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What is olanzapine, and how does it work (mechanism of action)?
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.
What brand names are available for olanzapine?
Zyprexa, Zyprexa Zydis, Zyprexa Relprevv
Is olanzapine available as a generic drug?
Do I need a prescription for olanzapine?
What are the side effects of olanzapine?
- Elderly patients with dementia related psychosis treated with antipsychotics are at an increased risk of death.
- When using olanzapine and fluoxetine in combination, also refer to the boxed warning section of the package insert for Symbyax.
Common side effects
Common side effects seen with olanzapine are:
- an inability to sit still (akathisia),
- dry mouth,
- orthostatic hypotension,
- tremor, and
- weight gain.
Several disorders of movement also may occur with olanzapine, for example, extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes). Tardive dyskinesia (involuntary movements of the mouth, tongue, jaw, or eyelids) also may occur in 1 in 100 patients receiving olanzapine. Some cases can be irreversible. The likelihood of developing tardive dyskinesia increases with prolonged treatment.
There may be an increased risk of elevated blood sugar levels and diabetes with olanzapine as well as the other antipsychotic medications in its class. Patients should be tested during treatment for elevated blood sugar. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
What is the dosage for olanzapine?
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.
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Which drugs or supplements interact with olanzapine?
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.
Is olanzapine safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of olanzapine in pregnant women. Olanzapine should only be administered to pregnant women if the benefits justify the unknown risks.
What else should I know about olanzapine?
What preparations of olanzapine are available?
Tablets: 2.5, 5, 7.5, 10, 15, 20 mg. Tablets (orally disintegrating): 5, 10, 15, 20 mg. Injection (immediate release): 10 mg vial. Suspension for Injection (extended release): 210, 300, and 405 mg (powder).
How should I keep olanzapine stored?
Tablets should be kept at room temperature, 20 C - 25 C (68 F - 77 F). Suspension is stored at room temperature not to exceed 30 C (86 F).
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Olanzapine (Zyprexa, Zydis, Zyprexa Relprevv) is a drug prescribed for the treatment of schizophrenia associated with bipolar disorder and some types of depression. Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking any medication.
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Related Disease Conditions
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).
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 vs. Schizophrenia
Bipolar disorder and schizophrenia are mental illnesses that share some risk factors and treatments. Symptoms of bipolar disorder include mood changes and manic and depressive episodes. Symptoms of schizophrenia include unusual behavior, delusions, and hallucinations.
Bipolar Disorder in Children, Teen, and Adults
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.
Morgellons disease is a rare condition causing delusions the sufferer has parasites under his or her skin. The disease has a skin, nerve and psychiatric symptoms. The cause remains unclear.
Brief Psychotic Disorder
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.
Post-traumatic Stress Disorder
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.
Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
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).
Mental health is an optimal way of thinking, relating to others, and feeling. All of the diagnosable mental disorders fall under the umbrella of mental illness. Depression, anxiety, and substance-abuse disorders are common types of mental illness. Symptoms and signs of mental illness include irritability, moodiness, insomnia, headaches, and sadness. Treatment may involve psychotherapy and medication.
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.
What Is Schizotypal Personality Disorder?
Schizotypal personality disorder is characterized by odd behaviors, feelings, perceptions, and ways of relating to others that interfere with one's ability to function. Medication and psychotherapy can help the sufferer to manage their symptoms.
Depression in Children
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.
Bipolar Disorder in Children and Teens
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.
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.
Depression in the Elderly
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
Treatment & Diagnosis
- Altered Mental Status
- Poor Hygiene
- Loss of Speech
- Abnormal Facial Expressions
- Unusual Behavior
- Lack of Facial Expressions
- Disorganized Speech
- Catatonia (Catatonic Behavior)
- Inability to Regulate Emotions
- Borderline Personality Disorder
- Anorexia Nervosa
- Bipolar Disorder
- Panic Attack
- Obsessive-Compulsive Disorder (OCD)
- Posttraumatic Stress Disorder (PTSD)
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Medications & Supplements
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- brexpiprazole (Rexulti)
- paliperidone palmitate (Invega Sustenna)
Prevention & Wellness
- Do Antipsychotic Meds for Kids Raise Diabetes Risk?
- Antipsychotic Meds Pose Little Danger to Fetus, Study Finds
- Lithium Beats Newer Meds for Bipolar Disorder, Study Finds
- Antipsychotic Drugs Tied to Risk of Early Death in Parkinson's Patients
- Too Few Psychiatric Patients Screened for Diabetes: Study
- Beware Safety Risks Posed by 'Off-Label' Drug Use
- Are Too Many Young Americans Getting Antipsychotics for ADHD?
- Study Finds Need for Improved Schizophrenia Care
- Certain Antipsychotic Meds Tied to Kidney Problems in Elderly
- Antipsychotic Meds Not That Helpful for Depression: Study
- Long-Term Use of Some Antipsychotics Not Warranted in Older Adults: Study
- Older Antipsychotics May Work as Well as Newer Ones: Review
- More Kids Taking Antipsychotics for ADHD: Study
- Many Primary Care Docs Don't Know Long-Term Effects of Chemo: Survey
- Prescription Meds Can Put on Unwanted Pounds
- Dementia: Some Antipsychotic Drugs Riskier Than Others
- Antipsychotics in Pregnancy Risky for Newborns
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