Baqar Raza.
Effectiveness of Olanzapine treatment of Schizophrenic patient in Pakistan.
Med Channel Jan ;12(1):75-81.

OBJECTIVE: The objective of this study was to determine the effectiveness of Olanzapine in treating symptoms of Schizophrenia in Pakistani patients. METHOD: Psychiatrist from all over the Pakistan were requested to enroll Schizophrenic patients for this open label, multi centered, prospective Observational Study. The duration of study was 6 months and there were 4 study assessment visits. The patients for this study were those investigator felt would more benefit from treatment with Olanzapine or a switch from their previous neuroleptic to Olanzapine. That includes patient with first episode psychosis, patient showing poor or partial response to current neuroleptic or suffering Clinical adverse drug reactions with their current neuroleptic. The patient enrolls during normal care out patient visits. They prescribed Olanzapine within the Titrate ranges of 5 to 20 mg per day. Investigators were free to titrate dose of the drug. The patient response to treatment was assessed on the brief psychiatric rating scales BPRS anchored version and clinical Global impresslon severity Scale. Adverse event documented and used as the primary parameter for safety. Vital sign particularly Blood Pressure, Pulse rate, weight checked at each visit also as additional safety parameter. RESULTS: A total of 243 patients were enrolled in this study. The mean age of the patient population was 31.25 +/- 11.2 years (mean +/- SD) the mean duration of illness was 6.05 +/- 5.6 years with 31% of patients suffering their first episode of schizophrenia. The patient population participating in this study were defined as mildly to markedly ill according to a baseline CGI severity scale of 5.04+/-0.89. The modal dose of Olanzapine during the study period was 10.0mg/day. Overall 61.7% (150/339; 95%CI 56%, 68%) of patients responded to Olanzapine treatment (BPRS drop of at least 40% from baseline to endpoint). There were significant drops in total BPRS and CGI-S scores after Visit 2 & 3 of Olanzapine treatment whereas further significant drops were observed at visit 4 at the end of the therapy (all p<0.0001). Similarly, CGI severity also fell significantly and gradually over the course of the eight weeks (all P values <0.0001). In total, 30 of the 243 patients (12.3%) failed to complete the study according to the study description. Heart rate decreased Significantly (-1.84 +/- 7.27 bpm, P=0.0001 using paired t test) and systolic blood pressure (-0.2 +/- 8.87 mmHg, P=0.761) did not decreased significantly over the study period. CONCLUSION: This Pakistan based open label, multi centered, prospective observational study confirm the effectiveness and safety of olanzipine 5-20mg/day in treating the schizophrenic patients in Pakistan.

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