Systemic review: High dose olanzapine treatment for treatment resistant schizophrenia

Abstract

ObjectivesSchizophrenia is a major mental illness with a progressive course. Thirty percent of cases of patients with schizophrenia do not respond to adequate trials of at least 2 different groups of antipsychotics are currently classified as having treatment resistant schizophrenia (TRS). Clozapine remains the gold standard, treatment of choice for TRS. However, clozapine does not come without its own challenges. Its risk profile, particularly agranulocytosis, reported in 1% of cases, has led to the necessity of weekly blood counts within the first 18 weeks of treatment and subsequently every month with slow dose titration. Clinically, sedation, weight gain and hypersalivation may further hamper the compliance of patients. Non-compliance has been reported to cause rebound psychosis. Recent studies have raised questions as to which antipsychotic is most efficacious for TRS. Thus, we conducted a systematic review of high dose olanzapine treatment for people with TRS.MethodA systematic review of prospective studies found through search of PubMed, Scopus and hand-searched key papers which included randomized controlled trials and open-label studies which looked at high dose of olanzapine treatment response for TRS.ResultsThe study is currently ongoing and preliminary results will be presented at the conference in April 2017.ConclusionsThe gravity of burden TRS brings to patients extends itself to their families, carers and clinicians. Further evidence on which antipsychotic is more efficacious for patients with TRS would have huge implications in terms of health benefits for the patients, better informed clinical decisions and also health economics in general.Disclosure of interestThe authors have not supplied their declaration of competing interest.