Original article

Korean Journal of Schizophrenia Research 2009;12(1):42-48.

급성 초조상태의 정신증 환자에 대한 올란자핀 근육주사제의 효과연구

Dong-Wook Jeon, MD, Jun-Hyung Baek, MD, Sung-Wook Yoon, MD, Jung-Joon Moon, MD, Jung-Eun Kim, MD, Woo-Jin Kim, MD, Min-Hyo Kim, MD, Sang-Kyoeng Lee, MD, PhD, Young-Hoon Kim, MD, PhD, Joo-Cheol Shim, MD, PhD and Bo-Geum Kong, MD, PhD

Abstract

Introduction: Acutely agitated patients present with intense symptoms and potentially violent behavior that may place them at great risk. Recently several studies reported that intramuscular (IM) olanzapine has shown to be an effective for treating them. In this study, we compared the effect of IM olanzapine with IM haloperidol or IM haloperidol plus lorazepam on acute agitation.
Methods:In a 2-hour, randomize and open labeled study, hospitalized patients with acute psychotic symptom in association with psychotic disorders and bipolar disorder defined by DSM-IV TR were randomly assigned to one of three groups；1) olanzapine 10 mg IM (n=15), 2) haloperidol 5 mg IM (n=15), 3) haloperidol 5 mg+lorazepam 4 mg IM (n=15). Acute agitation was defined both two criteria: 1) >14 scores in sum of, 2) >4 scores in any item of PANSS-excitement component (PANSS-EC). The PANSS-EC (excitement component), Clinical Global Impression-Severity, behavioral activity rating scale were assessed at baseline, 30, 60 and 120 minutes after first injection.
Results:No significant differences in baseline demographics and clinical characteristics were found among three groups. Although all three groups showed significantly decrement of PANSS-EC scores at 2 hours compared to baseline (time effect) (p<0.0001). However, no significant difference in PANSS-EC scores was found among groups. No serious adverse event was found in all three groups.
Conclusion:Olanzapine IM was effective in treating acutely agitated psychotic patients without serious treatment-emergent adverse events. However, no significant advantage of olanzapine IM was found over haloperidol IM alone or haloperidol+lorazepam IM. (Korean J Schizophr Res 2009;12:42-48)

Key Words: Acute agitation,Psychosis,Intramuscular antipsychotics.