***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Atypical antipsychotic drugs , in clinical doses , occupy 5-HT2 receptors near saturation , while D2 dopamine receptors , assessed usually in striatum by SPECT or PET methods , are occupied to different degrees . We hypothesized that these differences in D2 receptor occupancies may also be evaluated by a neuroendocrine approach , namely by measuring the plasma prolactin responses to i. m. administered haloperidol , since the expected elevations depend mainly on the free remaining D2 receptors in the tuberoinfundibular tract . Methods We measured the plasma prolactin levels at 0 , 30 , 60 , 90 , and 120 minutes after administration of 5 mg haloperidol i. m. in six groups of male patients with schizophrenia : a ) 33 patients in a drug-free state , b ) 15 patients on treatment with clozapine ( range 200–600 mg/day ) , c ) 15 patients on olanzapine ( 10–30 mg/day ) , d ) 14 patients on risperidone ( 8–16 mg/day ) , e ) 23 patients on haloperidol ( 10–40 mg/day ) , f ) 14 patients on sulpiride ( 600–1600 mg/day ) . Data were also obtained from a group of 14 healthy male control subjects . The differences in baseline prolactin levels and in the responses to acute haloperidol  of the seven groups were compared . Results The baseline prolactin levels did not differ significantly in the groups of controls ( 8.3±3.8 ng/ml ) , drug-free patients ( 8.0±3.6 ) and patients treated with clozapine ( 7.7±3.8 ) , they were moderately elevated in patients treated with olanzapine ( 16.8±8.9 ) , elevated in patients on haloperidol ( 34.4±17.3 ) , and they were even higher in the groups of patients treated with risperidone ( 54.9±22.4 ) or sulpiride ( 58.8±27.0 ) . All groups of patients gave attenuated prolactin responses to i. m. haloperidol compared to healthy controls . During treatment with haloperidol , risperidone , or sulpiride , no significant prolactin increases after i. m. haloperidol were observed . The group treated with olanzapine gave significant prolactin increases , which were lower than those obtained in the group of patients treated with clozapine , who gave responses similar to that of the drug-free patients . Conclusions Plasma prolactin levels and responses to i. m. haloperidol of patients on treatment with antipsychotic drugs , reflect the prolactin release potencies of the drugs , which are related , but not restricted , to their affinities to D2 dopamine receptors . According to the prolactin baseline levels and responses to i. m. haloperidol , the drugs of this study can be categorized for their potency to the pituitary dopamine system that controls prolactin release , as follows : sulpiride > risperidone > haloperidol > olanzapine > clozapine . This categorization is similar to that obtained by binding studies in striatal D2 dopamine receptors using brain imaging techniques BACKGROUND The purpose of this investigation was to test the efficacy of novel antipsychotic medications in the treatment of  cognitive impairment in early phase schizophrenia . METHODS Sixty-five patients in this multicenter double-blind study were r and omly assigned to olanzapine ( 5 - 20 mg ) , risperidone ( 4 - 10 mg ) , or haloperidol ( 5 - 20 mg ) . St and ard measures of clinical and motor syndromes were administered , as well as a comprehensive battery of tests to assess ( 1 ) motor skills , ( 2 ) attention span , ( 3 ) verbal fluency and reasoning , ( 4 ) nonverbal fluency and construction , ( 5 ) executive skills , and ( 6 ) immediate recall at baseline and after 6 , 30 , and 54 weeks of treatment . RESULTS The general cognitive index derived from the 6 domain scores revealed a significantly greater benefit from treatment with olanzapine relative to haloperidol and olanzapine relative to risperidone , but no significant difference was shown between risperidone and haloperidol . The improvement related to olanzapine was apparent after 6 weeks and enhanced after 30 and 54 weeks of treatment . Exploratory within-group analyses of the 6 cognitive domains after a conservative Bonferroni adjustment revealed a significant improvement with olanzapine only on the immediate recall domain , and similar analyses of the 17 individual tests revealed a significant improvement with olanzapine only on the Hooper Visual Organization Test . CONCLUSIONS These data suggest that olanzapine has some superior cognitive benefits relative to haloperidol and risperidone . A larger sample replication study is necessary to confirm and generalize the observations of this study and begin evaluation of the implication s of this change to cerebral function and quality of life for people with schizophrenia Subjective and objective evaluation of pharmacological treatment was made in 105 schizophrenic in- patients .  PANSS and Calgary scale as well as Van Putten scale were used . Fifty-four percent of subjects received classic neuroleptics and 46%--new atypical drugs for an average period of 8 weeks . The severity of schizophrenic symptoms during treatment as well as subjective evaluation of first effects of the drug did not differ among subjects treated with classic or atypical drugs .  Depressive symptoms decreased significantly during treatment with atypicals but not with classic drugs . Also a significant decrease of depression was found under olanzapine treatment . The severity of neuroleptic-induced side-effects did not differ in both groups . Neurological side effects were more prominent in subjects after 4 weeks of therapy with risperidone , in comparison to patients receiving olanzapine . Forty-seven per-cent of patients showed a dysphoric reaction to the first dose of medication . After treatment with atypical drugs , better subjective evaluation of pharmacotherapy correlated with less severe general and depressive schizophrenia symptoms . Patients ' better evaluation of olanzapine treatment correlated with less severe schizophrenic general symptomatology . The subjective evaluation of treatment was better in patients with less severe neurological side-effects of atypical drugs ( including olanzapine but not risperidone ) and less severe autonomic side-effects of classic drugs . The evaluation of pharmacotherapy made by patients ' family members did not correlate with subjects ' opinions after distribution of the first dose of the drugs , but correlated significantly with patients ' opinion after 8-weeks of treatment . The treatment received by the patients was judged better by the family members if less severe neurological side-effects were present Improved drug therapy for schizophrenia may represent the best strategy for reducing the costs of schizophrenia and the recurrent chronic course of the disease . Olanzapine and risperidone are atypical antipsychotic agents developed to meet this need . We report a multicenter , double-blind , parallel , 30-week study design ed to compare the efficacy , safety , and associated re source use for olanzapine and risperidone in Australia and New Zeal and . The study sample consisted of 65 patients who met DSM-IV criteria for schizophrenia , schizoaffective disorder , or schizophreniform disorder .  Olanzapine-treated patients showed a significantly greater reduction in Positive and Negative Syndrome Scale ( PANSS ) total , Brief Psychiatric Rating Scale ( BPRS ) total , and PANSS General Psychopathology scores at endpoint compared to the risperidone-treated patients . Response rates through 30 weeks showed a significantly greater proportion of olanzapine-treated patients had achieved a 20 % or greater improvement in their PANSS total score compared to risperidone-treated patients . Olanzapine and risperidone were equivalent in their improvement of PANSS positive and negative scores and Clinical Global Impression-Severity of Illness scale ( CGI-S ) at endpoint . Using generic and disease-specific measures of quality of life , olanzapine-treated patients showed significant within-group improvement in most measures , and significant differences were observed in favor of olanzapine over risperidone in Quality of Life Scale ( QLS ) Intrapsychic Foundation and Medical Outcomes Study Short Form 36-item instrument ( SF-36 ) Role Functioning Limitations -Emotional subscale scores . Despite the relatively small sample size , our study suggests that olanzapine has a superior risk : benefit profile compared to risperidone OBJECTIVE Newer antipsychotic drugs have shown promise in ameliorating neurocognitive deficits in patients with schizophrenia , but few studies have compared newer antipsychotic drugs with both clozapine and conventional agents , particularly in patients who have had suboptimal response to prior treatments . METHOD The authors examined the effects of clozapine , olanzapine , risperidone , and haloperidol on 16 measures of neurocognitive functioning in a double-blind , 14-week trial involving 101 patients . A global score was computed along with scores in four neurocognitive domains : memory , attention , motor function , and general executive and perceptual organization . RESULTS Global neurocognitive function improved with olanzapine and risperidone treatment , and these improvements were superior to those seen with haloperidol . Patients treated with olanzapine exhibited improvement in the general and attention domains but not more than that observed with other treatments . Patients treated with risperidone exhibited improvement in memory that was superior to that of both clozapine and haloperidol . Clozapine yielded improvement in motor function but not more than in other groups . Average effect sizes for change were in the small to medium range . More than half of the patients treated with olanzapine and risperidone experienced " clinical ly significant " improvement ( changes in score of at least one-half st and ard deviation relative to baseline ) . These findings did not appear to be mediated by changes in symptoms , side effects , or blood levels of medications . CONCLUSIONS Patients with a history of suboptimal response to conventional treatments may show cognitive benefits from newer antipsychotic drugs , and there may be differences between atypical antipsychotic drugs in their patterns of cognitive effects OBJECTIVE The authors sought to compare the effects of olanzapine , quetiapine , and risperidone on neurocognitive function in patients with early psychosis . METHOD In a 52-week double-blind , multicenter study , 400 patients early in the course of psychotic illness ( < 5 years ) were r and omly assigned to treatment with olanzapine ( 2.5 - 20 mg/day ) , quetiapine ( 100 - 800 mg/day ) , or risperidone ( 0.5 - 4 mg/day ) . The mean modal daily dose was 11.7 mg ( SD=5.3 ) for olanzapine , 506 mg ( SD=215 ) for quetiapine , and 2.4 mg ( SD=1.0 ) for risperidone . A total of 224 patients completed neurocognitive assessment s at baseline and at 12 weeks , and 81 patients also completed them at 52 weeks . Neurocognitive composite scores were calculated from the neurocognitive battery used in the Clinical Antipsychotic Trials of Intervention Effectiveness ( CATIE ) and from the Brief Assessment of Cognition in Schizophrenia . RESULTS At week 12 , there was significant improvement in neurocognition for each treatment ( p<0.01 ) , but no significant overall difference between treatments . Composite z score improvements on the CATIE neurocognitive battery were 0.17 for olanzapine , 0.33 for quetiapine , and 0.32 for risperidone .  Composite z score improvements on the Brief Assessment of Cognition in Schizophrenia were 0.19 for olanzapine , 0.34 for quetiapine , and 0.22 for risperidone . Statistically significant relationships between improvements in neurocognition and functional outcome were observed at weeks 12 and 52 . CONCLUSIONS Olanzapine , quetiapine , and risperidone all produced significant improvements in neurocognition in early-psychosis patients . Although cognitive improvements were modest , their clinical importance was suggested by relationships with improvements in functional outcome Olanzapine and risperidone , both second-generation antipsychotic agents , represent two different pharmacologic strategies . Although they share some in vitro properties , they differ by virtue of their chemical structure , spectrum of receptor binding affinities , animal neuropharmacology , pharmacokinetics , and in vivo neuroimaging profile . Based on such differences , it was hypothesized that the two compounds would show distinct safety and /or efficacy characteristics . To test this hypothesis , an international , multicenter , double-blind , parallel-group , 28-week prospect i ve study was conducted with 339 patients who met DSM-IV criteria for schizophrenia , schizophreniform disorder , or schizoaffective disorder . Results of the study indicated that both olanzapine and risperidone were safe and effective in the management of psychotic symptoms . However , olanzapine demonstrated significantly greater efficacy in negative symptoms ( Scale for Assessment of Negative Symptoms summary score ) , as well as overall response rate ( > or = 40 % decrease in the Positive and Negative Syndrome Scale total score ) . Furthermore , a statistically significantly greater proportion of the olanzapine-treated than risperidone-treated patients maintained their response at 28 weeks based on Kaplan-Meier survival curves . The incidence of extrapyramidal side effects , hyperprolactinemia , and sexual dysfunction was statistically significantly lower 
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Data regarding quality of life and economic outcomes are difficult to interpret , and for both these highly marketed new drugs we know very little from evaluative studies regarding service outcomes , general functioning and behaviour , engagement with services and treatment satisfaction .
There is little to differentiate between risperidone and olanzapine except on the issue of adverse effects and both these drugs have unpleasant adverse effects .
Risperidone is particularly associated with movement disorders and sexual dysfunction .
Olanzapine can cause considerable rapid weight gain .