Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder

Jan Volavka, P. Czobor, Brian Sheitman, Jean Pierre Lindenmayer, Leslie Citrome, Joseph P. McEvoy, Thomas B. Cooper, Miranda Chakos, Jeffrey A. Lieberman

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367 Citations (Scopus)

Abstract

Objective: The authors compared the efficacy and safety of three atypical antipsychotics (clozapine, olanzapine, and risperidone) with one another and with haloperidol in the treatment of patients with chronic schizophrenia or schizoaffective disorder. Method: In a double-blind trial, 157 inpatients with a history of suboptimal treatment response were randomly assigned to treatment with clozapine, olanzapine, risperidone, or haloperidol for 14 weeks (an 8-week escalation and fixeddose period followed by a 6-week variable-dose period). Results: Clozapine, risperidone, and olanzapine (but not haloperidol) resulted in statistically significant improvements in total score on the Positive and Negative Syndrome Scale. Improvements seen in total and negative symptom scores with clozapine and olanzapine were superior to haloperidol. The atypical drugs, particularly olanzapine and clozapine, were associated with weight gain. Conclusions: The effects of atypical antipsychotics in this population were statistically significant but clinically modest. The overall pattern of results suggests that clozapine and olanzapine have similar general antipsychotic efficacy and that risperidone may be somewhat less effective. Clozapine was the most effective treatment for negative symptoms. However, the differences among treatments were small.

Original languageEnglish
Pages (from-to)255-262
Number of pages8
JournalAmerican Journal of Psychiatry
Volume159
Issue number2
DOIs
Publication statusPublished - 2002

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olanzapine
Risperidone
Clozapine
Haloperidol
Psychotic Disorders
Schizophrenia
Antipsychotic Agents
Therapeutics
Weight Gain
Inpatients

ASJC Scopus subject areas

  • Psychiatry and Mental health

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Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder. / Volavka, Jan; Czobor, P.; Sheitman, Brian; Lindenmayer, Jean Pierre; Citrome, Leslie; McEvoy, Joseph P.; Cooper, Thomas B.; Chakos, Miranda; Lieberman, Jeffrey A.

In: American Journal of Psychiatry, Vol. 159, No. 2, 2002, p. 255-262.

Research output: Contribution to journalArticle

Volavka, J, Czobor, P, Sheitman, B, Lindenmayer, JP, Citrome, L, McEvoy, JP, Cooper, TB, Chakos, M & Lieberman, JA 2002, 'Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder', American Journal of Psychiatry, vol. 159, no. 2, pp. 255-262. https://doi.org/10.1176/appi.ajp.159.2.255
Volavka, Jan ; Czobor, P. ; Sheitman, Brian ; Lindenmayer, Jean Pierre ; Citrome, Leslie ; McEvoy, Joseph P. ; Cooper, Thomas B. ; Chakos, Miranda ; Lieberman, Jeffrey A. / Clozapine, olanzapine, risperidone, and haloperidol in the treatment of patients with chronic schizophrenia and schizoaffective disorder. In: American Journal of Psychiatry. 2002 ; Vol. 159, No. 2. pp. 255-262.
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