Risperidone vs. Olanzapine for Persistent Delusional Disorder
Risperidone and olanzapine were found to be equally effective for the treatment of persistent delusional disorder (PDD), according to a study published in Psychiatry Research.
Currently, there is a lack of prospective trials evaluating treatment outcomes in PDD for clinical guidance. Retrospective data have shown good response to second-generation antipsychotics. Researchers from India conducted a retrospective chart review of 455 patients with PDD that were prescribed either olanzapine or risperidone. Both groups were compared for dose, adherence, response, and adverse effects.
The review found no statistically significant difference between the two groups regarding adherence (>80%) and treatment response (>52% good response). Olanzapine showed efficacy at lower mean chlorpromazine equivalents vs. risperidone. For both drugs, predictors of good response included shorter mean duration of illness, good adherence, and absence of substance dependence.
"Our study indicates that acute PDD responds well to treatment with both risperidone and olanzapine, provided adherence can be ensured," lead author Karishma Kulkarni stated. This retrospective review further supported the efficacy of second-generation antipsychotic use for PDD where no treatment guidelines or randomized-controlled trials exist.
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