Published in:
01-09-2000 | Clinical Use
A Retrospective, Naturalistic Review Comparing Clinical Outcomes of In-Hospital Treatment with Risperidone and Olanzapine
Published in: Clinical Drug Investigation | Issue 3/2000
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Objective: To compare the time to first response and discharge, relapse rates and drug acquisition costs for risperidone and olanzapine within a hospital setting.
Design, Setting and Patients: Charts were reviewed for all patients with schizophrenia and schizoaffective disorder admitted to the acute psychiatry units of the Alberta Hospital Edmonton site over a 12-month period. Patients started therapy with and were discharged on either risperidone or olanzapine. Those individuals with a previous failure on an atypical antipsychotic, enrolled for clozapine treatment, or taking multiple antipsychotics were excluded. The time to initial response and discharge, antipsychotic dose at initial response and discharge, and 6- and 12-month readmission rates were recorded.
Results: Patient characteristics, number of previous admissions and time since diagnosis were similar between groups and did not correlate well with any outcomes. Patients receiving risperidone (n = 35) had a significantly shorter time to initial response (14.3 vs 30.9 days, p < 0.00001) as well as to discharge (36.6 vs 58.2 days, p = 0.0201) compared with the olanzapine group (n = 21). Daily doses at these points generated costs for olanzapine that were two to three times those of risperidone (year of costing 1997). Furthermore, the olanzapine group showed almost double the risperidone readmission rate at 12 months (61.9 vs 31.4%, p = 0.026).
Conclusions: Within this cohort of acutely psychotic patients, risperidone seemed to exhibit some significant clinical advantages over olanzapine, and may be a more cost-effective option.