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Purpose: To compare the characteristics of outpatients who were initiated on olanzapine or risperidone in the naturalistic treatment of schizophrenia in Japan. Methods: The Japan Medical Data Centre Database (JMDC) was used to identify patients diagnosed with schizophrenia or schizoaffective disorder using ICD-10 codes. Patients were required to be 20-65 years old, to have initiated olanzapine or risperidone therapy at an outpatient setting between January 2004 and July 2008, and to be continuously enrolled during the 6 months prior and 12 months post initiation date. Treatment groups were compared on demographics, medical and psychiatric comorbidities, prior medication use patterns, and prior health care resource utilization. Chi-square tests and t-tests were employed for univariate comparisons. Multivariate logistic regressions were used to assess the independent contribution of the predictors. Results: In both the multivariate and univariate models, olanzapine-initiated patients (n=334) were more likely than risperidone-initiated patients (n=502) to have a history of treatment with antidepressants (56.6% vs. 43.8%, p < 0.001) and a history of prior manic episodes (59.3% vs. 51.6%, p = 0.03). Discussion: Current findings suggest that in Japan, olanzapine and risperidone are not used interchangeably. Olanzapine appears to be used more often for schizophrenia patients with comorbid mood symptoms, as reflected by a prior diagnosis of manic episodes and prior treatment with antidepressants. Previous research has found that schizophrenia patients with depressive symptoms have a worse prognosis across a broad range of outcomes including the use of more relapse-related mental health services, higher rates of arrests, and suicidality, as well as poorer quality of life, mental functioning, family relationships, and medication adherence.

Characteristics of Outpatients Initiated on Olanzapine versus Risperidone in the Treatment of Schizophrenia in Japan: A Healthcare Database Analysis