What are the main side effects of olanzapine in a young adult male?

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Last updated: February 17, 2025View editorial policy

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From the Guidelines

The administration of olanzapine, an atypical antipsychotic, in a young adult male may result in several notable side effects, including sedation, drowsiness, and orthostatic hypotension 1. Common adverse effects also include weight gain and metabolic disturbances, such as hyperglycemia and dyslipidemia 1. Additionally, fatigue, constipation, dizziness, and restlessness may occur, particularly during the initial treatment phase, typically within the first 2-4 weeks of therapy at doses ranging from 5-20 mg/day 1.

Main Side Effects

  • Sedation and drowsiness: may occur, particularly during the initial treatment phase 1
  • Orthostatic hypotension: may occur, particularly during the initial treatment phase 1
  • Weight gain: may occur, with an average increase of 2.5 kg over a 6-week period at a dose of 10-15 mg/day 1
  • Metabolic disturbances: such as hyperglycemia and dyslipidemia, may occur 1
  • Fatigue, constipation, dizziness, and restlessness: may occur, particularly during the initial treatment phase 1 It is essential to monitor patients for these side effects and adjust the dosage or treatment plan as needed to minimize their impact 1.

From the FDA Drug Label

Most common adverse reactions (≥5% and at least twice that for placebo) associated with: Oral Olanzapine Monotherapy: Schizophrenia (Adults) – postural hypotension, constipation, weight gain, dizziness, personality disorder, akathisia.

5.5 Metabolic Changes: Atypical antipsychotic drugs have been associated with metabolic changes including hyperglycemia, dyslipidemia, and weight gain.

5.5 Hyperglycemia and Diabetes Mellitus: In some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients taking olanzapine.

5.5 Dyslipidemia: Undesirable alterations in lipids have been observed.

5.5 Weight Gain: Potential consequences of weight gain should be considered.

5.6 Tardive Dyskinesia: Discontinue if clinically appropriate.

5.7 Orthostatic Hypotension: Orthostatic hypotension associated with dizziness, tachycardia, bradycardia and, in some patients, syncope, may occur especially during initial dose titration.

5.9 Seizures: Use cautiously in patients with a history of seizures or with conditions that potentially lower the seizure threshold.

5.11 Potential for Cognitive and Motor Impairment: Has potential to impair judgment, thinking, and motor skills.

5.12 Anticholinergic (antimuscarinic) Effects: Use with caution with other anticholinergic drugs and in patients with urinary retention, prostatic hypertrophy, constipation, paralytic ileus or related conditions.

5.14 Hyperprolactinemia: May elevate prolactin levels.

The main side effects of olanzapine in a young adult male include:

  • Metabolic changes: hyperglycemia, dyslipidemia, and weight gain 2
  • Cardiovascular effects: orthostatic hypotension, dizziness, tachycardia, bradycardia, and syncope 2
  • Neurological effects: seizures, cognitive and motor impairment, and tardive dyskinesia 2
  • Anticholinergic effects: constipation, urinary retention, and hyperprolactinemia 2
  • Common adverse reactions: postural hypotension, constipation, weight gain, dizziness, personality disorder, and akathisia 2

From the Research

Side Effects of Olanzapine in Young Adult Males

The main side effects of olanzapine in young adult males include:

  • Drowsiness
  • Weight gain
  • Insomnia 3 Other side effects that have been reported in cases of olanzapine overdose include:
  • Delirium
  • Tachycardia
  • Dry skin and mucous membranes
  • Dilated pupils 4 It is worth noting that the side effect profile of olanzapine may vary depending on the individual and the specific context in which it is used.

Comparison with Other Antipsychotics

In comparison with other antipsychotics, such as quetiapine, olanzapine has been found to have a similar side effect profile, with both medications causing significant improvements in negative symptoms and similar rates of adverse events 5, 6 However, olanzapine may have a greater risk of weight gain and other metabolic side effects compared to some other antipsychotics.

Case Reports

There have been case reports of olanzapine being used to treat catatonic stupor in young adult males, with significant improvement in symptoms observed 7 Additionally, there have been reports of olanzapine overdose being treated with physostigmine, with varying degrees of success 4

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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