Background: Olanzapine is an atypical antipsychotic with proven therapeutic effect, though it is rarely used in agitated patients. This study was to assess the effectiveness and safety of a 20-mg initial dose of olanzapine to control agitation of hospitalized patients with schizophrenia and schizoaffective and schizofreniform disorders.

Material/methods: A group of 95 patients aged 18-65 years was observed for 7 days. Effectiveness was assessed according to the CGI and PANSS (including the positive and negative symptoms and excitement subscale PANSS-EC) scales. Adverse events were also recorded.

Results: Two therapeutic groups were distinguished: patients treated with olanzapine alone (OLZ) and those whose condition necessitated at least one administration of benzodiazepines (OLZ + BZ). Although these groups differed with respect to baseline symptom severity, improvement was similar. In the OLZ group, improvement according to the CGI scale was observed after 2 h and persisted to the end of the study. In the OLZ + BZ group there was improvement after 1 h, but not after 2 h. Significant improvement reappeared after 6 h and persisted. Improvement measured by the PANSS-EC scale was noted in the OLZ group after 2 h and in the OLZ + BZ group after 6 h, persisting in both groups from the 12th hr to the end of the observation.

Conclusions: Olanzapine is an antipsychotic which, used alone or in combination with benzodiazepines, is effective and well tolerated in treatment of agitation in schizophrenic patients. Further studies are warranted.

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