Author(s): Bithorai Basumatary, Bhavana Srivastava, Mrinmay Das, Reena Bhardwaj, Renu Khanchandani, Pooja Agrawal, Neha Verma, Gunjita Belwal

BACKGROUND Psychotic disorders are a group of chronic debilitating psychiatric illness characterised by loss in touch with reality and disorders of thought, behaviour, appearance and speech. The second generation atypical antipsychotic olanzapine has been reported to be the commonly prescribed antipsychotic. However, olanzapine can cause adverse effects like weight gain, hyperglycaemia, diabetes, dyslipidaemia and metabolic syndrome. Quetiapine, another second generation antipsychotic has good efficacy and has become well established in the treatment of schizophrenia and manic episodes. There are reports on adverse effects of hyperglycaemia and diabetes with quetiapine, but these are comparatively lesser than olanzapine. The aim of the study is to compare the efficacy of olanzapine and quetiapine in patients with psychotic disorders. MATERIALS AND METHODS It was an unicentric, open label, prospective and comparative clinical study. Subjects (n=80) who were diagnosed with psychotic disorder were randomly assigned to receive olanzapine (group 1) or quetiapine (group 2). The efficacy of the two drugs was assessed on the basis Brief Psychiatric Rating Scale (BPRS) scores at baseline, 1 week and 6 weeks. UKU scale (Udvalg Kliniske Undersogelser) and laboratory investigations were used to assess the safety profile. RESULTS The two study groups had comparable sociodemographic profile. Both the groups showed significant reduction in psychotic symptoms as compared from baseline to 1 week and 6 weeks (p<0.001). The intergroup comparison of the efficacy of the two groups did not show any statistically significant results. There was statistically insignificant differences in the occurrence of adverse effects in both the groups. Sedation (50% in both the groups) was the most common adverse effect in both the groups. The use of concomitant medications was comparable in both the groups. Benzodiazepines (56.3% in the olanzapine group and 51.9% in the quetiapine group) were the most common concomitant medication. CONCLUSION Olanzapine and quetiapine were effective in reducing psychotic symptoms. Both the drugs are equally efficacious. Quetiapine can be used as an alternative to olanzapine in managing psychotic disorders. Both groups had comparable safety profile and the adverse effects were tolerable. Benzodiazepines were the most common concomitant medication.