Olanzapine

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Contents

Indication

Dose

  • Schizophrenia, combination therapy for mania: 10mg daily, titrated to usual dose 5-20mg daily
  • Monotherapy for mania: 15mg daily, titrated to usual dose 5-20mg daily

Contra indications

  • Closed angle glaucoma
  • Dementia (increased risk of stroke)

Side effects

Atypical antipsychotic clinical issues

Contra-indications

Dementia is probably a contraindication for any antipsychotic (fair evidence for increased mortality in long term use) and has an interesting medicolegal potential as it is unclear if following recent changes in datasheets (SPCs) and warnings from the regulatory authorities (eg FDA) any manufacturer will share liability for out of licence use (off license) use in newly commenced patients. In the UK an urgent review is taking place as of 2008.

Cautions

Side-effects

Evidence

  • Midlands Therapeutics Review and Advisory Committee (MTRAC) review
  • Olanzapine for schizophrenia Cochrane Systematic Review
  • Olanzapine IM or velotab for acutely disturbed/agitated people with suspected serious mental illnesses Cochrane Systematic Review
  • Risperidone versus olanzapine for schizophrenia Cochrane Systematic Review
  • Scottish Medicines Consortium 2003 [1]
  • Scottish Medicines Consortium 2004 [2]
  • Scottish Medicines Consortium, 10 mg powder for solution for injection [3]

References

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