Clozapine, olanzapine, or typical antipsychotics for alcohol use disorder in patients with schizophrenia

Objectives: Previous research regarding the impact of olanzapine on substance use in patients with schizophrenia is mixed, and no data address its impact on alcohol use disorders. This retrospective study compared the effect of olanzapine to the effect of clozapine, an agent associated with improvements in alcohol use disorders in patients with schizophrenia, and to the effect of typical antipsychotic medications, which have not been associated with improvements in alcohol use disorders in these patients. We hypothesized that patients taking olanzapine would be more likely to become abstinent than those treated with typical antipsychotics but less likely to become abstinent than patients treated with clozapine. Methods: Data were collected by chart review. Results: Olanzapine treatment was more likely to be associated with abstinence than treatment with typical antipsychotics (chi-square = 4.22, df = 1, p =.040) and less likely to be associated with abstinence than clozapine treatment (chi-square = 13.02, df = 1, p =.0001). The majority of patients in the three medication groups were deemed improved in their psychiatric status. Conclusions: While these results should be interpreted with caution, the analyses reported here suggest that olanzapine may be more helpful for the treatment of alcohol disorders in patients with schizophrenia spectrum disorders than typical antipsychotics, but the impact appears to be small compared to the impact of clozapine, which seems more promising. This retrospective study adds to a growing literature suggesting that clozapine may be particularly helpful for the treatment of alcohol disorders in patients with schizophrenia. 2008 by The Haworth Press. All rights reserved.