Six-month outcomes for patients who switched to olanzapine treatment

Objective: This study evaluated the outcomes of patients in a community men tal health center who switched from treatment with another antipsychotic to olanzapine treatment. It also sought to determine whether simultaneous acc ess to case management and psychosocial rehabilitation and olanzapine leads to enhanced functional improvement. Methods: Six-month outcomes for a cons ecutive series of 104 patients who switched from a conventional antipsychot ic medication to olanzapine were evaluated. Forty-nine patients in the same treatment program who continued to take conventional antipsychotics were a lso monitored as a reference group. Outcomes of the group receiving olanzap ine were compared with their own baseline status and with outcomes of the r eference group. Results: At six months, patients in the olanzapine group de monstrated significant improvement over baseline across multiple measures o f symptoms and psychosocial function. Compared with the reference group, th e olanzapine group was more symptomatic at baseline and demonstrated signif icantly greater improvement at follow-up on the Brief Psychiatric Rating Sc ale and all subscales; Mini Psychiatric Rating Scale negative symptom, diso rganization, anxiety, depression, and medication side effects items; and Cl inical Global improvement scale and Case Manager's Rating Scale-Plus illnes s factors. There was a trend toward superior improvement in psychosocial fu nctioning among patients in the olanzapine group that achieved significance when patients in acute relapse at baseline were excluded. Conclusions: Ola nzapine is effective in managing markedly to severely ill patients with psy chotic disorders in a community mental health center. Simultaneous treatmen t with olanzapine, case management, and psychosocial rehabilitation leads t o enhanced functional improvement among nonrelapsing patients.