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Author: Admin | 2025-04-28
Have been caused by extrapyramidal side effects, biases symptom results in favor of olanzapine.Although early haloperidol discontinuation and use of the LOCF method in the ICT may thus explain the greater reduction in symptoms among patients who received olanzapine, it does not explain the fact that 32 percent of the patients who received haloperidol in the ICT were judged by their clinicians to have discontinued medication because of lack of effectiveness, compared with only 21 percent of the patients who received olanzapine (pAkinesia in the absence of prophylactic anticholinergicsClinical reports and controlled trials suggest that one kind of extrapyramidal side effect—akinesia—can readily be mistaken for refractory symptoms of schizophrenia, especially negative symptoms and depression, without being accompanied by telltale parkinsonism (5,6,7,8,9,10,11,12,13). The term "akinesia" is used in these studies to address a constellation of symptoms that is broader than the narrow neurologic use. In their 1969 textbook, Klein and Davis (5) presented a classic description of treatment without prophylactic anticholinergics: "Frequently these patients did not manifest extrapyramidal disorder but showed lack of spontaneity, inability to participate in social activities, general akinesia and complained of feeling lifeless and drowsy. At that point the introduction of antiparkinsonian medication regularly resulted in marked increase in the patient's spontaneity and feeling of capacity to engage in activity." In a 1987 review, Van Putten and Marder (6) similarly concluded that "akinesia may be the most toxic behavioral side effect of antipsychotic drugs" and added, "It is notoriously difficult to differentiate schizophrenic apathy and blunting from
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