Skip to main content
SpringerLink
Log in

Olanzapine in the Treatment of Psychosis

  • Living reference work entry
  • First Online:
NeuroPsychopharmacotherapy

  • 37 Accesses

Abstract

Olanzapine is a second-generation (atypical) antipsychotic primarily used to treat schizophrenia and bipolar disorder. It is taken by mouth or by injection into a muscle. Olanzapine has a broad spectrum of receptor affinities with highest affinity for 5-HT2A serotonin receptors and dopamine receptors; it is also a potent antagonist of muscarinic, histamine, and α-adrenergic receptors. The efficacy in treatment of psychoses was established in numerous randomized, double-blind, placebo-controlled studies and maintenance studies. Common side effects include weight gain, sedation, dizziness, feeling tired, constipation, and movement disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Attia E, Steinglass JE, Walsh BT, Wang Y, et al. Olanzapine versus placebo in adult outpatients with anorexia nervosa: A randomized clinical trial. Am J Psychiatry. 2019;176:449–56.

    Article  Google Scholar 

  • Barak Y, Shamir E, Zemishlani H, et al. Olanzapine vs. haloperidol in the treatment of elderly chronic schizophrenic patients. Prog Neuro-Psychopharmacol Biol Psychiatry. 2002;26:1199–202.

    Article  CAS  Google Scholar 

  • Bymaster FP, Calligaro DO, Falcone JF, Marsh RD, et al. Radioreceptor binding profile of the atypical antipsychotic olanzapine. Neuropsychopharmacology. 1996;14:87–96.

    Article  CAS  Google Scholar 

  • Bymaster FP, Nelson DL, DeLapp NW, Falcone JF, et al. Antagonism by olanzapine of dopamine D1, serotonin2, muscarinic, histamine H1 and alpha 1-adrenergic receptors in vitro. Schizophr Res. 1999;37:107–22.

    Article  CAS  Google Scholar 

  • Callaghan JT, Bergstrom RF, Ptak LR, et al. Olanzapine: pharmacokinetic and pharmacodynamic profile. Clin Pharmacokinetics. 1999;37:177–93.

    Article  CAS  Google Scholar 

  • Cantù F, Ciappolino V, Enrico P, Moltrasio C, et al. Augmentation with atypical antipsychotics for treatment-resistant depression. J Affect Disord. 2021;280:45–53.

    Article  CAS  Google Scholar 

  • Carbon M, Kane JM, Leucht S, Correll CU. Tardive dyskinesia risk with first- and second-generation antipsychotics in comparative randomized controlled trials: a meta-analysis. World Psychiatry. 2018;17:330–40.

    Article  Google Scholar 

  • 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;13:1545–73.

    Article  CAS  Google Scholar 

  • Désaméricq G, Schurhoff F, Meary A, Szöke A, Macquin-Mavier I, Bachoud-Lévi AC, Maison P. Long-term neurocognitive effects of antipsychotics in schizophrenia: a network meta-analysis. Eur J Clin Pharmacol. 2014;70:127–34.

    Article  CAS  Google Scholar 

  • Ennis ZN, Damkier P. Pregnancy exposure to olanzapine, quetiapine, risperidone, aripiprazole and risk of congenital malformations. A systematic review. Basic Clin Pharmacol Toxicol. 2015;116:315–20.

    Article  CAS  Google Scholar 

  • Gianfrancesco FD, Grogg AL, Mahmoud RA, et al. Differential effects of risperidone, olanzapine, clozapine, and conventional antipsychotics on type2 diabetes: findings from a large health plan database. J Clin Psychiatry. 2002;63:920–30.

    Article  CAS  Google Scholar 

  • Harvey RC, James AC, Shields GE. A systematic review and network meta-analysis to assess the relative efficacy of antipsychotics for the treatment of positive and negative symptoms in early-onset schizophrenia. CNS Drugs. 2016;30:27–39.

    Article  CAS  Google Scholar 

  • Hasan A, Falkai P, Wobrock T, Lieberman J, Glenthoj B, Gattaz WF, Thibaut F, Möller HJ. World Federation of Societies of biological psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects. World J Biol Psychiatry. 2013;14:2–44.

    Article  Google Scholar 

  • Hiemke C, Bergemann N, Clement HW, Conca A, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry. 2018;51:9–62.

    Article  CAS  Google Scholar 

  • Huhn M, Nikolakopoulou A, Schneider-Thoma J, Krause M, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet. 2019;394:939–51.

    Article  CAS  Google Scholar 

  • Komossa K, Rummel-Kluge C, Hunger H, Schmid F, Schwarz S, Duggan L, Kissling W, Leucht S. Olanzapine versus other atypical antipsychotics for schizophrenia. Cochrane Database Syst Rev. 2010;3:CD006654.

    Google Scholar 

  • Leucht S, Tardy M, Komossa K, Heres S, Kissling W, Salanti G, Davis JM. Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. Lancet. 2012;379:2063–71.

    Article  CAS  Google Scholar 

  • Leucht S, Cipriani A, Spineli L, Mavridis D, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet. 2013;382:951–62.

    Article  CAS  Google Scholar 

  • Luedecke D, Schöttle D, Karow A, Lambert M, Naber D. Post-injection delirium/sedation syndrome in patients treated with olanzapine pamoate: mechanism, incidence, and management. CNS Drugs. 2015;29:41–6.

    Article  CAS  Google Scholar 

  • Lykouras L, Zervas IM, Gournellis R, Malliori M, Rabavilas A. Olanzapine and obsessive-compulsive symptoms. Eur Neuropsychopharmacol. 2000;10:385–7.

    Article  CAS  Google Scholar 

  • McEvoy JP, Lieberman JA, Perkins DO, Hamer RM, et al. Efficacy and tolerability of olanzapine, quetiapine, and risperidone in the treatment of early psychosis: a randomized, double-blind 52-week comparison. Am J Psychiatry. 2007;164:1050–60.

    Article  Google Scholar 

  • Novick D, Montgomery W, Treuer T, Moneta MV, Haro JM. Real-world effectiveness of antipsychotics for the treatment of negative symptoms in patients with schizophrenia with predominantly negative symptoms. Pharmacopsychiatry. 2017;50:56–63.

    Article  CAS  Google Scholar 

  • Pagsberg AK, Tarp S, Glintborg D, Stenstrøm AD, et al. Acute antipsychotic treatment of children and adolescents with schizophrenia-spectrum disorders: a systematic review and network meta-analysis. J Am Acad Child Adoles Psychiatry. 2017;56:191–202.

    Article  Google Scholar 

  • Pillinger T, McCutcheon RA, Yuya Mizuno VL, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry. 2020;7:64–77.

    Article  Google Scholar 

  • Ripoli LH C Clinical. Psychopharmacology of borderline personality disorder: an update on the available evidence in light of the diagnostic and statistical manual of mental disorders – 5. Curr Opin Psychiatry. 2012;25:52–8.

    Article  Google Scholar 

  • Selle V, Schalkwijk S, Vázquez GH, Baldessarini RJ. Treatments for acute bipolar depression: meta-analyses of placebo-controlled, monotherapy trials of anticonvulsants, lithium and antipsychotics. Pharmacopsychiatry. 2014;47:43–52.

    Article  CAS  Google Scholar 

  • Soares-Weiser K, Bechard-Evans L, Lawson AH, Davis J, Ascher-Svanum H. Time to all-cause treatment discontinuation of olanzapine compared to other antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis. Eur Neuropsychopharmacol. 2013;23:118–25.

    Article  CAS  Google Scholar 

  • Sutherland A, Naessens K, Plugge E, Ware L, et al. Olanzapine for the prevention and treatment of cancer-related nausea and vomiting in adults. Cochrane Database Syst Rev. 2018;9:CD012555.

    PubMed  Google Scholar 

  • Tollefson GD, Beasley CM, 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.

    Article  CAS  Google Scholar 

  • Tran PV, Hamilton SH, Kuntz AJ, et al. Double-blind comparison of olanzapine versus risperidone in the treatment of schizophrenia and other psychotic disorders. J Clin Psychopharmacol. 1997;17:407–18.

    Article  CAS  Google Scholar 

  • Yatham LN, Kennedy SH, Schaffer A, et al. Canadian network for mood and anxiety treatments (CANMAT)and international society for BipolarDdisorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2018. Bipolar Disord. 2018;20:97–170.

    Article  Google Scholar 

  • Zhang JP, Gallego JA, Robinson DG, Malhotra AK, Kane JM, Correll CU. Efficacy and safety of individual second-generation vs. first-generation antipsychotics in first-episode psychosis: a systematic review and meta-analysis. Int J Neuropsychopharmacol. 2013;16:1205–18.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  2. Department of Psychiatry, University of Munich (LMU), Munich, Germany

    Gerd Laux

Authors
  1. Gerd Laux
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gerd Laux .

Editor information

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, University Hospital Leipzig, Leipzig, Germany

    Frank Schmidt

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Laux, G. (2022). Olanzapine in the Treatment of Psychosis. 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_453-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56015-1_453-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56015-1

  • Online ISBN: 978-3-319-56015-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation