Olanzapine in Chinese treatment-resistant patients with schizophrenia: an open-label, prospective trial

The role of olanzapine in treatment-resistant schizophrenia has still not been clearly resolved. In addressing this issue, the current report presents an open-label, prospective, 13 week trial with olanzapine use in Chinese schizophrenic patients who were resistant to more than two different classes of antipsychotics during a minimal 4 week treatment period for each antipsychotic drug at adequate dosage. Fifty-one inpatients were recruited after a cross-titration period and given 10-25 mg of olanzapine daily, without any concomitant antipsychotic medication. Patients were evaluated with the Brief Psychotic Rating Scale (BPRS), the Positive and Negative Symptoms Scale, the Clinical Global Impression Scale (CGI), the Abnormal Involuntary Movement Scale, the Simpson-Angus scale, and the Barnes Akathisia Scale. The olanzapine-treated patients showed significant improvement in both the positive and negative symptoms of schizophrenia by the end of the study. Overall, 20 of 51 (39.2%) responded to 10-25 mg of olanzapine per day as measured by the BPRS and CGI scores. Five patients dropped out due to the worsening of their psychotic symptoms, two patients discontinued owing to poor drug compliance, and the remaining patient complained of a lack of efficacy. Extrapyramidal side-effects were mild, and anticholinergic medications required has decreased. The present open study suggests that olanzapine may be effective and well-tolerated in Chinese treatment-resistant schizophrenic patients. Further double-blinded trials are needed to confirm this result.