olanzapine and Remission--Spontaneous

Topics: Amisulpride; Antipsychotic Agents; Benzodiazepines; Female; Follow-Up Studies; Humans; Hyperprolactinemia; Magnetic Resonance Imaging; Middle Aged; Olanzapine; Pituitary Gland; Pituitary Neoplasms; Prolactinoma; Psychotic Disorders; Remission, Spontaneous; Sulpiride; Thyrotropin-Releasing Hormone

We report the case of a 50-year-old female patient with non-active sarcoidosis and no kind of immunosuppression, admitted to our hospital because of increasing confusion and focal neurological deficits. Initially a tumor, herpes encephalitis, or neurosarcoidosis were suspected, but surprisingly biopsy revealed progressive multifocal leukoencephalopathy, additionally confirmed by JC-positive PCR in cerebrospinal fluid. Cases of sarcoidosis and progressive multifocal leukoencephalopathy have been reported before. This is the first case of a patient with no sign of active sarcoidosis and without immunosuppressive therapy who recovered spontaneously with a follow-up time of nearly 3 years.

Topics: Benzodiazepines; Brain; Female; Humans; Leukoencephalopathy, Progressive Multifocal; Magnetic Resonance Imaging; Middle Aged; Olanzapine; Remission, Spontaneous; Sarcoidosis; Selective Serotonin Reuptake Inhibitors

Few studies have prospectively examined remission and recovery as well as their predictors in schizophrenia simultaneously. Aims of the study were to identify remission and recovery rates as well as their predictors in schizophrenia.. 392 never-treated patients with schizophrenia were assessed over 3 years. Combined remission and recovery required concurrent achievement of symptomatic and functional remission as well as adequate quality of life for at least 6 and 24 months respectively. Predictors were analysed using stepwise logistic regression models.. At 3 years, remission rates for symptoms, functioning and subjective wellbeing were 60.3%, 45.4% and 57.0%; recovery rates were 51.7%, 35.0% and 44.3%. Of those, 28.1% were in combined remission and 17.1% in combined recovery. Predictors mainly included the baseline functional status and early remission within the first 3 months.. The proportion of patients who met combined remission or recovery criteria is low. Early treatment adaptations in case of early non-remission are mandatory.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Employment; Female; Follow-Up Studies; Germany; Humans; Male; Middle Aged; Olanzapine; Predictive Value of Tests; Prospective Studies; Psychiatric Status Rating Scales; Quality of Life; Remission, Spontaneous; Schizophrenia; Schizophrenic Psychology; Social Behavior; Treatment Outcome; Young Adult

Recent case studies suggest that impaired granulopoiesis, well-known to occur during clozapine treatment, may also be observed when olanzapine is administered. The underlying mechanisms are unknown, but haematopoietic cytokines such as granulocyte colony-stimulating factor (G-CSF) are likely to be involved.. We measured the plasma levels of G-CSF and of other cytokines longitudinally in a female patient who developed granulocytopenia twice, first during clozapine treatment and again when olanzapine was administered.. G-CSF levels, but not those of other cytokines, closely paralleled granulocyte counts, yielding a significant positive correlation. G-CSF was not detectable in plasma when granulocytopenia occurred. Granulocytopenia resolved spontaneously despite continuing treatment with olanzapine.. The present case suggests that clozapine and olanzapine both are able to induce transient granulocytopenia through a similar or common mechanism that does not involve a compensatory increase in G-CSF levels.

Topics: Adult; Agranulocytosis; Antipsychotic Agents; Benzodiazepines; Clozapine; Cytokines; Female; Granulocyte Colony-Stimulating Factor; Granulocytes; Hospitalization; Humans; Leukocyte Count; Olanzapine; Pirenzepine; Remission, Spontaneous; Schizophrenia