A retrospective, naturalistic review comparing clinical outcomes of in-hospital treatment with risperidone and olanzapine

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.