Abstracts / Schizophrenia Research 102/13, Supplement 2 (2008) 1279

610 COMPARISON OF REMISSION RATES AND

TOLERABILITY IN PATIENTS WITH EARLY-EPISODE
SCHIZOPHRENIA RECEIVING ARIPIPRAZOLE OR
HALOPERIDOL
Sheila Assuno-Talbott 1 , David Crandall 1 , James M Eudicone 1 ,
Andrei Pikalov 2 , Robert D McQuade 3 , John M Kane 4
1 Bristol-Myers Squibb, Plainsboro, NJ; 2 Otsuka America
Pharmaceutical Inc., Rockville, MD; 3 Otsuka Pharmaceutical
Development & Commercialization Inc., Princeton, NJ; 4 The Zucker
Hillside Hospital, Department of Psychiatry, Glen Oaks, NY, USA
sheila.talbott@bms.com
Introduction: This analysis compared remission rates in patients
with early-diagnosed schizophrenia receiving either aripiprazole or
haloperidol.
Methods: Pooled data from two 52-week, randomized, double-blind,
multicenter trials of aripiprazole vs. haloperidol in acutely ill patients
with schizophrenia were analyzed. Symptomatic remission was calculated according to RSWG criteria in patients with early-episode
schizophrenia (patients mean = 40 years with mean duration of illness
= 60 months).
Results: Remission rates were signicantly higher for early-episode
patients treated with aripiprazole compared with haloperidol (38% vs.
22%; p=0.003). Aripiprazole-treated patients achieved remission in a
shorter time than haloperidol-treated patients; however, this difference
was not statistically signicant between the two groups (log rank
p=0.1, HR=1.4, 95% CI: 0.9- 2.1). All remitters received signicantly
lower global clinical ratings than non-remitters (p<0.0001 for both
treatments). Aripiprazole was associated with a signicantly lower rate
of discontinuations due to AEs than haloperidol (10.6% vs. 29.3%;
p<0.001) and lower concomitant medication use for EPS (26% vs.
60%; p<0.0001).
Conclusions: Acutely ill patients with early-episode schizophrenia
treated with aripiprazole demonstrated a signicantly higher rate of
symptomatic remission compared with haloperidol-treated patients
based on RSWG criteria. Aripiprazole was better tolerated, as shown
by its lower discontinuation rates due to AEs and lower use of
anticholinergics. Although more data are needed, this preliminary
post-hoc analysis shows the efcacy and tolerability of aripiprazole in
patients with early-episode schizophrenia.
Acknowledgements: Supported by Bristol-Myers Squibb and Otsuka.
References
[1] Lieberman JA et al. CNS Spectr 2007; 12(3 Suppl 4):113.
[2] Wyatt RJ. Biol Psychiatry 1995;38:13.

611 CONCOMITANT USE OF ANTICHOLINERGIC AGENTS

WITH ATYPICAL ANTIPSYCHOTICS IN SCHIZOPHRENIA
Won-Myong Bahk 1 , Young Sup Woo 1 , Ho-Jun Seo 1 ,
Bo-Hyun Yoon 2 , Jeong-Ho Chae 1
1 Department of Psychiatry, College of Medicine, The Catholic
University of Korea, Seoul; 2 Naju National Hospital, Naju, Korea
wmbahk@caholic.ac.kr
Introduction: Antipsychotic drugs induce extrapyramidal symptoms
such as dystonia, akathesia and parkinsonian symptoms early in
the treatment. With the advent of atypical antipsychotic drugs, the
incidence of extrapyramidal symptoms has decreased, but danger
still exists. Hence, in treatment of schizophrenia with antipsychotics,
anticholinergic agents are often indicated.
Methods: In this observational, retrospective study, we examined
whether the initiation of risperidone, olanzapine, or quetiapine, the
three most widely prescribed atypical antipsychotics, is related to the
concomitant use of anticholinergic agents. We identied patients with
schizophrenia from outpatient clinics in the St. Marys hospital and
dened initiation of risperidone, olanzapine, or quetiapine as patients
who initiated on the target drug after January 1 2004 and continuously
use the antipsychotics for 6 months. The data were analyzed using on
way ANOVA, Mann-Whitney U test or Fishers exact tests.

261

Results: The study yield two major ndings. First, compared with
risperidone initiators, there were signicantly fewer olanzapine initiators who used anticholinergic agent concomitantly. Secondly, there
were signicantly fewer olanzapine or quetiapine initiators than
risperidone initiators who prescribed anticholinergic agent on the
same day when antipsychotics were initiated.
Conclusions: As the use of anticholinergic agent is a proxy for
the presence of extrapyramidal symptom, these ndings suggest that
risperidone may be more associated with extrapyramidal symptoms
than olanzapine or quetiapine. Controlled studies comparing them to
one another should be of particular interest.
References
[1] Ren XS, Huang YH, Lee AF, Miller DR, Qian S, Kazis L. Adjunctive use of atypical antipsychotics and anticholinergic drugs
among patients with schizophrenia. J Clin Pharm Ther. 2005 Feb;
30(1):65-71.

612 THE EFFECT OF HEPATOPROTECTORS ON

INCREASED SERUM TRANSAMINASE INDUCED BY
ATYPICAL ANTIPSYCHOTICS
Won-Myong Bahk 1 , Young Sup Woo 1 , Ho-Jun Seo 1 ,
Bo-Hyun Yoon 2 , Jeong-Ho Chae 1
1 Department of Psychiatry, College of Medicine, The Catholic
University of Korea, Seoul; 2 Naju National Hospital, Naju, Korea
wmbahk@caholic.ac.kr
Introduction: Atypical antipsychotics are reported to induce serum
transaminase increase frequently in Korea, although most cases are
benign. Thus, some hepatoprotectors are commonly prescribed to
manage rapid transaminase increase in patients with schizophrenia.
We performed a retrospective chart review to investigate the effect
of two hepatoprotectors [a biphenyldimethyldicarboxylate+garlic oil
combination (BDD) and a silymarin+silybin combination (SMR)] on
transaminase (AST/ALT) increase induced by atypical antipsychotics.
Methods: The records of 53 schizophrenic patients who experience
serum AST/ALT increase after treatment with atypical antipsychotics
were reviewed. We obtain the level of serum AST/ALT at the time
of hepatoprotectors administration, 1 week, 2 weeks, 3 weeks, and 4
weeks after administration.
Results: Among all patients, 36 patients were treated with BDD and
17 patients were treated with SMR. After administration of hepatoprotectors, both serum AST and ALT level were signicantly reduced
after 4 weeks. Further, both AST and ALT levels were signicantly
reduced in only one week. BDD was superior to SMR in number of
patients whose ALT level was reduced below in-house, upper limitation after 4 weeks. However, there was no difference between BDD
and SMR in aspect to AST level.
Conclusions: Both hepatoprotectors, BDD and SMR, were effective
in reducing serum AST/ALT level increased by atypical antipsychotics, especially within only one week. Increased liver enzymes
were normalized in most patients within 4 weeks. BDD was superior
to SMR in normalizing serum ALT level.
References
[1] Dumortier G, Cabaret W, Stamatiadis L, Saba G, Benadhira R,
Rocamora JF, et al. Hepatic tolerance of atypical antipsychotic
drugs. Encephale 2002;28:542-551.

613 COMBINED CLOZAPINE AND ELECTROCONVULSIVE

THERAPY IN CLOZAPINE-RESISTANTSCHIZOPHRENIA:
IMPACT ON CLINICAL AND COGNITIVE OUTCOME

Falko Biedermann 1 , Nicole Pfaffenberger 2 , Georg Kemmler 2 ,

W.Wolfgang Fleischhacker 2 , Alex Hofer 2
1 Medical University for Psychiatry of Innsbruck, Innsbruck;
2 Medical University, Innsbruck, Austria
Falko.Biedermann@uki.at
Introduction: Clozapine (CLZ) has been shown to have unique ef-