Does Olanzapine Delay Psychosis?
Recognition that the first schizophrenia diagnosis is often preceded by prodromal symptoms has led to efforts to prevent the full-blown illness. The Prevention Through Risk Identification, Management, and Education (PRIME) study points to a possible role for olanzapine. People with prodromal symptoms of psychosis received either olanzapine or placebo for 1 year. McGlashan et al. (p. 790) report that olanzapine significantly improved positive symptoms, e.g., hallucinations. The rate of conversion to full psychosis was 38% for the patients taking placebo and 16% for those taking olanzapine (see figure above). In the year after treatment stopped, the patients who had taken olanzapine experienced increasing symptoms and one-third became psychotic, further suggesting that olanzapine may help delay, but not prevent, psychosis in those at high risk.
