An observational study of the effectiveness and safety of intramuscular olanzapine in the treatment of acute agitation in patients with bipolar mania or schizophrenia/schizoaffective disorder

Hum Psychopharmacol. 2007 Oct;22(7):455-62. doi: 10.1002/hup.870.

Abstract

Objective: To determine the effect of intramuscular (IM) olanzapine in severely agitated patients.

Methods: This was an open-label multicenter 1-week observational study of IM olanzapine treatment in severely agitated inpatients and psychiatric emergency services with bipolar mania (n = 22) or schizophrenia (n = 52). Mean change from baseline to 2 h post-first injection (LOCF) in agitation was assessed by PANSS-Excited Component (PANSS-EC) (score range: 5-35 points) mean change from baseline to 15, 30, 45, 60, 90, and 120 min post-first injection, and visit-wise mean changes from mixed-model repeated measures analysis of variance. Kaplan-Meier survival curve analyses estimated time to categorical response (rating of <or=3 points each PANSS-EC item).

Results: Two hours post-injection of olanzapine (mean dose = 9.9 mg), patients exhibited mild calmness and agitation was significantly reduced by 19.2 +/- 1.0 points (p < 0.001) (mean baseline = 29.0). Over 90% of the patients received only one injection in the first 24 h and 50% had a categorical response within 30 min.

Conclusions: Severely agitated patients responded rapidly after a single injection of olanzapine with mild levels of sedation and without serious treatment-emergent adverse events.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use*
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / physiopathology
  • Female
  • Humans
  • Injections, Intramuscular
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Olanzapine
  • Psychiatric Status Rating Scales
  • Psychomotor Agitation / drug therapy*
  • Psychomotor Agitation / etiology
  • Schizophrenia / drug therapy*
  • Schizophrenia / physiopathology
  • Schizophrenic Psychology

Substances

  • Antipsychotic Agents
  • Benzodiazepines
  • Olanzapine