The Effects of Olanzapine and Risperidone on Learning and Retaining Entry-Level Work SkillsAuthor(s): Alex Kopelowicz , Robert Paul Liberman , Charles J. Wallace , Fabian Aguirre , Jim Mintz
Objective: This study compared the effects of olanzapine and risperidone, in combination with work skills training or occupational therapy, on the ability of patients with schizophrenia to learn three different entry-level job tasks. Methods: One hundred and twenty stable outpatients with schizophrenia or schizoaffective disorder were randomly assigned to open-label risperidone or olanzapine. After four weeks of treatment, subjects were randomly assigned to receive either work skills training or occupational therapy. Work skills training consisted of six sixty-minute sessions designed to train subjects on three entry-level job tasks. Occupational therapy sessions were matched for time and therapist attention. Subjects were assessed on psychiatric symptoms, level of functioning, side effects, and acquisition and retention of work skills at baseline, after four weeks on study medication, and at twelve and twenty-four weeks after study entry. Results: Subjects assigned to work skills training learned all three work tasks and retained two of the tasks significantly better than subjects assigned to occupational therapy. There were minimal differences between subjects assigned to risperidone and olanzapine. Conclusions: Patients with schizophrenia and schizoaffective disorder were able to learn and retain entry-level job skills while taking either antipsychotic medication. The highly structured skillstraining protocol used to teach entry-level job skills was prepotent over the pharmacological effects of antipsychotic medication. Future research is needed on the interaction between medications and skills training on key psychosocial outcomes such as the work functioning of patients with schizophrenia.