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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2018, Vol. 23 ›› Issue (11): 1292-1296.doi: 10.12092/j.issn.1009-2501.2018.11.016

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Association analysis of low dose olanzapine in controlling mental symptoms of NMDAR encephalitis

ZHANG Xiaoying1, WANG Kang2, WU Sha1, GUO Peng3   

  1. 1 Department of Neurology, Hangzhou Seventh People's Hospital, Hanghzou 310007, Zhejiang, China; 2 Department of Neurology and Brain Medical Centre, the First Affliated Hospital of Zhejiang University, Hangzhou 310006,Zhejiang, China; 3 Department of Anesthesiology, Shaoxing Central Hospital, Shaoxing 312000, Zhejiang, China
  • Received:2018-08-23 Revised:2018-10-11 Online:2018-11-26 Published:2018-11-22

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Abstract:

AIM: To analyze the effect of low-dose olanzapine on the association of psychiatric symptoms in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. METHODS: Twenty-six adults with anti NMDAR encephalitis treated in our hospital from March 2014 to March 2018 were divided into two groups randomly. The control group (13 cases) was treated with routine immunotherapy. The observation group (13 cases) was given low dose olanzapine on the basis of the above. The clinical efficacy and adverse reactions of the patients were observed. Negative and positive symptom scale (PANSS), explicit aggressive behavior scale (MOAS), nurse observation scale (NOSIE), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate the improvement of mental symptoms in patients 1 and 2 weeks after treatment. RESULTS: The total effective rate was 92.31% in the observation group, which was higher than 76.92% in the control group. The difference was statistically significant (P<0.05). Before treatment, difference of the MOAS and NOSIE scores of the two groups were not statistically different (P>0.05). At 1 and 2 weeks after treatment, the MOAS and NOSIE scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant (P<0.05). The scores of MOAS and NOSIE in the observation group were significantly lower than those in the control group at 1 and 2 weeks after treatment (P<0.05). Before treatment, difference of the HAMA and HAMD scores of the two groups were not statistically significant (P>0.05). At 1 and 2 weeks after treatment, the HAMA and HAMD scores of the two groups were significantly lower than those before treatment, and the difference was statistically significant (P<0.05). At 1 and 2 weeks after treatment, the HAMA and HAMD scores of the observation group were significantly lower than those of the control group (P<0.05). CONCLUSION: Continuous low-dose olanzapine can significantly improve the psychiatric symptoms of patients with anti-NMDAR encephalitis with fewer adverse reactions, but it requires more clinical validation.

Key words: anti N-methyl-D-aspartate receptor encephalitis, psychiatric symptoms, immunotherapy, olanzapine

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