What Is Zyprexa? Olanzapine’s Uses, Benefits, and Side Effects

If you’ve been prescribed olanzapine (brand name Zyprexa), you probably have some questions. For starters, what is Zyprexa? How does it work? And how will it affect you?

Though medication for mental health conditions can be transformational, it can also be a difficult journey. Starting and stopping your meds, experiencing side effects, and wondering whether there are better alternative treatments can end up being a very stressful experience.

To clarify what you can expect from this medication, this page will explain:

• What olanzapine is used to treat.
• How olanzapine works in the body.
• Common and rare side effects, and how to manage them.
• The experience of withdrawing from olanzapine, and how to do it safely.
• Alternative treatments.
• Some frequently asked questions about olanzapine.

What Is Olanzapine Used For?

Olanzapine is a type of atypical antipsychotic medication. Its FDA-approved uses include treating patients aged over 13 with schizophrenia and patients with bipolar disorder (whether episodes are mixed or manic).^[1]

It’s also approved to be used with fluoxetine (an SSRI) for patients with treatment-resistant depression and those with depression associated with bipolar type.^[1]

Its off-label uses include treating:^[1]

• Delirium.
• Acute agitation.
• Anorexia nervosa.
• Nausea caused by chemotherapy.

When using Zyprexa for bipolar disorder, research finds that treatment is enhanced by also prescribing lithium or valproate. This may be something your doctor suggests for you, particularly if you suffer from bipolar depression or acute mania, or if you want to prevent manic relapse.^[2]

Zyprexa for schizophrenia is a widely used approach. It’s suggested that olanzapine could be the best first-line treatment for patients with schizophrenia, if efficacy were the only consideration.^[3]

As we’ll explore later, olanzapine comes with adverse side effects which stand in the way of it being the most popular option. Currently, clinicians may opt to prescribe you another antipsychotic that has a less risky side effect profile.^[3]

You might be given olanzapine in tablet form (either those that can be swallowed or disintegrated in water) or via injection.

How Does Olanzapine Work?

Like other atypical antipsychotic medications, olanzapine works by acting on dopamine and serotonin receptors. By blocking action at these receptors, patients experience reduced hallucinations and delusions, and an improvement of disorganized speech, behavior, and thought.^[1]

The blocking of serotonin receptors also helps to reduce patient’s flat affect and improve their attention.^[1]

If you’re looking for signs Zyprexa is working for you, you might experience those listed above, as well as an improvement in mood and anxiety. Olanzapine could be superior to other antipsychotics because while it stabilizes mood, it can also improve your cognition.^[2]

Olanzapine Side Effects

Aside from the positive changes mentioned above, you may also experience some adverse effects from taking olanzapine. The most common is weight gain, as olanzapine (and other atypical antipsychotics) causes an increase in appetite.

To mitigate the risk around olanzapine and weight gain, your doctor will be cautious if you are obese, do not exercise regularly, or don’t have a lot of control over your food intake.

You should be informed about appropriate exercise and diet to mitigate this side effect. In addition, your doctor might also prescribe samidorphan, as this can lessen the risk of weight gain caused by olanzapine.^[1]

Common side effects you may experience include:^[4]

• Increased appetite.
• Drowsiness.
• Restlessness.
• Constipation.
• Dry mouth.
• Breast enlargement or discharge.
• Late or missed periods.

Olanzapine may cause other side effects too, so it’s important to speak with your doctor about what you can expect.

Another side effect to be aware of is impaired glucose tolerance, which is a precursor to diabetes. Other rare risks include developing tardive dyskinesia and NMS (conditions that impact your extrapyramidal nervous system).^[1]

Olanzapine and Sleep

When considering taking a prescription for any antipsychotic medication, patients may be concerned about how their sleep will be affected. This is understandable; severe sleep issues can hugely impact day-to-day life, work, school, relationships, and simply looking after your own well-being.

Compared to traditional antipsychotic medications, the impact on sleepiness is less pronounced with olanzapine. It causes less sedation while still treating agitation and psychosis.^[5]

While olanzapine and sleepiness is a valid concern, both chronic insomnia and sedation can be treated by your doctor. You might like to speak with them about possible alternative treatments if your sleep is significantly affected.^[5]

Long-Term Use of Olanzapine

There are both positive and negative outcomes associated with using olanzapine long term. On one hand, the majority of patients with schizophrenia treated with olanzapine are satisfied and likely to remain on it long term. This goes for patients taking oral tablets and the long-acting injectable form.^[6]

However, around 40% of patients taking olanzapine long term are likely to suffer significant weight gain.^[6] Unfortunately, that’s not the only long-term impact on health.

With an increased risk of developing EPS (extrapyramidal symptoms), diabetes, and tardive dyskinesia, it’s understandable if you don’t want to take olanzapine for a long time.

With the help of your doctor, it’s important to balance the potential negatives with what you might stand to gain. Relief from your mental health condition cannot be overstated, so long-term use may be preferred.

However, there are quite a few antipsychotic medications to choose from, each offering a slightly different profile. Depending on your unique circumstances and condition, you might choose an alternative treatment for long term use.

Taking olanzapine long term also means you’ll have to be more careful when withdrawing, which we’ll explore now.

Stopping Zyprexa Safely

If you’re thinking about withdrawing from olanzapine, we recommend speaking to your doctor about how to do so. You have a right to withdraw from antipsychotics; but, to give you the best experience possible, it’s vital to be aware of what to expect from withdrawal.

Some reported olanzapine withdrawal symptoms include:

• Nausea.
• Tremors.
• Anxiety and agitation.
• Headaches.
• Insomnia.
• Nervousness.
• Extreme feelings.
• The emergence of involuntary movement disorders.

In addition, 18% of patients who withdraw report psychosis (some who did not suffer psychosis before treatment), and around 26% report having more energy and clearer thinking.

People report withdrawal symptoms lasting between 2 weeks to several years and 24% of people take over a year to withdraw from olanzapine completely.^[7]

Since there are risks to discontinuing your prescription, tapering off Zyprexa should happen gradually.^[1] You can do this by gradually reducing your dose over several weeks or months, keeping the increments as small as possible.

Alternatives to Olanzapine

If you’re seeking treatment for schizophrenia or bipolar disorder, there are several alternative antipsychotic medications that might work for you.

One common comparison is olanzapine vs quetiapine (brand name, Seroquel). Research has found these medications equally effective at treating patients with psychosis and violent behavior.^[8]

Olanzapine seems to cause more weight gain than quetiapine and aripiprazole, and less sexual dysfunction than risperidone.

Olanzapine also carries a higher risk of causing diabetes than aripiprazole, quetiapine, and risperidone.

In terms of sedative effects, olanzapine carries less risk than clozapine but more than aripiprazole and risperidone.^[9]

Evidently, comparing side effects is complex as each antipsychotic medication has a unique profile. If you feel strongly about changing your treatment, speak to your doctor and share your concerns. They will be able to evaluate your circumstances and make a recommendation.

Find Comprehensive Mental Health Treatment at Mission Connection

At Mission Connection, we offer personalized outpatient treatment tailored to your unique needs.

Our expert clinical team provides medication management in conjunction with a range of other evidence-based mental health treatment approaches.

We offer outpatient care at our locations in California, Virginia, and Washington, including more intensive levels of care, such as a partial hospitalization program (PHP) or an intensive outpatient program (IOP). We treat a variety of mental health conditions and are in-network with most major insurance providers.

To find out more about our in-person, virtual telehealth, or hybrid program that combines in-person and virtual care, call us at 866-833-1822. You can also learn more about how to get started with treatment services online.

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