A commentary on the efficacy of olanzapine for the treatment of schizophrenia: the past, present, and future

Now, olanzapine is no longer the first choice of treatment for patients with schizophrenia. Even so, olanzapine remains widely used, lending indirect support to the hypothesis that olanzapine’s effectiveness differs from other antipsychotic treatment options.

Adverse Events from IV Olanzapine for Agitation in the ED

Similar to haloperidol, olanzapine can be used safely via the IV route despite both being FDA-approved for intramuscular (IM) administration only.

Big Pharma Meets Big Diagnosis, Big Courts, and Big Psychiatric Hospitals

The book is focused on the neuroleptic drug Zyprexa and two cases related to it — one in which Gottstein represented a client and one in which he became the accused — but importantly, it exemplifies problems throughout the systems of not only Big Pharma but also what could be called Big Diagnosis, Big Psychiatric Hospitals, and Big Mental Health-related Courts.

Delirium

Quetiapine might have the best overall side-effect profile, but olanzapine has advantages for some patients (e.g., lack of QTc prolongation, more flexible routes of administration).

Does the Combination of Parenteral Olanzapine with Benzodiazepines for Agitation in the ED Increase the Risk of Adverse Events?

Separating IV/IM olanzapine from parenteral benzodiazepines by 60 minutes is likely a safe practice, if co-administration of these medications is necessary or desired to treat agitated patients. Patients with ethanol on board are at a higher risk of adverse events

Droperidol vs. Zyprexa

Olanzapine had a higher rate of requiring another agent for adequate sedation.

Managing Delirium and Agitation in the Older Emergency Department Patient: The ADEPT Tool

Olanzapine 2.5–5 mg. Contraindications/risks: Caution in intoxicated or volume-depleted patients; may cause orthostatic hypotension or sedation.

Olanzapine (Zyprexa): increased incidence of cerebrovascular events in dementia trials

Second-generation antipsychotic drugs, which are felt to have fewer extrapyramidal adverse effects than the first-generation drugs, are sometimes used to control behavioural disturbances in elderly patients with dementia. However, similar to warnings issued in the last 2 years about risperidone and associations with hyperglycemia and cerebrovascular events, a warning was recently issued for another second-generation drug, olanzapine.

Olanzapine + Benzodiazepines

Data is controversial regarding this, but the co-administration has not been studied in depth, which is why it is not currently recommended to give both. According to the European Medicines Agency, it’s likely safe to administer olanzapine and a BZD at least 60 minutes apart...

Onset of IM Medications for Severe Agitation

An understanding of the onset and duration of medications used for agitation is vital to set expectations and safely treat patients. Most studies do not look at actual time to sedation, but rather what proportion of patients were sedated at specific time points (eg, 15, 30, 60 min).

Second-Generation Parenteral Antipsychotic (Olanzapine) as a First-Line Treatment for Acute Undifferentiated Agitation in the Emergency Department in Comparison With Haloperidol

IM olanzapine 10 mg is an effective and safe treatment for rapid sedation in acute undifferentiated agitation in the ER... In patients with acute agitation secondary to alcohol intoxication, haloperidol 5 mg is more effective than olanzapine 10 mg in achieving rapid sedation.

Sedation update: IV olanzapine & combo vs. monotherapy

We believe (and liberally practice under the auspice) that IV olanzapine is safe for a number of off-label indications. In agitated patients with IV access, the use of IV olanzapine avoids additional needle sticks for patients. It also eliminates the risk of needle stick injuries and exposure to blood-borne pathogens for the nursing staff who are asked administer IM olanzapine in these patients.

The Zyprexa Papers: Outing drug company corruption

The story could easily be adapted to a screenplay, as the courtroom drama unfolds, complete with transcripts from the trial. The story centres around the release of internal documents belonging to Eli Lilly, the pharmaceutical giant that manufactures the antipsychotic drug, Zyprexa. The internal documents reveal that Eli Lilly deliberately concealed knowledge that Zyprexa causes significant weight gain, diabetes, and other metabolic problems in a large percentage of patients. Not only had the drug company withheld the information from doctors, but it had actively denied there was a problem.

Use of Atypical Antipsychotic Drugs in Patients with Dementia

Studies indicate that olanzapine (Zyprexa) is an effective treatment for psychotic and behavior symptoms in patients with Alzheimer's disease. However, in patients with Parkinson's disease, olanzapine was found to increase motor symptoms and to be less effective than clozapine. Therefore, current recommendations discourage the use of olanzapine in patients with Parkinson's disease. In patients with Alzheimer's disease and psychotic symptoms, dosages should start at 1.25 to 2.5 mg per day and increase to 5 mg per day, if necessary.

“The Zyprexa Papers” author Jim Gottstein shares his thoughts

In The Zyprexa Papers, Mr. Gottstein gives a riveting first-hand account of what really happened, including new details about how a small group of psychiatric survivors spread the Zyprexa Papers on the Internet untraceably. All of this within a gripping, plain-language explanation of complex legal maneuvering and his battles on behalf of Bill Bigley, the psychiatric patient whose ordeal made possible the exposure of the Zyprexa Papers.