Olanzapine side effects and drug information
July 17 2017 by
Ray Sahelian, M.D.

Olanzapine is an antipsychotic pharmaceutical drug made by Eli Lilly and Co.

Danger, caution, warning, concerns
Prescrire Int. 2015. Atypical neuroleptics in elderly patients: acute kidney injury. Using data from health insurance databases, a Canadian team showed that patients aged 65 years or older had a statistically significant increased risk of hospitalisation with acute kidney injury within the 90 days after they were newly prescribed the oral "atypical" neuroleptics risperidone, quetiapine or olanzapine. Adverse effects that can lead to kidney injury were identified: hypotension, acute urinary retention, pneumonia, myocardial infarction and ventricular arrhythmia. All-cause mortality also increased.

Olanzapine side effects - weight gain and obesity
The reason some antipsychotic drugs used to treat schizophrenia cause patients to gain a lot of weight is due to an  increase in activity of an enzyme called AMPK in cells in the part of the brain that regulates eating behavior. The increase in the AMPK enzyme occurs even with very little doses of the olanzapine drug. The use of olanzapine drug has been crimped by concerns over weight gain.

Ther Adv Psychopharmacol. 2014. Olanzapine, weight change and metabolic effects: a naturalistic 12-month follow up. Olanzapine is an atypical antipsychotic drug used to treat schizophrenia. Some of the adverse effects related to its use are obesity, hyperlipidemia, type 2 diabetes and hypertension, which may result in development of metabolic syndrome. This study aimed to investigate a possible increase in some anthropometric and biochemical parameters, and the existence of any correlation between them in Brazilian patients with schizophrenia treated with olanzapine in the mid term. Thirty subjects with schizophrenia were evaluated, 16 women and 14 men, aged between 18 and 47 years. All patients underwent blood collection and anthropometric measurements at four different times during 12 months of follow up; thus each patient was his or her own control. Evaluation of some anthropometric measurements showed significant differences when comparing the mean values obtained in each of the different data collection times. However, the biochemical indicators of development of metabolic syndrome measured in our study did not show the same rate of increment, with only the total cholesterol and glucose levels presenting statistically significant changes, but without the same magnitude of weight change. We conclude that medium-term treatment with olanzapine promoted a substantial weight gain and increased visceral fat, while the metabolic profile did not show the same magnitude of change, suggesting a dissociation between weight gain and blood parameters, despite the severe weight gain observed among subjects evaluated.

Olanzapine side effects - black hairy tongue
Black hairy tongue associated with olanzapine treatment: a case report.
Mt Sinai J Medicine. 2006.
Olanzapine is an atypical antipsychotic drug approved for acute and long-term treatment of bipolar disorder. Although relatively safe as compared to other classical antipsychotic medications, there are a number of uncommon adverse effects of olanzapine such as oral cavity lesions. In addition to the relatively common side effect of dry mouth, several articles have reported an association between olanzapine treatment and the development of oral lesions such as apthous stomatitis, pharyngitis, glossitis and oral ulceration. Although there are several cases in which the tongue was affected in conjunction with stomatitis or pharyngitis, we could not find a case report indicating a direct relationship between olanzapine use and a tongue lesion. We present here the case of a patient with bipolar disorder, who developed recurrent black hairy tongue on two different occasions following the addition of olanzapine to lithium treatment. In the present case, xerostomia (dry mouth), which is an adverse reaction of both olanzapine and lithium, may have played a role in the development of black hairy tongue. All agents with a possible side effect of xerostomia may predispose patients to black hairy tongue, especially when they are administered in combination. To preclude the development of this complication with such drugs, extra time and effort should be given to improving oral hygiene.

Questions
Q. Is it safe to add to olanzapine the amino acid tyrosine and 5 htp? I have read it might be dangerous to take when having a mental ilness. My mental condition i have autism spectrum disorder and have had lot of chronic stress in the past. I think i might have chronic fatigue syndrome too or something like it. I am tired a lot. Lately i have been prescribed bupropion but i think i cant tolerate it very well. I stopped taking it since its too stimulating for me i think. I may have had a small seizure. Iam not sure i was very restless at night and i moved really quickly.
   A. It is risky to add tyrosine or high dose 5-HTP to this medication since it is difficult to predict such interactions. Perhaps low dose 5-HTP, such as 20 to 30 mg (a portion of a capsule) could be tried but only under medical supervision.