Olanzapine response in psychotic depression
by
Rothschild AJ, Bates KS,
Boehringer KL, Syed A
Department of Psychiatry,
University of Massachusetts Medical School,
Worcester 01655, USA.
J Clin Psychiatry 1999 Feb; 60(2):116-8

ABSTRACT

BACKGROUND: Psychotic depression is more common than is generally realized, occurring in an estimated 16% to 54% of depressed patients. In controlled studies of patients with schizophrenia, the atypical antipsychotic olanzapine has been shown to be superior in efficacy to haloperidol at doses of 10 mg/day. Since olanzapine may have antidepressant effects in addition to its antipsychotic properties, the purpose of this study was to assess the safety and efficacy of olanzapine in the treatment of psychotic depression. METHOD: Hospitalized patients with the discharge diagnosis of DSM-IV psychotic depression (major depression with psychotic features or bipolar I disorder, depressed phase...with psychotic features) who had been treated with olanzapine during the first 9 months of its availability in the United States were identified. An age- and sex-matched sample of hospitalized patients with psychotic depression treated with other antipsychotics during the same time period was also identified. The medical records were expunged of all references to medication treatment and then reviewed and scored in a blind fashion for indications, doses, response, and side effects. RESULTS: Fifteen psychotic depression patients (10 women, 5 men), aged 36.9 +/- 10.1 years, who were treated with olanzapine were retrospectively compared with 15 psychotic depression patients (10 women, 5 men), aged 35.0 +/- 8.2 years, treated with other antipsychotics. Ten (67%) of 15 patients taking olanzapine were much or very much improved upon discharge compared with only 4 (27%) of 15 patients taking other antipsychotics (Fisher exact test, p = .037). Olanzapine was well tolerated: no patient discontinued the medication because of side effects. Twelve (80%) of 15 patients in each group were taking antidepressants in addition to the antipsychotic. Of the 3 patients taking olanzapine but not taking an antidepressant, 2 were much or very much improved (1 patient taking olanzapine alone, 1 taking olanzapine plus valproate sodium). CONCLUSION: Olanzapine appears to be effective and safe for patients with psychotic depression. Further prospective studies are warranted to ascertain whether olanzapine's unique pharmacologic profile may make it particularly useful for the treatment of psychotic depression either alone or in combination with antidepressants.

Quetiapine
Amisulpride
Risperidone
Chronic depression
Psychotic depression
Paliperidone (Invega)
Atypical antipsychotics
Schizoaffective disorder
Schizophrenia: new drugs
Schizophrenia: neuroleptics
Are atypicals antidepressants?
Serotonin hypothesis of schizophrenia
Dopamine hypothesis of schizophrenia
Olanzapine (Zyprexa) and quality of life
Olanzapine/fluoxetine combo (Symbyax)
Atypicals versus traditional antipsychotics
Olanzapine (Zyprexa): prescribing information (PDF)
Olanzapine (Zyprexa), weight gain, hyperglycaemia and diabetes

Refs
HOME
HedWeb
Future Opioids
BLTC Research
Paradise-Engineering
Utopian Pharmacology
The Hedonistic Imperative
When Is It Best To Take Crack Cocaine?

The Good Drug Guide
The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family