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Dear Nurse Carol, In 10 words of less, exactly what are you saying? Remember, I'm a librarian and a Witch, not a nurse. But to tell the truth, between my Husband and my Dog, I'd have been better off to have been a nurse. just me, Marjorie At 04:19 PM 10/02/2000 -0700, you wrote: >janet, this is becoming increasingly obvious in psychiatric >practice. The Atypicals like Olanzapine/Zyprexa and >Risperidone/Risperdal were promoted as being free of the >EPS(motor fluctuations like the Thorazine shuffle), >dystonic reactions, and tardive dyskinesias of the older >meds. This has not been entirely accurate. The only psych >med that actually improves (some say masks)these >troublesome side-effects is Clozapine/Clozaril. I run a >Clozaril Clinic and we are currently tracking 100% of our >patients using the >Abnormal Involuntary Movement Scale. > Carole 54/51/?45(I'm beginning to think > even younger) > >--- janet paterson <[log in to unmask]> wrote: > > Olanzapine and clozapine: comparative effects on motor > > function in > > hallucinating PD patients. > > > > OBJECTIVE: To compare olanzapine and clozapine for safety > > and efficacy > > measures of psychosis and motor function in patients with > > PD and chronic > > hallucinations. > > > > BACKGROUND: Hallucinations occur in approximately one > > third of patients > > with PD treated chronically with dopaminergic drugs. > > > > Although clozapine is known to be an effective > > antipsychotic agent that > > does not significantly exacerbate parkinsonism, its use > > requires frequent > > blood count assessment. > > > > Olanzapine is another novel antipsychotic that is not > > associated with blood > > dyscrasia, and if equally effective could become the > > preferred drug for > > treating hallucinations in subjects with PD. > > > > METHODS: A randomized, double-blind, parallel comparison > > of olanzapine and > > clozapine in patients with PD with chronic hallucinations > > was conducted. > > > > The primary outcome measure was the Scale for the > > Assessment of Positive > > Symptoms (SAPS) for psychotic symptoms. > > > > The Unified Parkinson's Disease Rating Scale (UPDRS) > > motor subscale was > > used as a secondary outcome measure and as a safety > > monitoring tool. > > > > RESULTS: After 15 patients had completed the study, > > safety stopping rules > > were invoked because of exacerbated parkinsonism in > > olanzapine-treated > > subjects. > > > > UPDRS motor impairment scores from baseline to study end > > significantly > > increased with olanzapine treatment, and change scores > > between the > > olanzapine and clozapine groups significantly differed. > > > > The primary clinical domains responsible for the motor > > decline were gait > > and bradykinesia. > > > > Even with a smaller patient number than originally > > anticipated, clozapine > > significantly improved hallucinations and overall > > behavioral assessment, > > whereas olanzapine had no effect. > > > > CONCLUSIONS: At the doses studied, olanzapine aggravates > > parkinsonism in > > comparison with clozapine and should not be regularly > > used in the > > management of hallucinations in patients with PD. > > > > > > PMID: 10993997, UI: 20451175 > > Neurology 2000 Sep 26;55(6):789-94 > > Goetz CG, Blasucci LM, Leurgans S, Pappert EJ > > Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL; > > and San Marco > > Neurology > > > > janet paterson > > 53 now / 44 dx cd / 43 onset cd / 41 dx pd / 37 onset pd > > TEL: 613 256 8340 URL: http://www.geocities.com/janet313/ > > EMAIL: [log in to unmask] SMAIL: PO Box 171 Almonte > > Ontario K0A 1A0 Canada > > > >__________________________________________________ >Do You Yahoo!? >Yahoo! Photos - 35mm Quality Prints, Now Get 15 Free! >http://photos.yahoo.com/