M. Snaterse et R. Welch, A retrospective, naturalistic review comparing clinical outcomes of in-hospital treatment with risperidone and olanzapine, CLIN DRUG I, 20(3), 2000, pp. 159-164
Objective: To compare the time to first response and discharge, relapse rat
es and drug acquisition costs for risperidone and olanzapine within a hospi
tal setting.
Design, Setting and Patients: Charts were reviewed for all patients with sc
hizophrenia and schizoaffective disorder admitted to the acute psychiatry u
nits of the Alberta Hospital Edmonton site over a 12-month period. Patients
started therapy with and were discharged on either risperidone or olanzapi
ne. Those individuals with a previous failure on an atypical antipsychotic,
enrolled for clozapine treatment, or taking multiple antipsychotics were e
xcluded. The time to initial response and discharge, antipsychotic dose at
initial response and discharge, and 6- and 12-month readmission rates were
recorded.
Results: Patient characteristics, number of previous admissions and time si
nce diagnosis were similar between groups and did not correlate well with a
ny outcomes. Patients receiving risperidone (n = 35) had a significantly sh
orter time to initial response (14.3 vs 30.9 days, p < 0.00001) as well as
to discharge (36.6 vs 58.2 days, p = 0.0201) compared with the olanzapine g
roup (n = 21). Daily doses at these points generated costs for olanzapine t
hat were two to three times those of risperidone (year of costing 1997). Fu
rthermore, the olanzapine group showed almost double the risperidone readmi
ssion rate at 12 months (61.9 vs 31.4%, p = 0.026).
Conclusions: Within this cohort of acutely psychotic patients, risperidone
seemed to exhibit some significant clinical advantages over olanzapine, and
may be a more cost-effective option.