OLANZAPINE COMPARED WITH CHLORPROMAZINE IN TREATMENT-RESISTANT SCHIZOPHRENIA

Objective: The purpose of this study was to compare the efficacy of ol anzapine with that of chlorpromazine plus benztropine in patients with treatment-resistant schizophrenia. Method: One hundred three previous ly treatment-resistant patients with schizophrenia diagnosed according to the DSM-III-R criteria were given a prospective 6-week trial of 10 -40 mg/day of haloperidol. Eighty-four of them failed to respond to th at trial and agreed to be randomly assigned to nit 8-week fixed-nose t rial of either 25 mg/day of olanzapine alone ol 1200 mg/day of chlorpr omazine plus 4 mg/day of benztropine mesylate. Results: Fifty-nine (70 %) of the 84 subjects completed the trial. The primary outcome measure s were Brief Psychiatric Rating Scale total score and positive symptom score, Scale for the Assessment of Negative Symptoms global score, an d Clinical Global Impression score. An analysis of variance for the su bjects who completed the study showed no difference in efficacy betwee n the two drugs. Seven percent of the olanzapine-treated patients resp onded according to a priori criteria; no chlorpromazine-treated patien ts responded. The olanzapine-treated patients had fewer motor and card iovascular side effects than the chlorpromazine-treated patients. Extr apyramidal symptoms and akathisia were similar in the two groups, alth ough no antiparkinsonian drugs were wed in the olanzapine group. Concl usions: Olanzapine and chlorpromazine showed similar efficacy, and the total amount of improvement with either drug was modest. Olanzapine-t reated patients had fewer side effects than chlorpromazine-treated pat ients.