Open-label, prospective trial of olanzapine in adolescents with subaverage intelligence and disruptive behavioral disorders.

Full Abstract

OBJECTIVE:
Olanzapine, an atypical antipsychotic, has been shown to be efficacious for treatment of psychotic and mood disorders in adults. This prospective, open-label study was conducted to examine the safety and usefulness of olanzapine in treating disruptive behavior disorders in adolescents with subaverage intelligence.

METHOD:
Sixteen adolescents (ages 13-17 years) with borderline to moderate mental retardation and disruptive behavior were enrolled in an 8-week olanzapine trial (5-20 mg/day). Dependent measures included the Aberrant Behavior Checklist, Conners Parent Rating Scale, Clinical Global Impressions, and two side effects scales.

RESULTS:
Statistically significant improvement (p <.002) was found on the Irritability and Hyperactivity subscales of the Aberrant Behavior Checklist and the Conners Parent Rating Scale Hyperactivity Index. No subjects developed extrapyramidal side effects. However, four were terminated prematurely from the trial because of either worsening of symptoms (requiring psychiatric inpatient hospitalization in two subjects) or side effects. The most common side effect for the sample was weight gain (averaging 12.7 lb), with 67% of subjects gaining > or =10 lb. Although there was also a statistically significant increase in prolactin levels, no subjects reported prolactin-related side effects (e.g., gynecomastia, galactorhea, amenorrhea).

CONCLUSION:
Olanzapine may be useful in treating disruptive behavior in adolescents with subaverage intelligence. However, side effects, especially weight gain, are a significant issue. Future double-blind, placebo-controlled studies need to confirm these findings and assess long-term safety and outcome of olanzapine treatment.

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Author information

Author/s: Handen, Benjamin L (BL); Hardan, Antonio Y (AY);

Affiliation: University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic, Pittsburgh, PA 15203, USA.

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of the American Academy of Child and Adolescent Psychiatry (J Am Acad Child Adolesc Psychiatry), published in United States. (Language: eng)

Reference: 2006-Aug; vol 45 (issue 8) : pp 928-35

Dates: Created 2006/07/25; Completed 2006/09/08; Revised 2008/11/21;

PMID: 16865035, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Antipsychotic Agents - adverse effects; therapeutic use
Attention Deficit and Disruptive Behavior Disorders - drug therapy; epidemiology
Benzodiazepines - adverse effects; therapeutic use
Female

Associated Chemicals: Antipsychotic Agents (0) ; Benzodiazepines (12794-10-4) ; olanzapine (132539-06-1)

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