Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Olanzapine is a drug that is used to treat
schizophrenia and acute manic episodes associated with bipolar I disorder.
Olanzapine belongs to a drug class known as atypical antipsychotics. Other
members of this class include clozapine (Clozaril), risperidone (Risperdal),
aripiprazole (Abilify) and ziprasidone (Geodon). The exact mechanism of action
of olanzapine is not known. It may work by blocking receptors for several
neurotransmitters (chemicals that nerves use to communicate with each other) in
the brain. It binds to alpha-1, dopamine, histamine H-1, muscarinic, and
serotonin type 2 (5-HT2) receptors. Olanzapine was approved by the FDA in 1996.
STORAGE: Tablets should be kept at room temperature, 20-25 C (68-77 F).
Suspension is stored at room temperature not to exceed 30 C (86 F).
PRESCRIBED FOR: Olanzapine is used for treating schizophrenia and acute mixed
or manic episodes associated with bipolar disorder. It also is used as
maintenance therapy for bipolar disorder and treating agitation due to
schizophrenia or bipolar disorder. Olanzapine also is used in combination with
fluoxetine (Prozac) for treatment of resistant depression and treatment of
depression associated with bipolar disorder.
DOSING: The usual oral dose of olanzapine for treating schizophrenia is 10-20
mg once daily. Therapy is initiated with 5-10 mg/day, and the dose may be
increased by 5 mg a day at weekly intervals. The maximum dose is 20 mg daily.
The recommended dose of extended release injection is 150-405 mg every 2 or 4
weeks.
Treatment of bipolar disorder usually is initiated with oral doses of 10-15
mg once daily. The dose may be increased by 5 mg daily at 24 hour intervals. The
maximum dose is 20 mg daily.
The usual dose for treating agitation due to schizophrenia or bipolar
disorder is 10 mg administered by intramuscular injection (immediate release).
Additional 10 mg doses may be administered, but the efficacy of total doses
greater than 30 mg daily have not been adequately evaluated.
The recommended treatment for resistant depression is 5-20 mg of olanzapine
combined with 20-50 mg of fluoxetine once daily in the evening while the
recommended treatment for depression associated with bipolar disorder is 5-12.5
mg olanzapine combined with 20-50 mg fluoxetine once daily in the evening.
DRUG INTERACTIONS: Carbamazepine (Tegretol) can reduce blood concentrations
of olanzapine, possibly necessitating higher doses of olanzapine. Other drugs
that may also reduce blood levels of olanzapine are omeprazole (Prilosec) and
rifampin. Smoking may reduce blood concentrations of olanzapine. Ciprofloxacin
(Cipro), diltiazem (Cardizem, Dilacor, Tiazac), erythromycin, and fluvoxamine
(Luvox) may have the opposite effect, that is, they may increase blood levels of
olanzapine, and the dose of olanzapine may need to be reduced. Olanzapine can
cause orthostatic hypotension, a drop in blood pressure upon standing up that
may cause dizziness or even fainting. Taking olanzapine with either diazepam
(Valium), other related benzodiazepines or alcohol can exaggerate the
orthostatic hypotension caused by olanzapine.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Anorexia is an eating disorder characterized by markedly reduced appetite or total aversion to food. Anorexia is a serious psychological disorder and is a condition that goes well beyond out-of-control dieting. With anorexia, the drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. There are psychological and behavioral symptoms as well as physical symptoms of anorexia including: depression, social withdrawal, fatigue, food obsession, heart and gastrointestinal complications, kidney function, flaky skin, brittle nails, and tooth loss (this list is not exhaustive).
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Psychotic disorders are a group of serious illnesses that affect the mind. Different types of psychotic disorders include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, shared psychotic disorder, delusional disorder, substance-induced psychotic disorder, paraphrenia, and psychotic disorders due to medical conditions.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
Symptoms of a psychotic disorder vary from person to person and may change over time. The major
symptoms are hallucinations and delusions.
Hallucinations are unusual sensory experiences or perceptions of things that
aren't actually present, such as seeing things that aren't there, hearing
voices, smelling odors, having a "funny" taste in your mouth, and feeling
sensations on your skin even though nothing is touching your body.
Delusions are false beliefs that are persistent and organized, and that do
not go away after receiving logical or accurate information. For example, a
person who is certain his or her food is poisoned, even if it has been proven
that the food is fine, is suffering from a delusion.
Other possible symptoms of psychotic illnesses include:
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