From the Guidelines
Olanzapine is indicated for the treatment of schizophrenia, bipolar disorder, and chemotherapy-induced nausea and vomiting (CINV), as well as for the management of delirium symptoms in adult cancer patients. The primary indications for olanzapine include:
- Schizophrenia in adults and adolescents (13 years and older) 1
- Acute manic or mixed episodes associated with bipolar I disorder
- Maintenance treatment of bipolar I disorder
- Treatment-resistant depression (in combination with fluoxetine)
- Agitation associated with schizophrenia and bipolar I mania
- Chemotherapy-induced nausea and vomiting (CINV), specifically as part of a 4-drug regimen with aprepitant or fosaprepitant, a 5-HT3 antagonist, and dexamethasone 1
- Delirium symptoms in adult cancer patients, with a suggested starting dose of 2.5-5 mg p.o. or s.c. stat 1 Typical starting doses for olanzapine vary depending on the indication:
- For schizophrenia: 5-10 mg once daily, with a target dose of 10-15 mg/day
- For bipolar disorder: 10-15 mg once daily
- For agitation: 5-10 mg as needed
- For CINV: 10 mg given once before chemotherapy, then daily for 3 days 1
- For delirium: 2.5-5 mg p.o. or s.c. stat, with a reduced dose in older patients and patients with hepatic impairment 1 Olanzapine is an atypical antipsychotic that works by blocking multiple neurotransmitter receptors, including dopamine and serotonin, which helps reduce psychotic symptoms, stabilize mood, and decrease agitation 1. However, it's essential to monitor for side effects such as weight gain, metabolic changes, and extrapyramidal symptoms, and to consider the potential for drug-drug interactions, particularly with other antipsychotics and medications that affect the cytochrome P450 enzyme system 1. Regular blood glucose, lipid panel, and weight checks are recommended during treatment.
From the FDA Drug Label
ZYPREXA® (olanzapine) is an atypical antipsychotic indicated: As oral formulation for the: Treatment of schizophrenia. (1.1) Acute treatment of manic or mixed episodes associated with bipolar I disorder and maintenance treatment of bipolar I disorder. (1.2) Adjunct to valproate or lithium in the treatment of manic or mixed episodes associated with bipolar I disorder. (1.2) As ZYPREXA IntraMuscular for the: Treatment of acute agitation associated with schizophrenia and bipolar I mania. (1.4) As ZYPREXA and Fluoxetine in Combination for the: Treatment of depressive episodes associated with bipolar I disorder. (1.5) Treatment of treatment resistant depression. (1.6)
The indications for Olanzapine are:
- Schizophrenia
- Bipolar I Disorder: acute treatment of manic or mixed episodes and maintenance treatment
- Adjunct therapy: to valproate or lithium in the treatment of manic or mixed episodes associated with bipolar I disorder
- Acute agitation: associated with schizophrenia and bipolar I mania
- Depressive episodes: associated with bipolar I disorder
- Treatment resistant depression 2 2
From the Research
Indications for Olanzapine
- Olanzapine is prescribed for a number of psychiatric disorders, including:
- Olanzapine is also used for the prevention of relapse in bipolar disorder 6, 7
- Additionally, olanzapine is used for the treatment of agitation in patients with schizophrenia and bipolar mania 5
Specific Uses
- Treatment of acute mania, with superior efficacy to placebo and equal or superior efficacy to valproate 6, 7
- Prevention of manic and depressive relapses in patients with bipolar disorder, with efficacy comparable to lithium or valproate 6, 7
- Treatment of schizophrenia, with superior antipsychotic efficacy compared to haloperidol and risperidone 4
- Maintenance treatment of schizophrenia, with a long-acting injection formulation available 5