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Olanzapine (Zyprexa)

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Updated: July 25, 2005

Atypical Antipsychotic medication for treatment of agitation and psychosis in Alzheimer's

Olanzapine (Zyprexa)is one of a group of newer antipsychotic medications called atypical antipsychotics. These types of medication are seen as a better choice for people with Alzheimer's than other older antipsychotic medications. However Olanzapine is not approved for the treatment of elderly patients with dementia related psychosis.

Olanzapine belongs to a category of medications called psychotropics, drugs that affect the mind. Antipsychotic medicines are psychotropic medications that treat the symptoms of psychotic disorders such as schizophrenia.

What are atypical antipsychotic medications?
Atypical antipsychotic drugs are so called to differentiate between these newer antipsychotics and other conventional antipsychotics (such as (Chlorpromazine (Thorazine) and haloperidol). Atypical antipsychotic medications have a number of distinct differences and have been marketed as drugs that have fewer major neurological side effects such as extrapyramidal symptoms and very low rates of tardive dyskinesia. Atypical antipsychotics overall improve efficacy in the treatment of psychosis, especially symptoms such as emotional and social withdrawal, blunted mood, and impoverished speech. Atypical antipsychotics are approved for the treatment of schizophrenia but have also used in the treatment of agitation and psychosis in dementia and for bipolar disorder.

How Olanzapine (Zyprexa) works
Olanzapine (Zyprexa) works by blocking receptors on the nerves of the brain for several neurotransmitters (cells that transmit messages between cells)-dopamine and a subset of serotonin receptors.
Atypical antipsychotic medications were first introduced in the 1980s. Olanzapine (Zyprexa) was approved by the Food and Drug Administration (FDA) in 1996.

There is evidence that Olanzapine (Zyprexa) is very effective in treating psychosis associated with Alzheimer's disease.

Side effects of Olanzapine (Zyprexa)
Common side effects include;
Akathisia (a feeling of being unable to sit still
Constipation.
Drowsiness and over sedation.
Hypotension-low blood pressure. Dizziness.
Weightgain.
An increased risk of increased blood sugar levels and diabetes with olanzapine and the other antipsychotic medications.
Risk of falls.
More serious neurological side effects include:
Extrapyramidal symptoms-jerky, involuntary motions of the head, neck, arms, body, or eyes.
Tardive dyskinesia-involuntary movements of the mouth, tongue, jaw, or eyelids. Risk increases with prolonged use.

Medication presentation of Olanzapine (Zyprexa)
Zyprexa tablets is available as tablets that can be taken once a day, in strengths including 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg and 20 mg. The medication can be taken with or without meals. No routine blood monitoring is required.
Zyprexa Zydis is a formulation that dissolves in the mouth on contact with saliva. It can be taken with or without water. It is available in 5 mg, 10 mg, 15 mg and 20 mg tablets.
Make sure you read the prescription instructions correctly. Query anything that you are not sure of with your pharmacist or doctor.

Warning about Olanzapine (Zyprexa) and elderly people with dementia related psychosis
There is an increased risk of mortality in elderly patients with dementia related psychosis. Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks) in these patients revealed a risk of death in the drug-treated patients of between 1.6 to 1.7 times that seen in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. ZYPREXA® (olanzapine) is not approved for the treatment of elderly patients with dementia-related psychosis.

Other atypical antipsychotic medications
Other atypical antipsychotic medications include the following:
quetiapine (Seroquel)
risperidone (Risperdal)
ariprazole (Abilify)
ziprasidone (Geodon)
All these drugs have different effects and side effects in people generally and with people who have Alzheimer's disease.

More Research required into cognition and atypical antipsychotic drugs
It is generally recognized that more research is required into atypical antipsychotic medication effects on cognition. Cognition is mental activity such as thinking, attention, reasoning, decision making and dealing with concepts.

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