scholarly journals A Comparative Study between Olanzapine and Risperidone in the Management of Schizophrenia

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Saeed Shoja Shafti ◽  
Mahsa Gilanipoor

Introduction. Since a variety of comparisons between risperidone and olanzapine have resulted in diverse outcomes, so safety and efficacy of them were compared again in a new trial.Method. Sixty female schizophrenic patients entered into one of the assigned groups for random allocation to olanzapine or risperidone (n=30in each group) in a double-blind, 12-week clinical trial. Scale for Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS) were used as the primary outcome measures. Clinical Global Impressions-Severity Scale (CGI-S), Schedule for Assessment of Insight (SAI), and finally Simpson Angus Scale (SAS) as well were employed as secondary scales.Results. While both of olanzapine and risperidone were significantly effective for improvement of positive symptoms (P<0.0001), as regards negative symptoms, it was so only by means of olanzapine (P<0.0003). CGI-S and SAI, as well, were significantly improved in both of the groups. SAS increment was significant only in the risperidone group (P<0.02).Conclusion. While both of olanzapine and risperidone were equally effective for improvement of positive symptoms and insight, olanzapine showed superior efficacy with respect to negative symptoms, along with lesser extrapyramidal side effects, in comparison with risperidone.

Author(s):  
Tarun Vijaywargia

Background: This study evaluates and compares how negative and positive symptoms of schizophrenia were influenced with monotherapy with a first-generation anti-psychotic medication (Chlorpromazine) and a second generation anti-psychotic medication (Risperidone) and by their combination, both of which are commonly used in clinical psychiatric practice.Methods: It was randomized, double-blind, controlled clinical study performed in Indian newly diagnosed schizophrenic patients in the Department of psychiatry from Feb 2003 to March 2004. Patients 18 (eighteen) patients aged 20 to 60 years diagnosed schizophrenics according to ICD-10 Criteria who visited in outpatient department of psychiatry during study period. Three groups of 6 Patient each, group-1 - was treated with oral Chlorpromazine 100 mg 12 hly, group -2 - was treated with oral Risperidone 2mg 12 hly group 3 -was treated with combination of oral Chlorpromazine 100mg 12 hly + oral Risperidone 2 mg 12 hly. How symptomatology in schizophrenic patients affected, is measured by applying various validated psychiatric scales like Brief psychiatric Rating Score (BPRS), Scale for assessment of positive symptom(SAPS), and Scale for Assessment of Negative Symptoms (SANS).Results: the study showed that the combination therapy of oral Chlorpromazine 100 mg 12 hly + Risperidone 2mg 12 hly had reduced the overall beneficial effects which were achieved with monotherapy of both the drugs.Conclusions: In this study, the therapeutic effects of combination of oral Chlorpromazine 100 mg 12 hly + Risperidone 2 mg 12 hly found to be reduced on positive symptoms and negative symptoms of schizophrenia, assessed on SAPS and SANS scoring scales when compared with beneficial effects which were achieved with monotherapy of both the drugs.


CNS Spectrums ◽  
2004 ◽  
Vol 9 (S9) ◽  
pp. 19-23 ◽  
Author(s):  
Alexander L. Miller

ABSTRACTCombination treatments, especially combinations of antipsychotics, are used frequently for schizophrenia, despite a paucity of evidence regarding their safety and efficacy. Because the literature basis is weak and expert recommendations are largely lacking, providers should be vigilant in documenting improved outcomes for patients thought to benefit from combination treatments. Target symptoms that have been studied include psychosis, cognitive deficits, and negative symptoms. The strongest evidence is for augmentation of clozapine with another antipsychotic or with electroconvulsive therapy for persistent positive symptoms. Combination treatments for cognitive deficits and negative symptoms are being actively investigated, but current evidence is insufficient to recommend available agents for these components of schizophrenia. It is important that appropriate monotherapies be given adequate trials before resorting to combination therapies.


1996 ◽  
Vol 78 (1) ◽  
pp. 123-128 ◽  
Author(s):  
Ronald A. Capleton

20 schizophrenic patients were classified as having either predominantly negative ( n = 11) or predominantly positive symptoms ( n = 9), utilizing the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. Cognitive functioning was evaluated in these participants and 10 non-patient controls using a word-fluency test and word-generation task. Finally, all participants were evaluated using the Coglab Card Sort Test, a computerized version of the Wisconsin Card Sort Test. The only reliable difference in performance among groups was on perseverative errors on the Coglab Card Sort Test Schizophrenic participants made significantly more perseverative errors than controls and those classified as having primarily negative symptoms made more perseverative errors than those classified as having predominantly positive symptoms. These findings confirm previous reports with respect to cognitive functioning of schizophrenic patients and are consistent with the hypotheses regarding frontal lobe dysfunction in schizophrenia. These data encourage research with larger samples.


1995 ◽  
Vol 166 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Hai-Gwo Hwu ◽  
Happy Tan ◽  
Chu-Chang Chen ◽  
Ling-Ling Yeh

BackgroundThe clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.MethodOf schizophrenic patients fulfilling DSM–III criteria, 113 were recruited for this study. Personal, social and psychopathological data were collected and all cases were followed up at one and two years after discharge.ResultsThe presence of positive symptoms (64 cases), without concomitant negative symptoms, did not predict the follow-up social function and positive symptom score. Conversely, the presence of negative symptoms (31 cases) predicted worse social functioning (P < 0.05 to P < 0.005) and higher positive symptom scores (P < 0.01) at follow-up using MANOVA. Eighteen cases (15.9%) had neither positive nor negative symptoms and had the best clinical outcome.ConclusionsNegative, but not positive, symptoms assessed at discharge are an important predictor of poor outcome. In addition, negative symptoms may themselves expose a biological vulnerability to the presence of positive symptoms.


1997 ◽  
Vol 9 (2) ◽  
pp. 64-67
Author(s):  
R.S. Kahn

The dopamine (DA) hypothesis of schizophrenia, postulating that schizophrenia is characterized by increased dopamine function, has been the most influential theory on the pathogenesis of schizophrenia. It has recently been revised based on the appreciation that the core symptoms of schizophrenia may not be the positive (psychotic) symptoms, but rather the negative symptoms and the cognitive deficits found in schizophrenic patients. This revision has prompted the hypothesis that schizophrenia is characterized by both decreased prefrontal dopamine activity (causing deficit symptoms) and increased dopamine activity in mesolimbic dopamine neurons (causing positive symptoms).Notwithstanding this revision of a role for dopamine in schizophrenia, it has become increasingly evident that dysfunction of other monoaminergic systems may be as important in contributing to the pathophysiology of schizophrenia. Specifically, the putative role of serotonin (5-hydroxytryptamine, 5-HT) in schizophrenia is gaining considerable attention. Several observations, such as the ability of the 5-HT antagonist, ritanserin, to alleviate schizophrenic symptoms and, when added to haloperidol (Haldol®), to decrease its extrapyramidal side-effects (EPS), have stimulated studies into a role of 5-HT in schizophrenia. The finding that clozapine (Leponex®), clinically superior to conventional neuroleptics, is a weak DA2 antagonist but a potent 5-HT1c and 5-HT2 antagonist has further stimulated 5-HT-related research in schizophrenia.


1986 ◽  
Vol 148 (5) ◽  
pp. 587-589 ◽  
Author(s):  
Michael R. Trimble

The terms positive and negative symptoms have slipped into the language of contemporary psychiatry with comparative ease. It is not uncommon for these expressions to be used with little explanation, both at meeting and in written communications, with the implicit understanding that their meaning is understood and that somehow they are of value to our knowledge of psychopathology. However, that there are no clear guide-lines at present for our use of these terms is shown from a recent survey of psychiatrists' opinions from a market research company (Martin Hamblin Research-Personal Communication). As part of a series of questions asked to many psychiatrists of differing age, geographical location, and status, they were asked about the meaning of these terms, positive and negative symptoms and the proportion of schizophrenic patients having them. Of the categories quoted by Crow (1980–81) as positive symptoms, 68% considered that delusions were positive symptoms, 63% hallucinations, and only 35% thought disorder. In contrast, 18% thought that behaviour disturbance was a positive symptom, a similar figure (15%) being given for passivity feelings. Considerable variation was noted, however, with hallucinations being considered positive by only 33% of London psychiatrists, thought disorder by only 11% of those qualified 16–25 years, and one-quarter of all registrars and psychiatrists from Midland Health Districts considered passivity feelings to fall into this category. Even greater disagreement was recorded for negative symptoms. Thus, the symptom most often associated with this category was apathy, by 52% of respondents. Only 26% considered that withdrawal was a negative symptom, the percentage data for lack of motivation and blunting of affect being 37% and 15% respectively.


Author(s):  
Massih Sedigh-Rahimabadi ◽  
Mohammadmehdi Fani ◽  
Mahsa Rostami-chijan ◽  
Mohammad M. Zarshenas ◽  
Mesbah Shams

This study evaluates the safety and efficacy of Punica granatum var pleniflora mouthwash in treatment of diabetic gingivitis. In a double-blind randomized clinical trial 80 patients with diabetes mellitus and gingivitis were assigned to Golnaar and chlorhexidine 0.2% groups. After using mouthwashes for 2 weeks; participants underwent tooth scaling and the last visit was 2 weeks after scaling. The primary outcome measures were plaque, modified gingival and gingival bleeding indices, and pocket depth. Both interventions had significant improvement on all of the gingival and plaque indices ( P < .001 for all indices). There were no significant differences between Golnaar and chlorhexidine in primary outcome measures except for modified gingival index for which Golnaar mouthwash had a superiority after 2 weeks when comparing with chlorhexidine ( P = .039). Meanwhile, Golnaar mouthwash had no staining effect. Golnaar mouthwash is safe and effective in treatment of gingivitis in diabetic patients although further studies are recommended.


1997 ◽  
Vol 171 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Taha Karaman ◽  
Sibel Özkaynak ◽  
Korkut Yaltkaya ◽  
Çetin Büyükberker

BackgroundSeveral reports have documented the presence of motor abnormalities in schizophrenic patients.MethodThirty schizophrenics and 28 healthy controls were included in the study. Scalp-recorded bereitschaftpotentials (BPs) generated prior to voluntary movements were recorded in all subjects.ResultsThe early (NSI) and late components of BP and peak negativity were reduced in all schizophrenic patients. In particular, the NSI was reduced in patients with positive symptoms, and the late component in patients with negative symptoms.ConclusionsThese findings provide further support for the involvement of frontal cortex, subcortical structures and their connections in schizophrenia, and highlight some differences between positive and negative symptom clusters.


2001 ◽  
Vol 35 (2) ◽  
pp. 217-223 ◽  
Author(s):  
Ross M. G. Norman ◽  
Ashok K. Malla

Objective: It has been hypothesized that patients with a diagnosis of schizophrenia who have a positive family history for schizophrenia will show greater reactivity of their symptoms to increasing levels of stress or negative affect than will patients without such a family history. In the past this hypothesis has only been tested through manipulations of negative affect in laboratory settings. In this paper we test this hypothesis using longitudinal clinical data. Method: Data were derived from an earlier longitudinal study using monthly assessments of daily stressors (Hassles Scale) and symptom measures (the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms). We compared longitudinal stress to symptom relations in 12 patients with schizophrenia for whom a positive family history of schizophrenia could be identified with 12 matched schizophrenic patients without any known family history of psychiatric illness. Results: There was evidence that patients with a family history of schizophrenia demonstrated a stronger relation between stress and total score on the Scale for the Assessment of Positive Symptoms. This difference appears to have primarily reflected a greater reactivity to stress of reality distortion symptoms in the positive family history group. The two groups did not differ in apparent reactivity to stress of the disorganization and psychomotor poverty dimensions of symptomatology. Conclusions: The results of this study provide support from a naturalistic, longitudinal clinical study for the hypothesis that reactivity to stress of some symptoms of schizophrenia may vary as a function of family history of the disorder.


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