Higher Motor Activity in Schizophrenia Patients Treated With Olanzapine Versus Risperidone

Abstract

There are indications that atypical antipsychotics differ in the probability of causing motor retardation. Whereas olanzapine seems to exert sedation, risperidone might slow patients because of parkinsonism or increased negative symptoms. Objective data on gross motor activity are not available. We present actigraphic data of 16 schizophrenia patients treated with olanzapine (mean dose, 21.1 mg/d) and 23 with risperidone (mean dose, 4.7 mg/d) to investigate possible differences in their effects on motor activity. Participants wore actigraphs continuously for 24 hours at the nondominant arm. Groups did not differ in age, Positive and Negative Syndrome Scale scores, duration of illness, and number of episodes. Patients treated with olanzapine had higher activity levels than those treated with risperidone (P = 0.024); this effect was robust and also present after covarying for chlorpromazine equivalents and Positive and Negative Syndrome Scale scores. Movement index (proportion of active episodes) and the average duration of immobility, however, failed to show any difference between groups. The results indicate that patients on olanzapine are more active during the day than patients on risperidone. It remains unclear whether this difference is due to subthreshold parkinsonism with risperidone or stronger beneficial effects of olanzapine on psychomotor slowing. Because the average duration of immobility remained unaffected, sedation is not likely to be the cause for the observed differences.

Enhanced Persistency of Resting and Active Periods of Locomotor Activity in Schizophrenia

“…A potential limitation of the our study is the effects of antipsychotic medications on behavioral dynamics [20], [26], [27], [28]. Because the efficacy of antipsychotics is thought to be mediated mainly by blocking D 2 receptors in the striatum of the basal ganglia, which plays an important role in motor control [29], [30], antipsychotic medications may influence activity measures through the striatum.…”

“…Another atypical antipsychotic drug, risperidone, also decreases activity levels in SCZ patients as compared to healthy subjects, although there is no significant difference in the effect with olanzapine among patients [20]. In contrast, Walther et al demonstrated that SCZ patients treated with olanzapine have higher activity levels as compared to those treated with risperidone [28]. From a viewpoint of locomotor rhythm patterns, administration of clozapine results in rigidly entrained rest-activity cycles with distinctive onset and offset of activity, whereas classical neuroleptics (haloperidol or flupentixol) cause minor to major circadian rhythm abnormalities [27].…”

Motor Symptoms and Schizophrenia

“…They found a high prevalence of slowing, which was associated with negative symptoms, but independent from antipsychotic medication [12,84,85]. Furthermore, reduced physical activity in schizophrenia patients was reported in epidemiologic studies using self-reports [86,87], as well as in instrumental assessments using gait analyses [88,89] or wrist actigraphy [83,90,91,92,93]. …”

Cortico-Cortical White Matter Motor Pathway Microstructure Is Related to Psychomotor Retardation in Major Depressive Disorder

“…In fact, volitional motor activity, special motor skills and aerobic exercise are associated with white matter integrity [17], [18], [19], [20]. In addition, longitudinal studies demonstrated that training as well as limb immobilization may induce white matter changes of motor pathways [21], [22], [23].…”