Olanzapine

From Ganfyd

rINN: Olanzapine

Other Names

Zyprexa^®, Velotab^®

Pharmacological Information

Pharmacology Images

Olanzapine Molecule

Olanzapine in the:

BNF-registration required
BNF for children-registration required

DrugBank on Olanzapine

PubDrug on Olanzapine

UK SPCs of medicines with marketing authorisation

UK directory of medicines

UK Medicine Guide (eg pictures of capsules)

Metabolism & Interactions

CYP1A2

Mechanism of Action

dopamine receptor blockade etc

Relevant Clinical Literature

Pubmed on Olanzapine

NHS Evidence on Olanzapine

RCT with Olanzapine   from Pubmed

Systematic reviews   from Pubmed

TRIP Database on Olanzapine

N Eng J Med, Lancet,JAMA, BMJ   from Pubmed

Cochrane Collaboration   from Pubmed

Google Scholar on Olanzapine

Other Literature

PubChem on Olanzapine

CTD (Comparative Toxicogenomics Database) link

ChemIndustry.com link

Protein Structural Information

Biological Information (GenomeNet)

Protein Knowledgebase (UniProtKB)

Please read pharmacological data limitations

Indication

• Schizophrenia
• Mania

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

• Hyperglycaemia association stronger than for other atypicals^[1]

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

• Cardiovascular disease
• Epilepsy
• Elderly
• Dementia - increased risk stroke definite for olanzapine & risperidone
• Driving
• Withdrawal should be gradual
• Associated with increased venous thromboembolic disease

Side-effects

• Weight gain
• Parkinsonism
• Tardive dyskinesia
• Dizziness
• Postural hypotension
• Diabetes mellitus
• Neuroleptic malignant syndrome

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