Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the worldwide schizophrenia outpatients health outcomes (W-SOHO) study

BACKGROUND: With many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting. METHODS: W-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162) and vice versa (n=136). Clinical status was assessed at the visit when the first switch was made (i.e. before switching) and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH) overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization). RESULTS: 48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019). Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26), extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89) and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13). No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who switched to olanzapine (difference of 0.29 points, p=0.013). CONCLUSION: Our study showed that patients who switched from risperidone to olanzapine were likely to experience a more favorable treatment course than those who switched from olanzapine to risperidone. Given the nature of observational study design and small sample size, additional studies are warranted.

Compendium metaphysicae, juxta ductum & akribeian clarissimorum in hoc genere philosophorum concinnatum, & tam disputando quàm legendo studiosae juventuti propositum, in Regiâ Academiâ Aboënsi, ab Andrea Thuronio, phys. & log. prof. ordinario. Nunc primâ vice ad usum discentium in lucem prodiens

Dedikaatio: Petrus Brahe.

Förteckning öfver framlidne vice pastoren Fr. Mélarts efterlemnade boksamling, som kommer att genom offentlig auction försäljas i Helsingfors, uti november månad 1841

Imprimatur: F. L. Schauman.

1.° Tractatus pacis inter Ludovicum IX. Regem Francorum, et Henricum III. Regem Angliae : anno 1259. — 2.° Tractatus pacis inter Philippum III. Regem Francorum, et Edwardum I. Regem Angliae : anno 1279. — 3.° Tractatus pacis inter eosdem Reges : anno 1286. — 4.° Quarta et ultima pax facta inter Reges : anno 1303. translata de romancio in latinum, de verbo ad verbum. — 5.° Alia concordantia, seu compositio vel pax inter Reges : anno 1303. — 6.° Pronunciatio Bonifacii, Papae, super pacibus : anno pontificatus quarto. — 7.° De remediis Aquitanorum adversùs vexationem curiae Regis Franciae. — 8.° Copia arresti contra Arnaldum de Romynhano, dati anno 1312. — 9.° Variae litterae Philippi Pulchri et Ludovici X. de rebus Anglicis. — 10.° Bulla Clementis, Papae V. approbans donationem Motae et domorum de Pessaco, factam ecclesiae Burdegalensi à nobili viro Gaillardo de Guto, germano suo, anno primo pontificatus. — 11.° Traitté de paix conclu entre les Rois Philippe et Edouard ; sans date. — 12.° Lettres de Charles IV. Roy de France et de Navarre, touchant les excès commis au lieu de Saint-Sacerdos par le Senechal de Gascogne : l'an 1324. — 13.° Traitté entre la France et l'Angleterre : en la même année. — 14.° Judicium latum apud Oleronem, anno 1287. per D. Norwicensem Episcopum, contra D. Joannem de Greilliaco, dudum Senescallum Vasconiae. — 15.° Tractatus matrimonii inter Alienoram filiam Edwardi Regis Angliae, et Alphonsum filium majorem Petri Regis Aragonum. — 16.° Litterae Petri, Regis Aragonum, de matrimonio filii sui Alphonsi cum Alienora, filia primogenita Regis Edwardi. — 17.° Joannis XXII. bulla contra Michaëlem de Cesena, Ministrum generalem ordinis Minorum : VIII. idus Junii, pontificatus anno XII. — 18.° Edwardi, Regis Anglorum, constitutiones variae ad Aquitaniam spectantes et ad Angliam. — 19.° Traitté de paix entre les Rois de France et d'Angleterre, fait en l'an 1325. — 20.° Litterae Agennensium ad Carolum IV. Regem Franciae, pro Rege Angliae, nominatim de facto Sancti-Sacerdotis, scriptae anno 1324. — 21.° Tractatus matrimonii inter Alphonsum, Regem Castellae et Legionis, et Alienoram, filiam Edwardi Regis Angliae ; item alius inter Edwardum, Regis Angliae primogenitum, et Alienoram sororem Regis Castellae : anno 1325. — 22.° Instructions données par le Roy d'Angleterre à ses Ambassadeurs allans en Espagne pour le fait dudit mariage. — 23.° Abusiones quae exercentur in regno Angliae circa beneficia ecclesiastica ; et remedia sine quibus nunquam cessare creduntur. — 24.° Clementis V. bulla de saecularisatione monasterii de sancto Aemiliano, in dioecesi Burdigalensi ; data anno pontificatus quinto. — 25.° Litterae Edwardi II. Regis Angliae, de servanda pace facta cum Carolo IV. Rege Franciae. — 26.° Ejusdem litterae quibus Edmundum, Comitem Cantiae, fratrem suum, constituit Capitaneum in Ducatu Aquitaniae. — 27.° Lettres de Charles IV. Roy de France, contre le Roy d'Angleterre, qui refusoit de luy faire les foy et hommage pour la Duché d'Aquitaine : de l'année 1324. — 28.° Litterae ejusdem Caroli IV. Regis Francorum, de eadem re ; quibus Carolo, Comiti Valesiae, patruo suo, dat potestatem puniendi rebelles Aquitaniae ; datae anno 1324. — 29.° Litterae ejusdem de salvagardia Guillelmi Galteri, Clerici, datae anno 1323. — 30.° Ejusdem litterae pro Margareta de Guouda, tutrice Pontii domini de Castellione, filii sui, datae anno 1323. — 31.° Ejusdem litterae pro Comitissa Fuxi et Vicecomitissa Bearni et Marciani, tutrice Gastonis filii sui ; datae anno 1322. — 32.° Litterae Antonini Pessaigne, Senescalli Ducatus Aquitaniae, quibus Ostencium Jordani, Clericum ac Jurisperitum, constituit suum et Regis Angliae Procuratorem ; datae anno 1318. — 33.° Litterae Almarici domini de Credonio, Senescalli Ducatus Aquitaniae, quibus Roberto de la Vertadausa, Anglico, decem libras Turonensium parvorum singulis annis solvendas concedit vice et nomine Regis Angliae ; datae anno 1322. — 34.° Divers actes entre les Rois de France et d'Angleterre, pour assurer la paix ; faits depuis l'an 1259. jusques en 1323. — 35.° Acta processus habiti in curia Romana inter capitulum ecclesiae Coventrensis et capitulum ecclesiae Lichefeldiensis de electione Episcopi, tempore Joannis XXII. — 36.° Traitté d'alliance et de confederation entre la France et l'Ecosse contre l'Angleterre ; fait en 1325. — 37.° Articuli exhibiti à Procuratore ecclesiae Lichfeldensis. — 38.° Articuli exhibiti à Procuratore ecclesiae Coventrensis. — 39.° Joannis XXII. bulla de unione Episcopatuum Corkagiensis et Clonensis, data Avenione anno pontificatus XI. — 40.° Acta processus apud eumdem Papam agitati super praebenda sancti Stephani in ecclesia Beverlacensi.

Colbertinus