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Olanzapine Appears More Effective Than Risperidone for Long-Term Negative Social Functioning Symptoms in Schizophrenia Patients: Presented at APA

By Bruce Sylvester

NEW YORK, NY -- May 6, 2004 -- Olanzapine (Zyprexa) is significantly more effective than is risperidone in the treatment of negative symptoms of social functioning in long-term schizophrenia, say researchers.

Results of a 1-year, multicenter, randomized, open-label study were presented in 2 different poster presentations this week at the American Psychiatric Association Annual Meeting. One presentation focused on the negative, positive, and overall symptomatology and safety of olanzapine and risperidone, and the second focused on social functioning.

"This new data is important because schizophrenia patients have a very challenging time in ordinary social activities such as personal relationships and securing and maintaining employment," said lead investigator José M. Olivares, MD, psychiatrist and clinical researcher at the Complejo Hospitalario Universitario Xeral-Cíes in Vigo, Spain. "And failure in social functioning can lead to failure in compliance, which is essentially threatening to successful treatment."

Negative symptoms, such as apathy, low levels of initiative, and absence of emotional expression, are causes of low social function in most people with schizophrenia. Poorly motivated patients do not function adequately at school or work. Personal relationships often deteriorate because of unresponsiveness and inattentiveness to social cues.

One hundred and twenty outpatients were randomized to Zyprexa and 115 received risperidone.

At the study end, the olanzapine cohort achieved a significantly higher response rate (69.2%) than did the risperidone group (48.7%), with response defined as a 30% improvement in global score on the Scale for the Assessment of Negative Symptoms (SANS).

Treatment-emergent extrapyramidal symptoms (muscle stiffness, tremors or rigidity), or worsening of the previous symptoms, appeared in 28.9% of olanzapine subjects compared to 50.4% of the risperidone subjects.

Only 1.6% of the olanzapine subjects reported sexual dysfunction compared to 7.3% of risperidone subjects.

The investigators reported significantly greater improved overall social functioning for subjects who were taking olanzapine compared to those taking risperidone. Social functioning improvements were determined by the total score and individual behavioral category scores on the Social Functioning Scale (SFS). Mean improvement in SFS total scores was 7.75 in the olanzapine group and -0.92 in the risperidone group.

Olanzapine treatment also achieved higher numerical improvements than did risperidone in all SFS categories, reaching statistically significant differences in social engagement or withdrawal, independence (performance), independence (competence), recreation activities, and employment.

Finally, the researchers reported that the greatest difference between the olanzapine and risperidone groups was in changes from baseline in the occupation/employment category (0.86 vs -3.06).

Olanzapine (Zyprexa) is FDA-approved for the short-term and long-term treatment of schizophrenia, for maintenance in the treatment of bipolar disorder, and either alone or in combination with lithium or valproate for the short-term treatment of acute mixed or manic episodes associated with bipolar disorder. In March of 2004, Zyprexa IntraMuscular (olanzapine for injection) was approved by the FDA for the control of acute agitation associated with schizophrenia and bipolar mania.

The research was supported by Eli Lilly and Company.


[Presentation title: "Olanzapine versus risperidone: one-year results in social functioning in schizophrenia." Abstract #NR384]

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