A Simple Switching Strategy for Inadequately Treated Patients with Schizophrenia to Olanzapine: Changes in Psychopathology and Subjective Well-being

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Abstract
Introduction: The aim of the study was to assess the feasibility of abruptly switching inadequately treated psychotic outpatients from another oral antipsychotic to olanzapine and to evaluate subjective well-being under olanzapine. Methods: Previous medication was switched to olanzapine 10 mg/day and continued for 4 weeks (5-20 mg/day). Successful switch was predefined as no change or any improvement on the Clinical Global Impression-Improvement (CGI-I) scale after one week. A successful switch rate of ≥ 70 % was considered a positive study outcome. Well-being was evaluated using the Subjective Well-being under Neuroleptics (SWN) scale. Results: 198 patients (100 %) were switched to olanzapine. In 177 patients (89 %), CGI-I was unchanged (29 %) or improved (60 %) after one week of olanzapine treatment, indicating a positive study outcome (p < 0.001). SWN total score significantly improved from 127.9 (± 32.5) at baseline to 139.2 (± 31.5) at week 1, continuing to 149.3 (± 30.3) at week 4 (LOCF). Discussion: The findings suggest that an abrupt switch from another antipsychotic to olanzapine 10 mg/day can be performed successfully in psychotic patients, while rapidly improving subjective well-being.

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