clinical practice by assessment of a large and diverse sample population with schizophrenia. This document describes the findings of the first 6 months of IC-SOHO in Latin America. To date, this is the largest observational study of its type in this region. In this observational and prospective study, those out-patients with schizophrenia, who require a change or initiation of antipsychotic medication are hospitalized. Effectiveness was evaluated using the Clinical Global Impression-Seriousness (CGI-S) grading scale. Tolerability was assessed by questionnaires on adverse events and weight measurements. Herein, the comparisons between olanzapine (monotherapy), risperidone (monotherapy) and conventional antipsychotics (monotherapy and combined therapy) are presented. As a whole, 7,658 patients participated in the IC-SOHO; n=2,671 from 11 countries of Latin America that were included in this report. At 6 months, the proportion of patients who responded to olanzapine was significantly greater than those who responded to risperidone or conventional antipsychotics (p < 0.001). Patients from the olanzapine group had greater improvements in all the symptom domains, including general, positive, negative, depressive and cognitive symptoms in comparison with risperidone (p < 0.05) or conventional antipsychotics (p < 0.001). Extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) decreased from baseline in the groups treated with olanzapine and risperidone, but increased in the conventional group. The adverse events related with the sexual function were more prominent in the conventional group. Weight gain was observed in each treatment group, although the patients from the olanzapine group had greater weight grain followed by those of risperidone and then by those of conventional antipsychotics. Our findings in this population of the Latin American sample emulate the results of other studies in different samples, where it was found that olanzapine was more effective and better tolerated than risperidone or conventional antipsychotics. [ABSTRACT FROM AUTHOR]

Objective. To measure health related quality of life (HRQL) and social functioning in schizophrenic patients treated with olanzapine under regular clinical practice conditions. Methods. Out-patients diagnosed of schizophrenia and beginning treatment with olanzapine, quetiapine, risperidone or typical oral antipsychotics were included. Information on socio-demographic characteristics was obtained and in each visit (baseline, 3, 6 and 12 months) they were administered the generic HRQL questionnaire Euro-QoL-5D (EQ-5D) and the Social Functioning Scale (SFS). Results. A total of 1,198 patients were followed-up for 12 months. Mean age (SD) was 38.6 (13.3) years and 62.9% of them were men. In basal conditions the most affected dimensions of EQ-5D were anxiety/depression (76%), and daily activities (73.6%). After 12 months treatment the cohort of patients treated with olanzapine showed a better HRQL in the self-care dimension compared to all other treatments (p < 0.05), and in the dimensions of pain/discomfort, anxiety/depression and usual activities compared to the group treated with quetiapine and risperidone (p < 0.05). The Visual Analogue Scale (VAS) of the EQ-5D questionnaire showed a better health state after 12 months in the group treated with olanzapine compared to the groups of quetiapine or risperidone (p < 0.05). The SFS showed a better improvement in the cohort of olanzapine in the three studied dimensions after 12 months: isolation and social relationships in comparison to the risperidone group (p < 0.05), interpersonal communication in comparison to the risperidone and quetiapine group (p < 0.05) and independence performance in comparison to all the other treatments (p < 0,05). Conclusion. Schizophrenic patients treated with olanzapine for one year show a better improvement in HRQL and social functioning than those treated with other antipsychotics. [ABSTRACT FROM AUTHOR]