An observational study of the effectiveness and safety of intramuscular olanzapine in the treatment of acute agitation in patients with bipolar mania or schizophrenia/schizoaffective disorder

• Published in: Human psychopharmacology Vol. 22; no. 7; pp. 455 - 462
• Main Authors: Centorrino, Franca, Meyers, Adam L., Ahl, Jonna, Cincotta, Stephanie L., Zun, Leslie, Gulliver, Angela H., Kinon, Bruce J., Houston, John P.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-10-2007
• Subjects: acute agitation; Adolescent; Adult; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Benzodiazepines - adverse effects; Benzodiazepines - therapeutic use; Bipolar Disorder - drug therapy; Bipolar Disorder - physiopathology; bipolar mania; Female; Humans; IM olanzapine; Injections, Intramuscular; Kaplan-Meier Estimate; Male; Middle Aged; Psychiatric Status Rating Scales; Psychomotor Agitation - drug therapy; Psychomotor Agitation - etiology; schizoaffective disorder; schizophrenia; Schizophrenia - drug therapy; Schizophrenia - physiopathology; Schizophrenic Psychology
• ISSN: 0885-6222; 1099-1077
• DOI: 10.1002/hup.870

Objective
To determine the effect of intramuscular (IM) olanzapine in severely agitated patients.
Methods
This was an open‐label multicenter 1‐week observational study of IM olanzapine treatment in severely agitated inpatients and psychiatric emergency services with bipolar mania (n = 22) or schizophrenia (n = 52). Mean change from baseline to 2 h post‐first injection (LOCF) in agitation was assessed by PANSS‐Excited Component (PANSS‐EC) (score range: 5–35 points) mean change from baseline to 15, 30, 45, 60, 90, and 120 min post‐first injection, and visit‐wise mean changes from mixed‐model repeated measures analysis of variance. Kaplan–Meier survival curve analyses estimated time to categorical response (rating of ≤3 points each PANSS‐EC item).
Results
Two hours post‐injection of olanzapine (mean dose = 9.9 mg), patients exhibited mild calmness and agitation was significantly reduced by 19.2 ± 1.0 points (p < 0.001) (mean baseline = 29.0). Over 90% of the patients received only one injection in the first 24 h and 50% had a categorical response within 30 min.
Conclusions
Severely agitated patients responded rapidly after a single injection of olanzapine with mild levels of sedation and without serious treatment‐emergent adverse events. Copyright © 2007 John Wiley & Sons, Ltd.