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Pharmacopsychiatry 2005; 38(4): 147-157
DOI: 10.1055/s-2005-871236
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Patients’ Opinions of Olanzapine and Risperidone Following Long-term Treatment: Results from a Cross-sectional Survey

B. M. McGrath1 , R. P. Tempier2
  • 1Neurochemical & Bebensee Schizophrenia Research Units, Department of Psychiatry, University of Alberta, Alberta, Canada
  • 2Professor and Chair, Department of Adult Psychiatry, University of Saskatchewan, Ellis Hall, Royal University Hospital Saskatoon, Saskatchewan, Canada
Further Information

Publication History

Received: 12.4.2004 Revised: 9.8.2004

Accepted: 4.11.2004

Publication Date:
18 July 2005 (online)

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Introduction: The present study compares the subjective responses of patients in the stable phase of schizophrenia being treated with either olanzapine or risperidone. Methods: Several well-established, self-report inventories were used in this investigation, providing a means of assessing the impact of these medications from the perspective of the patient. Results: Patients randomly sampled from a continuing care clinic had been receiving treatment with olanzapine and risperidone for an average of 140 weeks and 225 weeks, respectively. The two treatment groups report highly positive attitudes toward their medication and a relatively high overall level of well-being and health-related quality of life. All patients report high levels of satisfaction with the mental health services they receive and their general health status. Olanzapine-treated patients were more likely to report reduced social and family interaction, as well as reduced sexual behavior and less participation in active recreational and pastime activities. Patients on olanzapine also reported greater difficulty in thinking clearly and more feelings of uselessness and of being lost and alone. The occurrence of antipsychotic-induced tardive dyskinesia and akathisia was low in both treatment groups. Discussion: Results point to a high level of subjective tolerability for both olanzapine and risperidone, with few differences between the two medications on the subjective dimensions of outcome assessed in this study. Future studies should expand on the findings here, building on the limitations toward a large study including a comparison group receiving long-term treatment with typical antipsychotics. Ultimately, the goal should be the incorporation of patient-oriented assessments into routine clinical practice. This is particularly important given the relationship among satisfaction with treatment, compliance, and quality of life.

References

  • 1 Al-Zakwani I S, Barron J J, Bullano M F, Arcona S, Drury C J, Cockerham T R. Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications.  Curr Med Res Opin. 2003;  19 (7) 619-626
    CrossrefPubMedGoogle Scholar
  • 2 Awad A G. Subjective response to neuroleptics in schizophrenia.  Schizophr Bull. 1993;  19 (3) 609-618
    PubMedGoogle Scholar
  • 3 Awad A G. Antipsychotic medications in schizophrenia: how satisfied are our patients?. In: Clear perspectives - management issues in schizophrenia: patient satisfaction, compliance and outcomes in schizophrenia. London (UK); AstraZeneca Pharmaceuticals 1999: 1-6
    Google Scholar
  • 4 Awad A G, Hogan T P. Early treatment events and prediction of response to neuroleptics in schizophrenia.  Prog Neuropsychopharmacol Biol Psychiatry. 1985;  9 85-588
    PubMedGoogle Scholar
  • 5 Awad A G, Hogan T P. Subjective response to neuroleptics and the quality of life: implications for treatment outcome.  Acta Psychiatr Scand. 1994;  89 (Suppl. 380) 27-32
    PubMedGoogle Scholar
  • 6 Awad A G, Hogan T P, Voruganti L NP, Heslegrave R J. Patients’ subjective experiences on antipsychotic medications: implications for outcome and quality of life.  Int Clin Psychopharmacol. 1995;  10 (Suppl. 3) 123-132
    PubMedGoogle Scholar
  • 7 Awad A G, Lapierre Y D, Angus C, Rylander A, and The Canadian Remoxipride G roup. Quality of life and response of negative symptoms in schizophrenia to haloperidol and the atypical antipsychotic remoxipride.  J Psychiatry Neurosci. 1997;  22 (4) 244-248
    PubMedGoogle Scholar
  • 8 Awad A G, Voruganti L N. New antipsychotics, compliance, quality of life, and subjective tolerability - are patients better off?.  Can J Psychiatry. 2004;  49 (5) 283-284
    PubMedGoogle Scholar
  • 9 Awad A G, Voruganti L NP, Heslegrave R J. A conceptual model of quality of life in schizophrenia: description and preliminary clinical validation.  Qual Life Res. 1997;  6 21-26
    PubMedGoogle Scholar
  • 10 Barnes T RE. A rating scale for drug-induced akathisia.  Br J Psychiatry. 1989;  154 672-676
    CrossrefPubMedGoogle Scholar
  • 11 Bartko G, Herczeg I, Bekesy M. Predicting outcome of neuroleptic treatment on the basis of subjective response and early clinical improvement.  J Clin Psychiatry. 1987;  48 363-365
    PubMedGoogle Scholar
  • 12 Bergner M, Bobbit R A, Carter W B, Gilson B S. The Sickness Impact Profile: development and final revision of a health status measure.  Med Care. 1981;  19 (8) 787-805
    CrossrefPubMedGoogle Scholar
  • 13 Csernansky J G, Schuchart E K. Relapse and rehospitalisation rates in patients with schizophrenia. Effects of second generation antipsychotics.  CNS Drugs. 2002;  16 (7) 473-484
    Google Scholar
  • 14 Dolder C R, Jeste D V. Incidence of tardive dyskinesia with typical versus atypical antipsychotics in very high risk patients.  Biol Psychiatry. 2003;  53 (12) 142-1145
    PubMedGoogle Scholar
  • 15 Franz M, Lis K, Pluddemann K, Gallhofer B. Conventional versus atypical neuroleptics: subjective quality of life in schizophrenic patients.  Br J Psychiatry. 1997;  170 422-425
    PubMedGoogle Scholar
  • 16 Glick I D, Berg P H. Time to study discontinuation, relapse, and compliance with atypical and conventional antipsychotics in schizophrenia and related disorders.  Int Clin Psychopharmacol. 2002;  17 (2) 65-68
    PubMedGoogle Scholar
  • 17 Guy W. (editor). AIMS, in ECDEU Assessment Manual. Rockville, MD; U.S. Department of Health, Education, and Welfare 1976: pp. 534-537
    Google Scholar
  • 18 Hamilton S H, Revicki D A, Edgel L, Genduso L A, Tollefson G D. Clinical and economic outcomes of olanzapine compared with haloperidol for schizophrenia - results from a randomized clinical trial.  Pharmacoeconomics. 1999;  15 469-480
    PubMedGoogle Scholar
  • 19 Hellewell J S. Patients’ subjective experiences of antipsychotics: clinical relevance.  CNS Drugs. 2002;  16 (7) 457-471
    PubMedGoogle Scholar
  • 20 Hertling I, Philipp M, Dvorak A, Glaser T, Mast O, Beneke M, Ramskogler K, Saletu-Zyhlarz G, Walter H, Lesch O M. Flupenthixol versus risperidone: subjective quality of life as an important factor for compliance in chronic schizophrenic patients.  Neuropsychobiology. 2003;  47 (1) 37-46
    PubMedGoogle Scholar
  • 21 Hogan T P, Awad A G. Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures.  Psychol Med. 1992;  22 347-352
    PubMedGoogle Scholar
  • 22 Hogan T P, Awad A G, Eastwood M R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity.  Psychol Med. 1983;  13 177-183
    PubMedGoogle Scholar
  • 23 Jacovljevic M, Dossenbach M R, Friedel P, Schausberger B, Grundy S L, Hotujac L, Folnegovic-Smalc V, Uglesic B, Tollefson G. Olanzapine versus fluphenazine in the acute (6-week) treatment of schizophrenia.  Psychiatr Danub. 1999;  11 3-11
    PubMedGoogle Scholar
  • 24 Jarema M, Murawiec S, Szafranski T, Szaniawska A, Konieczynska Z. Subjective and objective evaluation of treating schizophrenia with classic or atypical drugs.  Psychiatr Pol. 2001;  35 (1) 5-19
    PubMedGoogle Scholar
  • 25 Kanter J. Clinical case management: definition, principles, components.  Hosp Community Psychiatry. 1989;  40 361-368
    Google Scholar
  • 26 Karagianis J L, LeDrew K K, Walker D J. Switching treatment-resistant patients with schizophrenia or schizoaffective disorder to olanzapine: a one-year open-label study with five-year follow-up.  Curr Med Res Opin. 2003;  19 473-480
    CrossrefPubMedGoogle Scholar
  • 27 Karow A, Naber D. Subjective well-being and quality of life under atypical antipsychotic treatment.  Psychopharmacology. 2002;  162 3-10
    CrossrefPubMedGoogle Scholar
  • 28 Kim K, Pae C, Chae J, Bahk W, Jun T, Kim D. et al . Effects of olanzapine on prolactin levels of female patients with schizophrenia treated with risperidone.  J Clin Psychiatry. 2002;  63 (5) 408-413
    PubMedGoogle Scholar
  • 29 Larsen E B, Gerlach J. Subjective experience of treatment, side-effects, mental state and quality of life in chronic schizophrenic out-patients treated with depot neuroleptics.  Acta Psychiatr Scand. 1996;  93 381-388
    PubMedGoogle Scholar
  • 30 Lieberman J A, Tollefson G, Tohen M, Green A I, Gur R E, Kahn R. et al . Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trail of olanzapine versus haloperidol.  Am J Psychiatry. 2003;  160 (8) 1396-1404
    CrossrefPubMedGoogle Scholar
  • 31 Llorca P M, Chereau I, Bayle F J, Lancon C. Tardive dyskinesias and antipsychotics: a review.  Eur Psychiatry. 2002;  17 129-138
    PubMedGoogle Scholar
  • 32 May P RA, Van Putten T, Yale C, Potepan P, Jenden D J, Fairchild M D. et al . predicting individual response to drug treatment in schizophrenia: a test dose model.  J Ner Ment Dis. 1976;  162 (3) 177-183
    PubMedGoogle Scholar
  • 33 McGrath B M, Tempier R P. Cross-sectional analysis of medication prescriptions for a continuing care patient population using the psychiatry quality measurement. Presented at the 9th Congress of the International Federation of Psychiatric Epidemiology Edmonton, Alberta, Canada; May 2002
    Google Scholar
  • 34 McGrath B M, Tempier R P. Implementing quality management in psychiatry: from theory to practice - shifting focus from process to outcome.  Can J Psychiatry. 2003;  48 (7) 467-474
    PubMedGoogle Scholar
  • 35 Moritz S, Woodward T S, Krausz M, Naber D, and the PERSIST Study G roup. Relationship between neuroleptic dosage and subjective cognitive dysfunction in schizophrenic patients treated with either conventional or atypical neuroleptic medication.  Int Clin Psychopharmacol. 2002;  17 41-44
    PubMedGoogle Scholar
  • 36 Naber D. A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables.  Int Clin Psychopharmacol. 1995;  10 (Suppl. 3) 133-138
    CrossrefPubMedGoogle Scholar
  • 37 Naber D, Moritz S, Lambert M, Pajonk F, Holzbach R, Mass R. et al . Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs.  Schizophr Res. 2001;  50 79-88
    CrossrefPubMedGoogle Scholar
  • 38 Naber D, Walther A, Kircher T, Hayek D, Holzbach R. Subjective effects of neuroleptic predict compliance. In Gaebel W, Ward AG, editors Prediction of neuroleptic treatment outcome in schizophrenia: concepts and methods. Vienna; Springer-Verlag 1994: pp. 85-98
    Google Scholar
  • 39 Patel N C, Dorson P G, Edwards N, Mendelson S, Crismon M L. One-year rehospitalization rates of patients discharged on atypical versus conventional antipsychotics.  Psychiatr Serv. 2002;  53 (7) 891-893
    CrossrefPubMedGoogle Scholar
  • 40 Pereira S, Pinto R. A survey of the attitudes of chronic psychiatric patients living in the community toward their medication.  Acta Psychiatr Scand. 1997;  95 464-468
    PubMedGoogle Scholar
  • 41 Puri B K. SPSS in practice: an illustrated guide. 2nd Edition New York; Oxford University Press, Inc 2002: pp. 1-175
    Google Scholar
  • 42 Rabinowitz J, Bromet E J, Davidson M. Short report: comparison of patient satisfaction and burden of adverse effects with novel and conventional neuroleptics: a naturalistic study.  Schizophr Bull. 2001;  27 (4) 597-600
    PubMedGoogle Scholar
  • 43 Ritsner M, Perelroyzen G, Ilan H, Gibel A. Subjective response to antipsychotics of schizophrenia patients treated in routine clinical practice: a naturalistic comparative study.  J Clin Psychopharmacol. 2004;  24 (3) 245-254
    PubMedGoogle Scholar
  • 44 Sacristan J A, Gomez J C, Montejo A L, Vieta E, Gregor K J, and the EFESO Study G roup. Doses of olanzapine, risperidone, and haloperidol used in clinical practice: results of a prospective pharmacoepidemiologic study.  Clin Ther. 2000;  22 (5) 583-599
    CrossrefPubMedGoogle Scholar
  • 45 Sarwer-Foner G J. The role of neuroleptic medication in psychotherapeutic interaction.  Compr Psychiatry. 1960;  1 291-300
    PubMedGoogle Scholar
  • 46 Sarwer-Foner G J. On the mechanisms of action of neuroleptic drugs: a theoretical psychodynamic explanation.  Recent Adv Biol Psychiatry. 1963;  6 217-232
    PubMedGoogle Scholar
  • 47 Schillevoort I, de Boer A, Herings R MC, Roos R AC. Risk of extrapyramidal syndromes with haloperidol, risperidone, or olanzapine.  Ann Pharmacother. 2001;  35 1517-1522
    CrossrefPubMedGoogle Scholar
  • 48 Stokes M E, Davis C S, Koch G G. Categorical data analysis using The SAS System. 2nd Edition North Carolina; SAS Institute 2000: pp. 626
    Google Scholar
  • 49 Strauss J S. Subjective experiences of schizophrenia: toward a new dynamic psychiatry-II.  Schizophr Bull. 1989;  15 (2) 177-187
    PubMedGoogle Scholar
  • 50 Tempier R. Quality of life and schizophrenia: the impact of novel antipsychotic medications.  Can Psychiatr Assoc Bull. 1999;  31 (5) 144-146
    PubMedGoogle Scholar
  • 51 Tomb D A. Psychiatry. 6th edition Philadelphia; Lippincott Williams & Wilkins 1999: pp. 19-39
    Google Scholar
  • 52 Van Putten T, May P RA. Subjective response as a predictor of outcome in pharmacotherapy.  Arch Gen Psychiatry. 1978;  35 447-480
    PubMedGoogle Scholar
  • 53 Van Putten T, May P RA, Marder S R. Subjective responses to thiothixene and chlorpromazine.  Psychopharmacol Bull. 1980;  16 (3) 36-38
    PubMedGoogle Scholar
  • 54 Van Putten T, May P RA, Marder S R. Response to antipsychotic medication: the doctor’s and the consumer’s view.  Am J Psychiatry. 1984;  141 (1) 16-19
    PubMedGoogle Scholar
  • 55 Van Putten T, May P RA, Marder S R, Wittmann L A. Subjective response to antipsychotic drugs.  Arch Gen Psychiatry. 1981;  38 187-190
    PubMedGoogle Scholar
  • 56 Volavka J, Czobor P, Sheitman B, Lindenmayer J P, Citrome L, McEvoy J P. et al . Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder.  Am J Psychiatry. 2002;  159 255-262
    Google Scholar
  • 57 Voruganti L, Awad A G. Neuroleptic dysphoria: towards a new synthesis.  Psychopharmacol. 2004;  171 121-132
    CrossrefPubMedGoogle Scholar
  • 58 Voruganti L NP, Cortese L, Oyewumi L, Cernovsky Z, Zirul S, Awad A. Comparative evaluation of conventional and novel antipsychotic drugs with reference to their subjective tolerability, side-effect profile and impact on quality of life.  Schizophr Res. 2000;  43 135-145
    CrossrefPubMedGoogle Scholar
  • 59 Watanabe A, Shibata I, Kato T. Differences of satisfaction with medication between patients with schizophrenia treated with typical antipsychotics and atypical antipsychotics.  Psychiatry Clin Neurosci. 2004;  58 268-273
    CrossrefPubMedGoogle Scholar
  • 60 Weiden P, Aquila R, Standard J. Atypical antipsychotic drugs and long-term outcome in schizophrenia.  J Clin Psychiatry. 1996;  57 (Suppl. 11) 53-60
    PubMedGoogle Scholar
  • 61 Williams B. Patient satisfaction: a valid concept?.  Soc Sci Med. 1994;  38 (4) 509-516
    CrossrefPubMedGoogle Scholar
  • 62 Windgassen K. Treatment with neuroleptics: the patient’s perspective.  Acta Psychiatr Scand. 1992;  86 405-410
    CrossrefPubMedGoogle Scholar
  • 63 Woods S W. Chlorpromazine equivalent doses for the newer atypical antipsychotics.  J Clin Psychiatry. 2003;  64 (6) 663-667
    CrossrefPubMedGoogle Scholar
  • 64 Ziegler D M, Peachey T J. A study of treatment outcomes from atypical antipsychotic medications in the Virginia public system of community care.  Community Ment Health J. 2003;  39 (2) 169-182
    CrossrefPubMedGoogle Scholar

Brent M. McGrath, BSc, MSc

Department of Psychiatry

University of Alberta, Mackenzie Centre

8440 - 112 Street

Edmonton

Alberta

Canada

T6G 2B7

Phone: 780-492-6028

Fax: 780-407-6672

Email: brent.mcgrath@ualberta.ca