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Zyprexa (Olanzapine) - Summary

 
 



ZYPREXA SUMMARY

ZYPREXA (olanzapine) is a psychotropic agent that belongs to the thienobenzodiazepine class.

ZYPREXA is indicated for the following:

SCHIZOPHRENIA

Oral ZYPREXA is indicated for the treatment of schizophrenia.

The efficacy of ZYPREXA was established in short-term (6-week) controlled trials of schizophrenic inpatients (see CLINICAL PHARMACOLOGY).

The effectiveness of oral ZYPREXA at maintaining a treatment response in schizophrenic patients who had been stable on ZYPREXA for approximately 8 weeks and were then followed for a period of up to 8 months has been demonstrated in a placebo-controlled trial (see CLINICAL PHARMACOLOGY). Nevertheless, the physician who elects to use ZYPREXA for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient (see DOSAGE AND ADMINISTRATION).

BIPOLAR DISORDER

Acute Monotherapy -- Oral ZYPREXA is indicated for the treatment of acute mixed or manic episodes associated with Bipolar I Disorder.

The efficacy of ZYPREXA was established in two placebo-controlled trials (one 3-week and one 4-week) with patients meeting DSM-IV criteria for Bipolar I Disorder who currently displayed an acute manic or mixed episode with or without psychotic features (see CLINICAL PHARMACOLOGY).

Maintenance Monotherapy -- The benefit of maintaining bipolar patients on monotherapy with oral ZYPREXA after achieving a responder status for an average duration of two weeks was demonstrated in a controlled trial (see Clinical Efficacy Data under CLINICAL PHARMACOLOGY). The physician who elects to use ZYPREXA for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient (see DOSAGE AND ADMINISTRATION).

Combination Therapy -- The combination of oral ZYPREXA with lithium or valproate is indicated for the short-term treatment of acute manic episodes associated with Bipolar I Disorder.

The efficacy of ZYPREXA in combination with lithium or valproate was established in two placebo-controlled (6-week) trials with patients meeting DSM-IV criteria for Bipolar I Disorder who currently displayed an acute manic or mixed episode with or without psychotic features (see CLINICAL PHARMACOLOGY).

AGITATION ASSOCIATED WITH SCHIZOPHRENIA AND BIPOLAR I MANIA

ZYPREXA IntraMuscular is indicated for the treatment of agitation associated with schizophrenia and bipolar I mania. "Psychomotor agitation" is defined in DSM-IV as "excessive motor activity associated with a feeling of inner tension." Patients experiencing agitation often manifest behaviors that interfere with their diagnosis and care, e.g., threatening behaviors, escalating or urgently distressing behavior, or self-exhausting behavior, leading clinicians to the use of intramuscular antipsychotic medications to achieve immediate control of the agitation.

The efficacy of ZYPREXA IntraMuscular for the treatment of agitation associated with schizophrenia and bipolar I mania was established in 3 short-term (24 hours) placebo-controlled trials in agitated inpatients with schizophrenia or Bipolar I Disorder (manic or mixed episodes) (see CLINICAL PHARMACOLOGY).


See all Zyprexa indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Zyprexa (Olanzapine)

Zyprexa in schizophrenia shown to prevent brain loss
Source: The Doctors Lounge - Psychiatry
Zyprexa (olanzapine) was found to decrease brain loss in schizophrenia patients according to the Archives of General Psychiatry.

Medications for patients with first episode psychosis may not meet guidelines
Source: Depression News From Medical News Today [2014.12.08]
Many patients with first-episode psychosis receive medications that do not comply with recommended guidelines for first-episode treatment, researchers have found.

Findings presented at the Society for Neuroscience meeting by Johns Hopkins scientists
Source: Autism News From Medical News Today [2014.11.24]
A Blood Pressure Hormone Implicated in PsychosisIn an effort to find a marker that predicts psychosis, postdoctoral researcher Lindsay Hayes, Ph.D.

more news >>

Published Studies Related to Zyprexa (Olanzapine)

Sleep architecture and cognitive changes in olanzapine-treated patients with depression: a double blind randomized placebo controlled trial. [2014]
depression (e.g., illness severity and cognitive function) were also determined... CONCLUSIONS: Olanzapine augmentation treatment generally did not improve SWS but

Long-term effects of asenapine or olanzapine in patients with persistent negative symptoms of schizophrenia: a pooled analysis. [2013]
prompted a pooled analysis of the treatment effects of both drugs... CONCLUSION: In this pooled analysis, ASE and OLA did not differ significantly

A randomized controlled trial of olanzapine improving memory deficits in Han Chinese patients with first-episode schizophrenia. [2013]
Olanzapine is an atypical antipsychotic for the treatment of schizophrenia, in which memory impairment is a core deficit. The methods of positive and negative syndrome scale (PANSS), Wechsler memory scale-4th edition (WMS-IV) and event-related potential (ERP) were used to study the effects of olanzapine on the cognitive function in the first-episode schizophrenic patients...

Pharmacokinetic evaluation of olanzapine + fluoxetine for the treatment of bipolar depression. [2013]
INTRODUCTION: A proprietary combination of the atypical antipsychotic drug olanzapine and the serotonin reuptake inhibitor fluoxetine (OFC, Symbyax) was approved for the treatment of bipolar depression based on a double-blind, placebo-controlled comparison of olanzapine, OFC, and placebo.In the absence of comparisons to mood stabilizers combined with each other and/or antidepressants, the role of OFC in the treatment of bipolar depression remains unclear.

Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, randomized, double-blind, placebo-controlled clinical trial. [2013]
rapid patient sedation... CONCLUSION: Intravenous droperidol or olanzapine as an adjunct to midazolam is

more studies >>

Clinical Trials Related to Zyprexa (Olanzapine)

Comparison of Intramuscular Olanzapine Depot to Oral Olanzapine and Low-Dose Depot in Patients With Schizophrenia [Completed]
This is a randomized, double-blind study to determine how well intramuscular (IM) olanzapine depot works compared to oral olanzapine; evaluate the safety and tolerability of IM olanzapine depot compared to oral olanzapine; evaluate different doses of IM olanzapine depot; and determine the blood levels of IM olanzapine depot in patients at different points in time after an injection.

Effects of Modafinil on Olanzapine Weight Gain [Completed]
This study is designed as a 3 week, randomized, double blind, placebo controlled, trial. Olanzapine and modafinil will be titrated to 10mg and 200mg respectively. Feeding lab assessments will be conducted at baseline and endpoint. Assessments of hunger/satiety, kilocalories consumed and weight will be obtained. Plasma ghrelin and PYY3-36 levels will be drawn at baseline and endpoint prior to breakfast and two hours post.

Study hypothesis: The modafinil/olanzapine group will gain less weight than the olanzapine/placebo group over three weeks of drug intake.

Olanzapine Pamoate Depot Versus Oral Olanzapine on Treatment Outcomes in Outpatients With Schizophrenia [Active, not recruiting]
To compare the health outcome of patients with schizophrenia, who are at risk for relapse, when treated with a long acting injection form of olanzapine versus treatment with oral olanzapine.

Augmenting Zyprexa With Naltrexone to Ameliorate Metabolic Side-Effects [Recruiting]
The main purpose of this study is to determine whether the opioid antagonist naltrexone is helpful in ameliorating the weight gain and other adverse metabolic side effects experienced by schizophrenic patients taking the second generation antipsychotic (SGA) Zyprexa. Schizophrenics may have an altered/enhanced endogenous opioidergic drive, and because of this, normally painful stimuli will be sensed as less painful in schizophrenics vs. healthy controls. A secondary hypothesis for this study is that naltrexone augmentation of Zyprexa will normalize subjective pain ratings. Our tertiary objective is to examine the safety and tolerability of naltrexone in Zyprexa-treated patients with schizophrenia.

PET Imaging and Olanzapine Treatment in Borderline Personality Disorder [Active, not recruiting]
The overall design of the study is to perform both a PET and MRI scan on objectively identified borderline personality disorder patients, to treat them with olanzapine for 8 weeks, and to then re-scan the patients with PET.

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Reports of Suspected Zyprexa (Olanzapine) Side Effects

Weight Increased (199)OFF Label USE (147)Overdose (142)Diabetes Mellitus (117)Hospitalisation (77)Confusional State (68)Hypertension (68)Death (67)Somnolence (66)Pneumonia (61)more >>


PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 7 ratings/reviews, Zyprexa has an overall score of 6. The effectiveness score is 7.71 and the side effect score is 6.86. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
 

Zyprexa review by 20 year old female patient

  Rating
Overall rating:  
Effectiveness:   Highly Effective
Side effects:   No Side Effects
  
Treatment Info
Condition / reason:   depression
Dosage & duration:   10mg taken every night for the period of six years
Other conditions:   anorexia nervosa
Other drugs taken:   Lamictal, birth control (Jolessa)
  
Reported Results
Benefits:   Went from severely depressed before starting the medication to almost entirely free of depression a week after starting the medication; helped with insomnia.
Side effects:   drowsiness in the beginning, but I quickly got used to it.
Comments:   I entered a hospuital six years ago for suicidality; I wasn't sleeping, I wasn't eating (I had anorexia nervosa), and I was extremely depressed. I started taking 10mg of Zyprexa the first night I was there. I was really drowsy all the next day, but it waned over a few days (now it doesn't affect my energy level at all.) In about a week, my depression just lifted. This medicine has worked miracles for me- I've been depression-free since starting it- and I wouldn't go off it for any reason.

 

Zyprexa review by care giver of 81 year old male patient

  Rating
Overall rating:  
Effectiveness:   Considerably Effective
Side effects:   Severe Side Effects
  
Treatment Info
Condition / reason:   agitation management r/t Lewy Body Syndrome Demen
Dosage & duration:   20mg taken x1 / daily for the period of 5 years
Other conditions:   B/P ,Diabetes, obesity, SVT's,osteoporosis
Other drugs taken:   ASA, Cardia, Fosamax, glyburide,Lorazepam, Metformin, Namenda,Razadyne, Simvastatin, Zetia, Plavix
  
Reported Results
Benefits:   The Zyprexa minimized agitative outbursts
Side effects:   The pt developed severe "gait freezing" , gait shuffling, severe muscle weakness, and gereral stupor
Comments:   Since many of these s/s are also s/s of the disease-Lewy Body Syndrome Demenia, it took research and experimentation by me and the MD to realize that it was the med adn not the disease in this case. The pt has been taken off the drug and no longer has these pronounced s/s.

 

Zyprexa review by 43 year old female patient

  Rating
Overall rating:  
Effectiveness:   Ineffective
Side effects:   Moderate Side Effects
  
Treatment Info
Condition / reason:   Bipolar Disorder Type II
Dosage & duration:   15mg taken 3 times per day for the period of approximately 2 years
Other conditions:   none
Other drugs taken:   Effexor XR & Tegretol (Carbamazapine)
  
Reported Results
Benefits:   While taking Zyprexa, I never experienced any episodes of hypomania (low mania) which typically accompany Bipolar Type II; however, I attribute this mostly to the fact that Zyprexa is very sedating. It should be noted that although Zyprexa is classified as an A-typical antipsychotic, it is also used as a mood stabilizer in patients with Bipolar Disorder.
Side effects:   Increased appetite which of course lead to weight gain which caused me to feel depressed! I am not exaggerating when I say my appetite was almost insatiable. Excessive sleepiness during the day which caused me to actually start falling asleep while talking to someone on several occassions. It also made me feel almost "numb" emotionally. Sedation along with an insatiable appetite caused me to gain over 25 pounds.
Comments:   My psychiatrist prescribed Zyprexa to help with the mood swings of Bipolar Disorder. I am classified as Bipolar Type II because I do not experience the extreme highs of mania (manic episodes) that accompany Bipolar Type I. I do, however, experience hypomania (hypo meaning low) so my moods still swing from highs to the extreme lows of depression.

See all Zyprexa reviews / ratings >>

Page last updated: 2014-12-08

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