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Olanzapine helps manage symptoms of schizophrenia, the manic phase of manic-depression, and other psychotic disorders. It is thought to work by opposing the action of serotonin and dopamine, two of the brain's major chemical messengers. The drug also is available as Zydis, which dissolves rapidly with or without liquid.

Olanzapine therapy can cause extreme low blood pressure, increased heart rate, dizziness, and, in rare cases, a tendency to faint when first standing up. These problems are more likely if you are dehydrated, have heart disease, or take blood pressure medicine. To avoid such problems, your doctor may start with a low dose of Olanzapine and increase the dosage gradually.

DOSING: The usual oral dose for treating schizophrenia is 10 mg once daily. Therapy is initiated with 5-10 mg/day and the dose may be increased by 5 mg a day in weekly intervals. Doses greater than 10 mg daily have not been shown to be more effective than 10 mg daily. The safety and efficacy of doses greater than 20 mg daily have not been evaluated.

Treatment of bipolar disorder usually is initiated with oral doses of 10-15 mg once daily. The dose may be increased by 5 mg daily at 24 hour intervals. Doses greater than 20 mg daily have not been evaluated. In clinical trials, doses of 5-20 mg daily were effective.

SIDE EFFECTS: Side effects seen with olanzapine include akathisia (an inability to sit still), constipation, dizziness, drowsiness, insomnia, dry mouth, orthostatic hypotension (see DRUG INTERACTIONS), tremor, and weight gain.
Several disorders of movement also may occur with olanzapine, for example, extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes). Tardive dyskinesia (involuntary movements of the mouth, tongue, jaw, or eyelids) also may occur in 1 in 100 patients receiving olanzapine. Some cases can be irreversible. The likelihood of developing tardive dyskinesia increases with prolonged treatment.

There may be an increased risk of increased blood sugar levels and diabetes with olanzapine as well as the other antipsychotic medications in its class. Patients should be tested during treatment for elevated blood sugar.