Rabbit syndrome treated with olanzapine

Clinical Practice and Epidemiology in Mental Health, 2007

Background: Rabbit syndrome is a movement disorder that is associated with long-term exposure to neuroleptic medications. Of particular interest and importance is the risk of rabbit syndrome with exposure to the newer atypical antipsychotics. Our recent experience with such a case brought to light the importance of exploring this risk.

Mental Illness, 2009

Rabbit syndrome (RS) is an antipsychoticinduced rhythmic motion of the mouth/lips resembling the chewing movements of a rabbit. The movement consists of a vertical-only motion, at about 5 Hz, with no involvement of the tongue. Long-term exposure to typical antipsychotics has clearly been associated with RS, but little is known of the risk of RS due to exposure to newer atypical antipsychotics. There have been isolated reports of RS in patients treated with the atypical agents risperidone, aripiprazole, olanzapine, and clozapine. We present the case history of a 44year old female patient treated for paranoid schizophrenia for 22 years and RS during her last 10-month clozapine treatment. Background information from the literature is also discussed.

East African Medical Journal, 2009

Background: Whereas the Fiji government provides all aspects of mental health care services free of charge to its citizens, many schizophrenics have failed to respond to classical antipsychotic drugs. Objective: To assess the efficacy and safety of olanzapine among various patients with severe psychiatric disorders. Setting: Naturalistic setting. Design: Descriptive study. Measurements: Outcome was based on reduction of symptoms on the PANSS (≥ 40%) and CGI shift to 1-3. Subjects: The were 64 patients (30 males) aged 17-77 years. Thirty six (56.3%) had schizophrenia, eight mania, ten severe depression, four obsessive compulsive disorder (OCD), one each had schizo-affective and delusional disorders, while the remaining had chronic brain diseases. Results: At weeks 3, 8,12, the proportion of subjects with 40% improvement was 60.6%, 79.9%, and 76.8%, respectively. Positive and negative symptoms improved. Thirteen (48.1%) of the 27 long-stay treatment-resistant schizophrenics achieved clinical recovery at eight weeks. All with primary diagnosis of severe depression and mania achieved full clinical recovery (mostly within two weeks). Two OCD cases achieved clinical recovery at week eight. Conclusion: Olanzapine was safe for all categories of patients. There was not a single case of extrapyramidal reaction among subjects who did not have it pre-treatment; and the drug was safe in a suicidal overdose of 205mg. Most patients experienced weight gain; two adolescent girls had temporary amenorrhoea and one subject had transient rise in liver transaminases which normalised without discountinuing the drug.

Psychiatry and Clinical Neurosciences, 2008

Aims: It clarifies a difference between early acute phase and late acute phase in medication.

Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2004

Background: Tardive dyskinesia (TD) is a potentially persistent and disabling abnormal involuntary movement disorder. The aim of this 8-month study was to determine if olanzapine treatment could lead to a significant and persistent reduction in preexisting TD. Methods: Eligible schizophrenia patients met restricted Research Diagnosis criteria of TD requiring, in part, a rating of at least moderate severity (score z 3) in one or more of seven body regions on the Abnormal Involuntary Movement Scale (AIMS). Patients received olanzapine, 5 -20 mg/day, for 8 months. During this period, they underwent one to two dose reduction periods under blinded conditions. Concurrent changes in TD, psychopathology, parkinsonism and akathisia were assessed with the AIMS, the Positive and Negative Syndrome Scale (PANSS), and the Simpson-Angus and Barnes Akathisia Scales, respectively. Results: A significant reduction in mean AIMS total score was demonstrated at endpoint (n = 92; p < 0.001) as well as at each visit ( p < 0.001) and as early as Week 1 on olanzapine. Approximately 70% of patients no longer met the restricted Research Diagnostic criteria for persistent TD (RD-TD) after 8 months of treatment. No statistically significant rebound worsening of TD was found during either blinded drug reduction period. Significant improvement in psychopathology ( p = 0.001) and parkinsonism ( p < 0.001) was observed. Conclusions: Improvement in the severity of preexisting TD was achieved with olanzapine and persisted throughout the 8-month study and during each dose reduction period. Overall improvement in clinical status suggests that olanzapine may be effective for the long-term management of schizophrenia patients with preexisting TD. Published by Elsevier Inc.

Psychopharmacology, 1996

Olanzapine is a potential new "atypical" antipsychotic agent. This double-blind, acute phase study compared two doses of olanzapine [1 mg/day (Olzl.0); 10 mg/day (Olzl0.0)] with placebo in the treatment of 152 patients who met the DSM-III-R criteria for schizophrenia and had a Brief Psychiatric Rating Scale (BPRS)-total score (items scored 0-6) _>24. In overall symptomatology improvement [BPRS-total score and Positive and Negative Syndrome Scale (PANSS)-total score], Olzl0.0 was statistically significantly superior to placebo. In positive symptom improvement (PANSSpositive score, BPRS-positive score), Olzl0.0 was statistically significantly superior to placebo. In negative symptom improvement (PANSS-negative score), Olzl0.0 was statistically superior to placebo. Olz 1.0 was clinically comparable to placebo in all efficacy comparisons. The only adverse event to show an overall statistically significant incidence difference was anorexia (reported for 10% of placebo-treated and 0% of Olzl0.0-treated patients). The Olzl0.0-treated patients improved over baseline with respect to parkinsonian and akathisia syrup-This study was funded by Eli toms, and these changes were comparable with those observed with placebo. There were no dystonias associated with Olzl0.0 treatment. At endpoint, the incidence of patients with elevated prolactin values did not differ statistically significantly between placebo-treated and Olzl0.0-treated patients. Olanzapine appears to be not only safe and effective, but a promising atypical antipsychotic candidate.

Bulletin of Clinical Psychopharmacology, 2012

Schizophrenia Research, 1998

As many as half of all schizophrenic patients have abused alcohol or illicit drugs. This study determines the extent of substance abuse in a treatment-resistant population and assesses the response of this population to olanzapine treatment. Sixty patients with a DSM-III-R diagnosis of schizophrenia were included in an open 7-week trial of up to 25 mg/day of olanzapine. A history of substance abuse was present in 23 (38%) of the patients. At baseline evaluation, patients with a history of substance abuse had lower CGI scores and less negative symptomatology while having a higher rate of tardive dyskinesia. The overall group improved significantly over time. There were no differences in response between the substance-abusing (SA) and non-substance-abusing (NSA) patients as measured by the total BPRS, GGI and SANS ratings. The NSA group had significantly greater improvement in negative symptoms as measured by the BPRS negative symptom factor. Sixty-nine per cent (16/23) of the SA group and 60% (22/37) of the NSA were considered olanzapine responders by a priori criteria (p=NS). Extrapyramidal symptoms declined significantly in the overall group, but did not significantly differ between the SA and NSA groups. Treatmentrefractory patients with prior substance abuse had a comparable outcome on olanzapine therapy to those with no history of abuse, as well as no increase in adverse effects. This suggests that olanzapine may be of benefit to SA patients who have a greater tendency for antipsychotic side effects and tardive dyskinesia.

Sommario. La progettazione ecocompatibile di un impianto elettrico mira ad integrare gli aspetti ambientali ecologici, elettrici e di utilizzazione: caratteristiche naturali elettriche, sicurezza, inquinamento, emissione di rumore, economia di energia e di costi, competitività commerciale. L'ecoprogettazione consiste in un progetto globale e permanente per il conseguimento delle prestazioni ottimali durante il ciclo di vita per una utilizzazione intelligente e possibilmente razionale con il risparmio energetico e per la sicurezza delle persone. La configurazione dell'impianto, la sua esecuzione, gestione e manutenzione devono costituire le fasi di un'unica e coordinata strategia progettuale nella vita dell'impianto. La ecoprogettazione degli impianti elettrici negli edifici può avviare un processo di evoluzione dello status quo normativo e tecno-logico superando la corrente convinzione che l'innovazione metodologica e di qualità nel settore sia giunta alla completa saturazione.