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PubMed2002

Switching to olanzapine from previous antipsychotics: a regional collaborative multicenter trial assessing 2 switching techniques in Asia Pacific.

BACKGROUND: This open-label, multicenter, randomized study compared the efficacy and safety of switching moderately ill Asian patients with schizophrenia from their current regimen of antipsychotic medication to the atypical antipsychotic olanzapine using either a direct switch method or a start-taper switch method. METHOD: Asian inpatients and outpatients with DSM-IV schizophrenia (N = 108) currently treated with predominantly typical antipsychotics were switched to olanzapine (initial dose of 10 mg/day) for 6 weeks. Patients were randomly assigned to 1 of 2 groups: the direct switch group (N = 54) received only olanzapine, while the start-taper switch group (N = 54) received olanzapine and their usual antipsychotic in decreasing doses for the first 2 weeks. A successful switch was defined as completing 6 weeks of therapy without worsening of symptoms (Clinical Global Impressions-Severity of Illness scale [CGI-S]) or extrapyramidal side effects (Simpson-Angus Scale). Overall efficacy was assessed using the Positive and Negative Syndrome Scale (PANSS), and safety was assessed by recording adverse events and measuring vital signs. RESULTS: Statistically significant (p < .001) improvements from baseline to endpoint occurred in both switch groups in the CGI-S score and the PANSS total score and subscores. However, no significant differences were observed between the switch groups for any efficacy measure. Both techniques had comparable rates of successful switching (direct switch, 74.1% vs. start-taper switch, 67.9%). The frequency of treatment-emergent adverse events was similar between switch groups with no clinically significant differences in any laboratory value or vital sign. Weight gain occurred in both switch groups (p < .001), but the groups were not statistically different from each other. Both switch groups showed statistically significant (p < .01) improvements from baseline to endpoint on the Simpson-Angus Scale and Barnes Akathisia Scale. CONCLUSION: Moderately ill Asian patients with schizophrenia may experience a decrease in symptom severity and improvement in extrapyramidal symptoms when switched from their current medication to olanzapine therapy.

Adolescent↗
PubMedDate not supplied

PVO / NGO initiatives, Asia. Karmajibi Kallyan (KKS), Bangladesh and Save the Children Fund Australia (SCFA).

Karmajibi Kallyan (KKS) and Save the Children Fund Australia (SCFA) are implementing a program that integrates HIV/AIDS prevention and income generation activities aimed at the pre-adolescent girl servants of commercial sex workers in the Rajbari district of Bangladesh. The initial objectives of the program were to identify and establish alternative income generating activities for 150 girl servants; provide literacy education to these girls based on such topics as primary health care (HIV/AIDS prevention), credit, and small business management; and promote HIV/AIDS awareness in the wider community. Since implementation, the program has adjusted its objectives in order to meet the needs of the community. Many of the girls are much younger than the project originally planned for--most are only 7 or 8 years old--therefore, KKS and SCFA have begun identifying income generation possibilities for their mothers and encouraging the girls to focus on their education. They are also hoping to expand their literacy programs to other children in the community. For more information, please contact HIDNA (HIV/AIDS and International Development Network of Australia), ACFOA, Private Bag 3, Deakin ACT 2600, Australia; tel: +61 6 285 1816; fax: +61 6 285 1720; e-mail: acfoa@peg.apc.org. (ECHIDNA, Bulletin No. 5, September 1995)

Acquired Immunodeficiency Syndrome↗