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.