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Oral olanzapine: a guide to its use in adults with schizophrenia or bipolar I disorder

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Abstract

Olanzapine, an atypical antipsychotic, is a well-established option for the first-line treatment of schizophrenia, and as first-line or adjunctive therapy in the acute or preventative treatment of manic or mixed episodes associated with bipolar I disorder. The use of olanzapine is associated with better or similar efficacy than other commonly used antipsychotics, which may result in lower rates of treatment discontinuation. Treatment may generally be initiated at therapeutic dosages. Relative to other antipsychotics, olanzapine has a lower risk of extrapyramidal symptoms, but a greater risk of weight gain.

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References

  1. Bhana N, Foster RH, Olney R, et al. Olanzapine: an updated review of its use in the management of schizophrenia. Drugs. 2001;61(1):111–61.

    Article  PubMed  CAS  Google Scholar 

  2. Komossa K, Rummel-Kluge C, Hunger H, et al. Olanzapine versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2010;(3):CD006654.

  3. McCormack PL, Wiseman LR. Olanzapine: a review of its use in the management of bipolar I disorder. Drugs. 2004;64(23):2709–26.

    Article  PubMed  CAS  Google Scholar 

  4. Narasimhan M, Bruce TO, Masand P. Review of olanzapine in the management of bipolar disorders. Neuropsychiatr Dis Treat. 2007;3(5):579–87.

    PubMed  CAS  Google Scholar 

  5. Pierre JM. Extrapyramidal symptoms with atypical antipsychotics: incidence, prevention and management. Drug Saf. 2005;28(3):191–208.

    Article  PubMed  CAS  Google Scholar 

  6. Zyprexa (olanzapine) tablet for oral use: US prescribing information. Indianapolis: Eli Lilly and Company; 2011.

  7. Beasley CM Jr, Sanger T, Satterlee W, et al. Olanzapine versus placebo: results of a double-blind, fixed-dose olanzapine trial. Psychopharmacology. 1996;124:59–67.

    Article  Google Scholar 

  8. Beasley CM Jr, Tollefson G, Tran P, et al. Olanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial. Neuropsychopharmacology. 1996;14(2):111–23.

    Article  PubMed  CAS  Google Scholar 

  9. Beasley CM Jr, Hamilton SH, Crawford AM, et al. Olanzapine versus haloperidol: acute phase results of the international double-blind olanzapine trial. Eur Neuropsychopharmacol. 1997;7:125–37.

    Article  PubMed  CAS  Google Scholar 

  10. Tollefson GD, Beasley CM Jr, Tran PV, et al. Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorders: results of an international collaborative trial. Am J Psychiatry. 1997;154:457–65.

    PubMed  CAS  Google Scholar 

  11. Beasley CM Jr, Hamilton SH, Dossenbach M, et al. Relapse prevention with olanzapine [abstract no. B.57]. Schizophr Res. 2000;41(1):196–7.

    Article  Google Scholar 

  12. Tran PV, Dellva MA, Tollefson GD, et al. Oral olanzapine versus oral haloperidol in the maintenance treatment of schizophrenia and related psychoses. Br J Psychiatry. 1998;172:499–505.

    Article  PubMed  CAS  Google Scholar 

  13. Boter H, Peuskens J, Libiger J, et al. Effectiveness of antipsychotics in first-episode schizophrenia and schizophreniform disorder on response and remission: an open randomized clinical trial (EUFEST). Schizophr Res. 2009;115(2–3):97–103.

    Article  PubMed  Google Scholar 

  14. Liu-Seifert H, Osuntokun OO, Feldman PD. Factors associated with adherence to treatment with olanzapine and other atypical antipsychotic medications in patients with schizophrenia. Compr Psychiatry. 2012;53(1):107–15.

    Article  PubMed  Google Scholar 

  15. Attard A, Taylor DM. Comparative effectiveness of atypical antipsychotics in schizophrenia: what have real-world trials taught us? CNS Drugs. 2012;26(6):491–508.

    Article  PubMed  CAS  Google Scholar 

  16. Citrome L. A systematic review of meta-analyses of the efficacy of oral atypical antipsychotics for the treatment of adult patients with schizophrenia. Expert Opin Pharmacother. 2012;13(11):1545–73.

    Article  PubMed  CAS  Google Scholar 

  17. Leucht S, Cipriani A, Spineli L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet (Epub 26 Jun 2013).

  18. Tohen M, Sanger TM, McElroy SL, et al. Olanzapine versus placebo in the treatment of acute mania. Am J Psychiatry. 1999;156:702–9.

    PubMed  CAS  Google Scholar 

  19. Tohen M, Jacobs TG, Grundy SL, et al. Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2000;57:841–9.

    Article  PubMed  CAS  Google Scholar 

  20. Tohen M, Baker RW, Altshuler LL, et al. Olanzapine versus divalproex in the treatment of acute mania. Am J Psychiatry. 2002;159(6):1011–7.

    Article  PubMed  Google Scholar 

  21. Zajecka JM, Weisler R, Sachs G, et al. A comparison of the efficacy, safety, and tolerability of divalproex sodium and olanzapine in the treatment of bipolar disorder. J Clin Psychiatry. 2002;63(12):1148–55.

    Article  PubMed  CAS  Google Scholar 

  22. Berk M, Ichim L, Brook S. Olanzapine compared to lithium in mania: a double-blind randomized controlled trial. Int Clin Psychopharmacol. 1999;14(6):339–43.

    Article  PubMed  CAS  Google Scholar 

  23. Perlis RH, Baker RW, Zarate CA Jr, et al. Olanzapine versus risperidone in the treatment of manic or mixed States in bipolar I disorder: a randomized, double-blind trial. J Clin Psychiatry. 2006;67(11):1747–53.

    Article  PubMed  CAS  Google Scholar 

  24. Tohen M, Goldberg JF, Gonzalez-Pinto Arrillaga AM, et al. A 12-week, double-blind comparison of olanzapine vs haloperidol in the treatment of acute mania. Arch Gen Psychiatry. 2003;60(12):1218–26.

    Article  PubMed  CAS  Google Scholar 

  25. Tohen M, Calabrese JR, Sachs GS, et al. Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine. Am J Psychiatry. 2006;163(2):247–56.

    Article  PubMed  Google Scholar 

  26. Tohen M, Greil W, Calabrese JR, et al. Olanzapine versus lithium in the maintenance treatment of bipolar disorder: a 12-month, randomized, double-blind, controlled clinical trial. Am J Psychiatry. 2005;162(7):1281–90.

    Article  PubMed  Google Scholar 

  27. Tohen M, Ketter TA, Zarate CA, et al. Olanzapine versus divalproex sodium for the treatment of acute mania and maintenance of remission: a 47-week study. Am J Psychiatry. 2003;160(7):1263–71.

    Article  PubMed  Google Scholar 

  28. Houston JP, Tohen M, Degenhardt EK, et al. Olanzapine-divalproex combination versus divalproex monotherapy in the treatment of bipolar mixed episodes: a double-blind, placebo-controlled study. J Clin Psychiatry. 2009;70(11):1540–7.

    Article  PubMed  CAS  Google Scholar 

  29. Tohen M, Chengappa KN, Suppes T, et al. Efficacy of olanzapine in combination with valproate or lithium in the treatment of mania in patients partially nonresponsive to valproate or lithium monotherapy. Arch Gen Psychiatry. 2002;59(1):62–9.

    Article  PubMed  CAS  Google Scholar 

  30. Tohen M, Chengappa KN, Suppes T, et al. Relapse prevention in bipolar I disorder: 18-month comparison of olanzapine plus mood stabiliser v. mood stabiliser alone. Br J Psychiatry. 2004;184:337–45.

    Article  PubMed  Google Scholar 

  31. Carlson CD, Cavazzoni PA, Berg PH, et al. An integrated analysis of acute treatment-emergent extrapyramidal syndrome in patients with schizophrenia during olanzapine clinical trials: comparisons with placebo, haloperidol, risperidone, or clozapine. J Clin Psychiatry. 2003;64(8):898–906.

    Article  PubMed  CAS  Google Scholar 

  32. Haddad PM, Sharma SG. Adverse effects of atypical antipsychotics: differential risk and clinical implications. CNS Drugs. 2007;21(11):911–36.

    Article  PubMed  CAS  Google Scholar 

  33. Gentile S. Long-term treatment with atypical antipsychotics and the risk of weight gain: a literature analysis. Drug Saf. 2006;29(4):303–19.

    Article  PubMed  CAS  Google Scholar 

  34. Newcomer JW. Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review. CNS Drugs. 2005;19(Suppl 1):1–93.

    PubMed  CAS  Google Scholar 

  35. Evans S, Newton R, Higgins S. Nutritional intervention to prevent weight gain in patients commenced on olanzapine: a randomized controlled trial. Aust N Z J Psychiatry. 2005;39(6):479–86.

    PubMed  Google Scholar 

  36. Littrell KH, Hilligoss NM, Kirshner CG, et al. The effects of an educational intervention on antipsychotic-induced weight gain. J Nurs Scholarsh. 2003;35(3):237–41.

    Article  PubMed  Google Scholar 

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Acknowledgement

The manuscript was reviewed by R. Janknegt, Orbis Medical Centre, Sittard-Geleen, The Netherlands.

Disclosure

The preparation of this article was not supported by any external funding. During the review process, the manufacturer of the agent under review will be offered an opportunity to comment on the articles. Changes resulting from comments received will be made by the author on the basis of scientific and editorial merit.

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  1. Adis, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, North Shore, 0754, Auckland, New Zealand

    Katherine A. Lyseng-Williamson

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  1. Katherine A. Lyseng-Williamson
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Correspondence to Katherine A. Lyseng-Williamson.

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Lyseng-Williamson, K.A. Oral olanzapine: a guide to its use in adults with schizophrenia or bipolar I disorder. Drugs Ther Perspect 29, 291–296 (2013). https://doi.org/10.1007/s40267-013-0074-4

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