C. Bellantuono, E. Spina - Vol. 8, March 2002, Issue 1
Testo Immagini Bibliografia Summary Indice
Il trattamento degli stati di agitazione
psicotica con olanzapina iniettabile. Aspetti farmacologici e clinici
The treatment of psychotic states with injectable olanzapine. Pharmacological
and clinical aspects
Introduction (Tab. I)
Olanzapine (OLZ) is a new antipsychotic (AP) drug carachterized by a receptor affinity profile close to the clozapine one. Differently from the other traditional AP it is more selective for both D2 mesolimbic and mesochortical receptors rather than for nigrostriatal ones and this selectivity well explains the low EPS induction after short and long term treatments with OLZ.
OLZ, used between 5 and 20 mg/day, demonstrated a good antipsychotic action over the variety of dimensions in schizophrenia and specifically on positive, primary negative and affective symptoms.
Methods
Preliminary studies show a potential role of OLZ even in the terapy of many psychotic conditions like maniac excitements, bipolar relapse prevention, behavioural disturbances relapse prevention in patient with Dementia.
The favourable safety profile pointed out a great handy and ease of use of OLZ even at high dosages as well as a low incidence of clinically relevant side effects. The most frequently reported side effect was weight gain.
Results (Fig.2)
Pharmacokinetic studies and controlled clinical trias documented that the new i.m. formulation of OLZ showed, at the reported dosages (from 10 mg to 30 mg over 24 hours), good efficacy (similar to the one measured with haloperidol) and tolerability (superior to the one evidentiated with haloperidol) in the treatment of patients needing control due to agitation and excited behaviour.
Conclusions
Due to a favourable profile of low potential interactions with other molecules, the i.m. formulation of OLZ can be safely administered even in association with other psychotropic drugs and more in general with other drugs.
The new i.m. Zyprexa formulation, that will be available on the market in the near future, will be the first available by i.m. route among atypical AP drugs in Italy. It represents a clinical advantage for psychiatrists and for those, as mental health operators, who daily must manage and face psychotic patients in emergency and/or in acute phase.