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Pharmacopsychiatry 2008; 41(5): 182-189
DOI: 10.1055/s-2008-1077050
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Treatment of Severe Agitation with Olanzapine in 166 Patients with Schizophrenia, Schizoaffective, or Bipolar I Disorder

M. Lambert 1 [*] , C. G. Huber 1 [*] , D. Naber 1 , A. Schacht 2 , T. T. Wagner 2 , H.-P. Hundemer 2 , A. Karow 1 , B. G. Schimmelmann 3
  • 1Psychosis Early Detection and Intervention Centre (PEDIC), Centre for Psychosocial Medicine, Department of Psychiatry and Psychotherapy, University Medical Centre, Hamburg-Eppendorf, Germany
  • 2Medical Neuroscience Department, Lilly Deutschland GmbH, Bad Homburg, Germany
  • 3Department of Child and Adolescent Psychiatry, University Duisburg-Essen, Duisburg, Germany
Further Information

Publication History

received 28.09.2007 revised 02.02.2008

accepted 03.03.2008

Publication Date:
01 September 2008 (online)

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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.

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1 These authors made equal contributions to the paper.

Correspondence

PD Dr. med. M. Lambert

Psychosis Early Detection and Intervention Centre (PEDIC)

Centre for Psychosocial Medicine

Department of Psychiatry and Psychotherapy

University Medical Centre Hamburg-Eppendorf

Martinistr. 52

20246 Hamburg

Germany

Phone: 49/40/428 03 76 70

Fax: +49/40/428 03 54 55

Email: lambert@uke.uni-hamburg.de