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Mood Stabilizers: Olanzapin

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NeuroPsychopharmacotherapy

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Abstract

Olanzapine was the first of the second generation antipsychotics which was approved for the treatment of bipolar I disorder. The U.S. Food and Drug Administration (FDA) approval includes olanzapine as monotherapy and adjunctive to lithium or valproate for bipolar I mania or mixed episodes, as intramuscular application for agitation in bipolar I mania, and combined with fluoxetine for bipolar I depression.

Efficacy in treatment of bipolar I disorder has been demonstrated in randomized controlled trials (RCTs) and confirmed by meta-analyses, though considerable safety concerns, that is, high risk of metabolic adverse events such as weight gain, increase of fasting glucose, diabetes mellitus, and dyslipidemia, have partially limited the recommendations in current guidelines and thorough metabolic monitoring of patients is required for treatment with olanzapine.

Additional evidence suggests efficacy of olanzapine in maintenance treatment and relapse prevention of bipolar I disorder, though evidence on long-term treatment and relapse prevention is still very limited.

With respect to pharmacokinetics and drug-drug interactions, olanzapine does not exert a strong potential of interacting with other psychotropic drugs. However, cigarette smoking can decrease olanzapine bioavailability and efficacy.

It is of note that a large part of clinical studies/RCTs contributing to the scientific literature and evidence for olanzapine in the treatment of bipolar disorder were industry-related.

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Authors and Affiliations

  1. Centre for Addiction and Mental Health; Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Stefan Kloiber

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  1. Stefan Kloiber
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Correspondence to Stefan Kloiber .

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Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Bayern, Germany

    Christian Riederer

Section Editor information

  1. Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany

    Andreas Menke

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Kloiber, S. (2021). Mood Stabilizers: Olanzapin. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_46-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_46-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

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