Zyprexa (olanzapine) Overview

side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more

Zyprexa Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Zyprexa pages

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Zyprexa (olanzapine) highlights: side effects, dosage, reviews, how to take & discontinue, uses, etc. The “More…” links are to pages with greater detail. The Comprehensive Zyprexa pages have all information from all the “More about…” pages, but with less explanatory material.

§1.  Brand & Generic Names; Drug Class

US brand name:	Zyprexa
Generic name:	olanzapine
What is Zyprexa (olanzapine)?
Zyprexa (olanzapine) is in the Antipsychotics class of drugs.

More Zyprexa generic equivalents, worldwide & generic availability, etc.

§2.  What is Zyprexa (olanzapine) Used For?

§2.1  US FDA Approved Treatment(s)

Schizophrenia in adults & adolescents; Bipolar 1 in adults & adolescents

§2.2  Popular Off-Label Uses

Augmenting antidepressants for treatment-resistant depression and various panic & anxiety disorders, including PTSD and OCD. Monotherapy for those same panic & anxiety disorders. Tourette’s, EPS, TD and other tic/movement disorders.

More Zyprexa approved & off-label uses

§3.  When Will Zyprexa (olanzapine) Start Working?

Fast. Really fast. You should start feeling better the next day. OK, the next day “better” could be relative in that you may not give a rat’s ass about anything at all, but that usually goes away and is replaced by something that closely approximates the mysterious condition known as “normal.”

§4.  Will Zyprexa Really Work for What You Have?

Excellent. Zyprexa has a great track record with schizophrenia and bipolar disorder.

More about how long until, and how well will Zyprexa work; and how Zyprexa compares with other drugs

§5.  How to Take Zyprexa (olanzapine)

§5.1  Bipolar Mania

Lilly recommends starting at 10–15mg of Zyprexa once a day to treat bipolar disorder. If no improvement is seen go up to by 5mg a day to a maximum of 20mg a day.
All I can say is, unless you’re seriously flipped out that is way too high to start and way too fast to hit the maximum dosage.
If you’re taking other meds to treat the bipolar disorder we suggest starting at 2.5mg of Zyprexa a day. If you’re not taking any other meds then you and your doctor need to figure out how crazy you are on a scale of 2.5 to 10mg of Zyprexa. After that increase the dosage by 2.5mg a day every 4–5 days as required. If you need to increase the dosage faster than that, maybe you should be taking a short vacation in a psychiatric hospital.

§5.2  Schizophrenia

The recommended dosage for schizophrenia starts with 5–10mg of Zyprexa a day with a target dosage of 10mg a day. You can go up to 15mg of Zyprexa a day after a week, but the clinical trials show that 10mg a day is the usual effective maintenance dosage.
I don’t know enough about schizophrenia to argue with them, other than I don’t like target dosages. If your symptoms are under control at 5mg, then stay at 5mg and talk to your doctor about increasing the dosage if and when any symptoms return.

§6.  How to Stop Taking Zyprexa (olanzapine)

Your doctor should be recommending that you reduce your dosage of Zyprexa by 5mg a day every six days if you need to discontinue Zyprexa. Making it a week is just easier to remember. You can stop immediately if it’s an emergency, but I wouldn’t recommend doing that without a doctor’s supervision. The major problem with stopping antipsychotics is a sudden return of your symptoms.

More about taking and withdrawing Zyprexa

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§7.  Zyprexa (olanzapine) Pros and Cons

§7.1  Pros

There is no better med for a severe and/or complicated mental health crisis, like smashing-everything-in-sight dysphoric mania, psychotic depression with intense anxiety, or someone with schizophrenia who is having a psychotic episode with auditory and visual hallucinations.

§7.2  Cons

You’ll gain five pounds the moment you fill the prescription. Long-term use carries the risk of type 2 diabetes (diabetes mellitus).

§7.3  Interesting Stuff your Doctor Probably didn’t Tell You about Zyprexa (olanzapine)

How quickly Zyprexa is metabolized varies fairly widely by different groups of people. Smokers clear it 40% faster than non-smokers. Men clear it 30% faster than women. Old people take 1.5 times longer. To quote the PI sheet, “The clearance in young smoking males, for example, may be 3 times higher than that in elderly nonsmoking females.”

§7.4  What Zyprexa (olanzapine) Is Best Known for

Making you fatter than the McGuire twins.
Quickly putting an end to ultradian rapid cycling, dysphoric manias, mixed states, and other extremely unpleasant aspects of bipolar disorder.
More pros, cons, and interesting stuff about Zyprexa

§8.  Zyprexa (olanzapine) Side Effects

§8.1  Typical Zyprexa Side Effects

Headache, weight gain, nausea, weight gain, dry mouth, weight gain, sleepiness, weight gain, constipation, weight gain, not giving a damn about anything (a.k.a. the zombification effect), weight gain, excessive daytime sleepiness and general lethargy, and weight gain. Because Zypexa is a potent anticholinergic the anticholinergic side effects like headache, constipation and dry mouth can hang around, they just won’t be as bad as they are at first. That’s the price you pay for EPS, TD and other movement disorders being rare.
Eventually the lethargy and sleepiness go away.

§8.2  Uncommon Zyprexa Side Effects

Diabetes mellitus, increased cholesterol and other problems associated with excessive weight gain. Accidental injury. Increased breast size (porno boobs or man boobs, take your pick), with or without lactation, loss of libido and a host of other sexual dysfunctions, and other symptoms of too much prolactin (hyperprolactinemia). Dizziness, irregular heart beat, feeling faint after standing up, and other symptoms of really low blood pressure (orthostatic hypotension). The orthostatic hypotension comes and goes with dosage increases.

§8.3  Freaky Rare Zyprexa Side Effects

Getting intoxicated from water (score!) and getting hung over with no previous intoxicating effects (bummers!). Fecal incontinence. Priapism (i.e. the never-ending hard-on) from an overdose along with Neurontin and at a high dosage all by itself. There have been other reports of this freaky rare side effect when mixing Zyprexa with other meds, including lithium. Kids, don’t try this at home as a Viagra substitute. Although who can honestly resist the temptation of being constantly drunk, hard, and always taking a dump whether you want to or not? Zyprexa is a manly med for manly men.
More Zyprexa side effects

§9.  What You Really Need to be Careful About with Zyprexa (olanzapine)

Truly excessive weight gain that leads to diabetes mellitus.
More Zyprexa black box and other warnings, pregnancy category, etc.

§10.  Zyprexa (olanzapine) Half-Life & How Long Until Zyprexa Clears Your System

Half-life: An average of 30 hours. Clearance: 6 to 7 days.
Drugs.com’s drug-drug and drug-food interaction checker
More Zyprexa pharmacokinetics & noted drug-drug & drug-food interactions
Clearance given here is “plasma clearance,” or how long it takes to be out of your blood so there’s nothing swimming around to attach itself to your brain and start doing stuff. Complete clearance is a complex equation based on a lot of factors which may or may not be published in the PI sheet or even figured out by independent researchers. If we’ve found it and calculated it you’ll find that on the pharmacokinetics page.

§11.  How Zyprexa (olanzapine) Works

the current best guess at any rate
Zyprexa works by being a broad-spectrum atypical antipsychotic that impedes the transmission of serotonin, norepinephrine, and dopamine at a bunch of receptors. It is also a potent anticholinergic (which helps to prevent antipsychotic-induced movement disorders like TD and EPS), and one of, if not the most potent antihistamine on the planet, which is one reason why it makes you so tire and makes you gain so much weight.
More about how Zyprexa works. AKA Zyprexa mechanism/method of action, or pharmacodynamics.

§12.  Comments, Zyprexa PI Sheet, and More

Zyprexa is one of those meds that people love to hate, and the damage done to Zyprexa’s reputation due to Eli Lilly’s suppression of data regarding diabetes and weight gain has overshadowed what a life-saving medication it is. Zyprexa as monotherapy may or may not be a long-term solution for most people, but as a rescue med there’s none better.
Of course anything that is mainly used as a rescue med and relatively low-dosage add-on isn’t going to account for 40% of a corporation’s revenue the way Zyprexa did for Lilly during its heyday in the early 2000s; so it’s not surprising that Lilly wanted to hide little details about dosage-related side effects like weight gain, lipids, and blood sugar.
More comments As if I didn’t go on long enough here.
Zyprexa’s Full US Prescribing Information / PI Sheet
Consumer/patient comments about, reviews of, and experiences with Zyprexa
If you have any questions about Zyprexa (olanzapine), please see the Crazy Meds’ Zyprexa (olanzapine) discussion board
Allegedly Useful Links. Mostly official sites we could find for this med, PI sheets from countries other than the US, and reviews from consumer review sites.

Zyprexa Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Zyprexa pages

Date created Wednesday, 20 July 2011 at 11:21:11 Page Author: Jerod Poore Last edited by: Jerod Poore on November 09, 2012, at 04:18 PM

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Zyprexa (olanzapine) Overview by Jerod Poore is copyright 2011 Jerod Poore

Zyprexa is a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.

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¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]

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