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Dropout rates with olanzapine or risperidone: a multi-centre observational study

  • Pharmacoepidemiology and Prescription
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European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

In patients with schizophrenia, risperidone and olanzapine are the two most commonly used atypical anti-psychotics. A recent meta-analysis based on randomized trials suggests that, in the long term, olanzapine can have a lower frequency of treatment discontinuation (or dropout) in comparison with risperidone. To better test this hypothesis, our observational study was aimed at assessing whether or not this advantage of olanzapine versus risperidone could be confirmed in a patient series examined in an observational setting.

Methods

Our study was based on a retrospective multi-centre observational design. We collected the following information from each patient: demographic characteristics; current anti-psychotic treatment (olanzapine or risperidone, under the condition of a stable therapy over months −1 to −4); cumulative dose of the drug; previous anti-psychotic treatment (during months −5, −6, −7 and/or, when available, also before month −7); daily dose and treatment duration. Our primary analysis traced back the patient’s history from the date of enrollment retrospectively up to month −7. The secondary analysis followed-up the patient’s history prior to month −7, thus extending this retrospective recording as long as possible (depending on what information was actually available for individual patients).

Results

The patients were enrolled from 31 institutions. In our primary analysis (months −1 to −7), a total of 144 patients were included; in this subgroup treated with olanzapine or risperidone as initial drug (n=94), we observed 4 of 54 switches from olanzapine to risperidone and 11 of 40 switches from risperidone to olanzapine (P=0.01). A total of 454 patients were enrolled in our secondary analysis (from month −1 up to month −73); the same comparison showed 9 of 236 switches from olanzapine to risperidone and 17 of 150 switches from risperidone to olanzapine (P=0.004).

Conclusion

Our analysis confirms the results of a recent meta-analysis and shows that olanzapine might imply a lower risk of dropout than risperidone.

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Authors and Affiliations

  1. Laboratorio SIFO di Farmacoeconomia, Drug Information Centre, Azienda Ospedaliera Careggi, viale Morgagni 85, 50134 , Florence, Italy

    F. Pelagotti, B. Santarlasci, F. Vacca, S. Trippoli & A. Messori

Authors
  1. F. Pelagotti
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  2. B. Santarlasci
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  3. F. Vacca
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  4. S. Trippoli
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  5. A. Messori
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Corresponding author

Correspondence to A. Messori.

APPENDIX A

APPENDIX A

The coordinators of the study: A Messori, F Pelagotti, B Santarlasci, M Vaiani, S Trippoli, F Vacca, Laboratorio SIFO di Farmacoeconomia, (c/o Azienda Ospedaliera Careggi, Firenze) and the following participants (all located in Italy): Alessandro Bernardini, Niccolini Patrizia, Enrica Bonadeo (Alessandria); Silvia Martinetti, Valeria Recanelga, Guglielmo Occhionero, Giuseppe Bonavolntà, Claudio Cardona (Asti); Italo Santin, Francesco Coppa (Belluno); Daniela Corsini, Boncompagni (Bologna); Marilisa Sebastiani, Angelo Malinconico, Nicola D’Erminio (Campobasso); Teresa Galdieri, Emilio Isu, Enrico Perra, (Cagliari); Vincenzo Inzirillo, Carmelo Florio (Catania); Valeria Scilla, Raffaele Di Lorenzo (Catanzaro); Vittorio Battaglia, Maria Avantaneo, Cecilia Dal cielo, Impallomeni (Cuneo); Piro Brunella, Liguori Giorgio, Giampiero Dramisio, Gina Volpintesta, Nella Felice, Carmela Altomare, Carmela Oriolo, Buccomico Domenico, Francesco Trotta, Giuseppina De Stefano, Nicotera Mario (Cosenza); Giuseppe Taurino, Cristina Martinelli, Stefania Bigini, Fabrizio Lazzerini (Massa Carrara); Erminia Taormina, Parisi (Enna); Roberta Barbaro, G. Raponi, Gastoni (Foligno-Pg); Chiara Cherubini, Ilo Rossi (Ravenna); Barbara Fazzi, Enrico Marchi (Lucca); Rocco Iacovino, Angela Montesano (Matera); Mariangela Dairaghi, Elio Zino (Novara); Giovanni Bologna, Paolo Cironi (Piacenza); Marina Pitton, Calogero Anzallo (Pordenone); Domenica Costantino, Antonio Numera (Reggio Calabria); Giusy Calì, Antonuccio Orazio, Giuseppina Muccio, Gaetano Bozzanca, Luisa Ballerini, Lucia Insiriello, Giuseppe Augello, Antonio Cappellani, Salvina Schiavone (Siracusa); Franco Molter, Renzo De stefani, C. Agostini (Trento); Giuliana Dossi, Puccio Giuseppe (Verbania); Mariella Conti (Viterbo).

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Pelagotti, F., Santarlasci, B., Vacca, F. et al. Dropout rates with olanzapine or risperidone: a multi-centre observational study. Eur J Clin Pharmacol 59, 905–909 (2004). https://doi.org/10.1007/s00228-003-0705-0

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  • DOI: https://doi.org/10.1007/s00228-003-0705-0

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