RSS-Feed abonnieren
DOI: 10.1055/s-2007-958520
© Georg Thieme Verlag KG Stuttgart · New York
Outcomes in Schizophrenia Outpatients Treated with Amisulpride or Olanzapine
Publikationsverlauf
received 25. 5. 2006
revised 18. 7. 2006
accepted 25. 7. 2006
Publikationsdatum:
27. Februar 2007 (online)
![](https://www.thieme-connect.de/media/pharmaco/200701/lookinside/thumbnails/10.1055-s-2007-958520-1.jpg)
Abstract
Introduction: We compared stable patients with schizophrenia who were treated with either amisulpride or olanzapine in terms of symptomatic outcome, neurocognitive functioning, functionality, and subjective outcome.
Methods: Sixty outpatients with chronic schizophrenia who had been treated with either amisulpride or olanzapine for at least six months were investigated.
Results: The scores of positive, negative, and cognitive symptoms did not differ between the two groups, but patients treated with olanzapine had significantly lower scores on the excitement and depression/anxiety components of the PANSS. With regard to cognitive variables, patients treated with amisulpride showed significantly lower values regarding verbal fluency and significantly better verbal memory than patients treated with olanzapine. Both treatment groups were comparable with respect to functional and subjective outcome variables.
Discussion: These observations add to the evidence that continuous treatment with different second-generation antipsychotics with relatively few side effects leads to comparable outcomes in patients with schizophrenia.
Key words
amisulpride - olanzapine - schizophrenia - outcome - cognition - employment - quality of life - needs
References
- 1 Andreasen NC, Carpenter Jr WT, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005; 162 441-449
-
2 Aschenberger S, Tucher O, Langer KW.
Regensburger Wörtflüssigkeits-Test . Göttingen: Hogrefe Verlag für Psychologie 2000 - 3 Awad AG, Voruganti LNP. Impact of atypical antipsychotics on quality of life in patients with schizophrenia. CNS Drugs. 2004; 18 877-893
- 4 Beasley CM, Tollefson GD, Tran PV. Efficacy of olanzapine: an overview of pivotal clinical trials. J Clin Psychiatry. 1997; 58 ((suppl 10)) 7-12
-
5 Benton AS, Spreen O.
Der Benton Test . Handbuch: 7. Auflage 1996 - 6 Bymaster FP, Rasmussen K, Calligaro DO, Nelson DL, DeLapp NW, Wong DT. et al . In vitro and in vivo biochemistry of olanzapine; a novel, atypical antipsychotic drug. J Clin Psychiatry. 1997; 58 ((suppl 10)) 28-36
- 7 Corrigan PW, Reinke RR, Landsberger SA, Charate A, Toombs GA. The effects of atypical antipsychotic medications on psychosocial outcomes. Schizophr Res. 2003; 63 97-101
-
8 Delis DC, Kramer JH, Kaplan E, Ober BA.
California Verbal Learning and Memory Test (Manual) . San Antonio, TX: Psychological Corporation 1987 -
9 Fleischhacker WW. Pharmacological treatment of schizophrenia: a review. In Maj M, Sartorius N, editors
Schizophrenia. WPA Series Evidence and Experience in Psychiatry . Chichester, NY, Weinheim, Brisbane, Singapore, Toronto: John Wiley & Sons, LTD 2002 p. 75-113 - 10 Foldemo A, Bogren L. Need assessment and quality of life in outpatients with schizophrenia: a 5-year follow-up study. Scand J Caring Sci. 2002; 16 393-398
- 11 Harvey PD, Green MF, Keefe RSE, Velligan DI. Cognitive functioning in schizophrenia: a consensus statement on its role in the definition and evaluation of effective treatments for the illness. J Clin Psychiatry. 2004; 65 361-372
-
12 Heaton RK, Chelune GJ, Taley JL, Kay GG, Curtiss G.
Wisconsin Card Sorting Test Manual: Revised and Expanded . Odessa, FL: Psychological Assessment Resources 1993 - 13 Hofer A, Baumgartner S, Edlinger M, Hummer M, Kemmler G, Rettenbacher MA. et al . Patient outcomes in schizophrenia I: correlates with sociodemographic variables, psychopathology, and side effects. Eur Psychiatry. 2005; 20 386-394
- 14 Hofer A, Kemmler G, Eder U, Edlinger M, Hummer M, Fleischhacker WW. Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. J Clin Psychiatry. 2004; 65 932-939
- 15 Hofer A, Rettenbacher MA, Widschwendter CG, Kemmler G, Hummer M, Fleischhacker WW. Correlates of subjective and functional outcomes in outpatient clinic attendees with schizophrenia and schizoaffective disorder. Eur Arch Psychiatry Clin Neurosci. 2006; 256 246-255
- 16 Hummer M, Huber J. Hyperprolactinaemia and antipsychotic therapy in schizophrenia. Curr Med Res Opin. 2004; 20 189-197
-
17 Institute of Medicine .
Crossing the quality chasm: a new health system for the 21st century . Washington, DC: Institute of Medicine 2001 - 18 Karow A, Naber D. Subjective well-being and quality of life under atypical antipsychotic treatment. Psychopharmacology. 2002; 162 3-10
- 19 Karow A, Schnedler D, Naber D. What would the patient choose? Subjective comparison of atypical and typical neuroleptics. Pharmacopsychiatry. 2006; 39 47-51
- 20 Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13 261-276
- 21 Kemmler G, Holzner B, Neudorfer C, Meise U, Hinterhuber H. General life satisfaction and domain-specific quality of life in chronic schizophrenic patients. Qual Life Res. 1997; 6 265-273
- 22 Kluge M, Wehmeier PM, Dittmann RW, Langer F, Czekalla J, Lehmann M. et al . A simple switching strategy for inadequately treated patients with schizophrenia to olanzapine: changes in psychopathology and subjective well-being. Pharmacopsychiatry. 2005; 38 6-12
- 23 Larsen EB, Gerlach J. Subjective experience of treatment, side effects, mental state and quality of life in schizophrenic outpatients treated with depot neuroleptics. Acta Psychiatr Scand. 1996; 96 381-388
-
24 Lehrl S.
Manual zum MWT-B . Erlangen: Verlag Dr. med. D. Straube 1977 - 25 Leucht S, Pitschel-Walz G, Engel RR, Kissling W. Amisulpride, an unusual ‘atypical’ antipsychotic: a meta-analysis of randomized controlled trials. Am J Psychiatry. 2002; 159 180-190
- 26 Lindenmayer JP, Bernstein-Hyman R, Grochowski S. Five-factor model of schizophrenia. J Nerv Ment Dis. 1994; 182 631-638
- 27 Lindenmayer JP, Grochowski S, Hyman RB. Five factor model of schizophrenia: replication across samples. Schizophr Res. 1995; 14 229-234
- 28 Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K. The UKU Side Effect Rating Scale - a new comprehensive rating scale for psychotropic drugs and a cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand. 1987; 334 ((suppl)) 1-100
- 29 Marwaha S, Johnson S. Schizophrenia and employment. A review. Soc Psychiatry Psychiatr Epidemiol. 2004; 39 337-349
-
30 McGurk SR, Powchick P. The central cholinergic system and cognitive dysfunction in schizophrenia. In Sharma T, Harvey PD, editors
Cognition in Schizophrenia . New York NY: Oxford University Press 2000 p. 266-285 - 31 Meltzer HY, McGurk SR. The effects of clozapine, risperidone, and olanzapine on cognitive function in schizophrenia. Schizophr Bull. 1999; 25 233-255
-
32 Mueser KT. Cognitive functioning, social adjustment, and long-term outcome in schizophrenia. In: Sharma T, Harvey PD, editors.
Cognition in Schizophrenia . New York NY: Oxford University Press 2000: 15-177 - 33 Ochoa S, Haro JM, Autonell J, Pendas A, Teba F, Marquez M. et al . Met and unmet needs of schizophrenia patients in a Spanish sample. Schizophr Bull. 2003; 29 201-210
- 34 Olivier B. Serotonergic mechanisms in aggression. Novartis Found Symp. 2005; 268 171-183 , discussion 183-189, 242-253
- 35 Peuskens J, Möller HJ, Peuch A. Amisulpride improves depressive symptoms in acute exacerbations of schizophrenia: comparison with haloperidol and risperidone. Eur Neuropsychopharmacology. 2002; 12 305-310
-
36 Priebe S, Heinze M, Jäckel A.
Berliner Bedürfnis Inventar (BeBI) . FU Berlin: Abteilung für Sozialpsychiatrie 1993 - 37 Rettenbacher MA. Disturbances of glucose and lipid metabolism during treatment with new generation antipsychotics. Curr Opin Psychiatry. 2005; 18 175-179
- 38 Rettenbacher MA, Eder-Ischia U, Bader A, Edlinger M, Hofer A, Hummer M. et al . QTc variability in schizophrenia patients treated with antipsychotics and healthy controls. J Clin Psychopharmacol. 2005; 25 206-210
- 39 Saleem P, Olie JP, Loo H. Social functioning and quality of life in the schizophrenic patient: advantes of amisulpride. Int Clin Psychopharmacol. 2002; 17 1-8
- 40 Sartorius N, Fleischhacker WW, Gjerris U, Kern U, Knapp M, Leonard BE. et al . The usefulness and use of second generation antipsychotic medications - an update. Curr Opin Psychiatry. 2003; 16 ((suppl 1)) 1-44
- 41 Schoemaker H, Claustre Y, Fage D, Rouquier L, Chergui K, Curet O. et al . Neurochemical characteristics of amisulpride, an atypical dopamine D2/D3 receptor antagonist with both presenaptic and limbic selectivity. J Pharmacol Exp Ther. 1997; 280 83-97
-
42 Slade M, Loftus L, Phelan M, Thornicroft G, Wykes T.
CAN: The Camberwell Assessment of Need . Gaskell, London 1999 - 43 The WHOQOL Group . Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998; 28 551-558
- 44 Tollefson GD, Sanger TM, Lu Y, Thieme ME. Depressive signs and symptoms in schizophrenia: a prospective blinded trial of olanzapine and haloperidol. Arch Gen Psychiatry. 1998; 55 250-258
- 45 Van Oekelen D, Luyten WHML, Leysen JE. 5-HT2A and 5-HT2C receptors and their atypical regulation properties. Life Sci. 2003; 72 2429-2449
- 46 Wagner M, Quednow BB, Westheide J, Schlaepfer TE, Maier W, Kühn KU. Cognitive improvement in schizophrenic patients does not require a serotonergic mechanism: randomized controlled trial of olanzapine vs amisulpride. Neuropsychopharmacology. 2005; 30 381-390
- 47 Weiden PJ, Shaw E, Mann JJ. Causes of neuroleptic noncompliance. Psychiatr Ann. 1986; 16 571-575
- 48 Woodward ND, Purdon SE, Meltzer HY, Zald DH. A meta-analysis of neuropsychological change to clozapine, olanzapine, quetiapine, and risperidone in schizophrenia. Int J Neuropsychopharmacol. 2005; 8 457-472
-
49 Zimmermann P, Fimm B.
Testbatterie zur Aufmerksamkeitsprüfung (TAP), Version 1 . Herzogenrath: Vera Fimm/Psychologische Testsysteme 2002
Correspondence
A. Hofer
Department of Biological Psychiatry·Innsbruck Medical University
Anichstrasse 35
A-6020 Innsbruck
Austria
Telefon: +43/512/504 23 66 9
Fax: +43/512/504 25 26 7
eMail: a.hofer@i-med.ac.at