What is Zyprexa (Olanzapine) Used For?
Zyprexa is an antipsychotic medication that is FDA approved, with certain age restrictions, for the treatment of schizophrenia, mixed episodes of bipolar, and for psychoses. It should not be prescribed in the elderly population where dementia-related psychosis symptoms are present, and should not be prescribed under the age of 13 due to an increased risk of suicidality.
Over the years, various off-label uses have emerged and have been documented by the National Institute of Mental Health, who warns that there is no strong body of evidence supporting the efficacy of such uses of the drug for symptoms like agitation, anxiety, obsessive behaviors, and similar.1
However, despite these cautions expressed by NIMH and other researchers, the makers of Zyprexa engaged in promoting such practices. As a result, Eli Lily has agreed to pay out an astounding figure, roughly $1.4 billion in lawsuits filed against the drug company for promoting and marketing such off-label uses of its drug Zyprexa, which figure amounts to one of the largest single corporate fine ever paid out in history.2
Astoundingly, these payouts have been topped for similar misleading practices by Abbot Laboratories at $1.5 billion,11 Johnson and Johnson at $2.2 billion,10 Pfizer at $2.3 billion,9 and GlaxoSmithKline at a whopping $3 billion.8
Consumers are cautioned to research a drug, including the FDA Black Box warnings, and investigate the way the drug works and side effects to expect, before deciding if a drug is the best choice.
Certain compound drugs may contain olanzapine, such as Zyprexa Zydis. Here are some of the reasons Zyprexa or its various versions are known to be prescribed. Importantly, please note some are off-label uses:
- Agitated State
- Anxiety disorders
- Eating disorders such as anorexia, anorexia nervosa
- Nausea after chemotherapy
- Asperger Syndrome (a form of autism)
- Body dysmorphic disorder, where a person becomes obsessively concerned about imagined defects or unwanted characteristics or attributes of their physical body
- OCD, obsessive-compulsive disorder
- Paranoid disorder
Zyprexa (Olanzapine) Alternative Names and Slang
Zyprexa is one of the hundreds, perhaps thousands of brand names for olanzapine. The drug has been a financial blockbuster for all the pharmaceutical companies around the world who make the drug. It is not sought after or known as a street drug except perhaps as a diverted drug, so Zyprexa has not developed slang or street names in the illicit drug trade.
Some other trade names include Zyprexa Sydis, Olanzapina Arrowblue, Olanzapine Torrent, Jolyon, Dopin, Marathon, Kozylex, Olanazpine SUN, and many others.
Zyprexa (Olanzapine) Side Effects
Side effects from taking Zyprexa have been a controversial subject since 2006 when some documents leaked from Eli Lily were revealed by the New York Times. These documents described illegal marketing practices, promoting illegal off-label uses of the drug, and that the company downplayed the side effects of Zyprexa in order to prevent a drop in sales.2, 5, 6, 7, 8, 9, 10, 11
Below is a list of known side effects, generally starting with the most severe of these:
- Tardive dyskinesia, a movement disorder that is, sadly, irreversible in the majority of cases which causes involuntary facial movements like tongue rolling, grimaces, lip-smacking, etc.
- Life-threatening allergic reaction, causing high fever, stiff rigid muscles, profuse sweating, confusion, coma, shaking, tachycardia, and can be fatal.
- Suicidal ideation, thoughts about harming yourself.
- High blood sugar, can lead to diabetes, weight gain, drowsiness, blurred vision, etc.
- Yellowing of the eye whites or skin, which can indicate liver damage.
- Akathisia, profound internal restlessness, constant movement, intolerable to endure, inability to stop moving, that can lead to suicidality for relief.
- Breast enlargement and lactation or discharge.
- Weakness, sudden onset including fever, chills, swollen gums, sores in the mouth, pain on swallowing, other flu-like symptoms.
- Changes in behavior or personality, mood swings, can be rapid.
- Shaking, tremors.
- Parasomnias are acts done while sleeping, including sleep-walking, sleep-talking, leaving the home to go out running or shopping, driving, having sex, moving possessions, all while “asleep”. The patient wakes up confused and does not recall doing these actions.
- Pavor nocturnes, night terrors, usually involve screaming, flailing, kicking, panic, and terror when still asleep.
- Pain on swallowing, difficulty in closing the throat muscles.
- Dry mouth
- Weight gain especially in teens
- Uncontrolled urination
- Abdominal or stomach pain
- Memory loss, amnesia
- Inability to articulate speech clearly.
- Pins and needles or numbness in extremities.
- Pains or aches, especially common in arms and legs.
Zyprexa (Olanzapine) Withdrawal Symptoms
Please be aware that withdrawals from Zyprexa can be notoriously harsh. These can include:
- Schizophrenic-like symptoms, even in healthy patients with no such symptoms before taking the drug
- Bipolar symptoms, manic/depressive swings
- Crying spells, mood swings, can be rapidly changing
- Motor movement disorders
- Intense nausea, vomiting that persists over days and weeks
- Insomnia, can last for days or weeks or longer
- Memory loss
- Panic attacks
- Profuse sweating
- Weight loss
- Increased cholesterol levels
- Muscle cramps
Discontinuing/Quitting Zyprexa (Olanzapine)
There is some indication that Zyprexa blocks dopamine from the D2 receptor, which is likely what calms manic or agitated symptomology. In an effort to adapt to this dopamine deficiency, the body builds new dopamine receptors. This is thought to explain, at least in part, why withdrawal from the medication can be so incredibly harsh, even to be considered worse than heroin or benzodiazepine withdrawals.
Zyprexa restricts the expression of dopamine while it is being taken. But when the drug is reduced, dopamine expression will come back, flooding receptors and potentially turning on a rapid onset of mania. This is why the taper is best done slowly.
Dopamine is only one of many chemicals that are affected by Zyprexa. We can imagine that similar interruptions and chaotic responses are going on in other areas of the brain and the central nervous system, potentially causing significant unusual, unpredictable reactions and cross-reactions. This can be very hard on a person who is also perhaps mentally fatigued or confused, and who may become resistant to taking direction. These circumstances can make the situation very difficult to manage.
If, despite best efforts to guide a patient, there is yet an unwillingness or inability to adhere to tapering guidelines, this might result in needing to work closely with a doctor who has hospital admitting privileges and who is familiar with drug cessation, to retain control and safety for the patient. Then once the patient is stabilized, the taper may be resumed at a slower pace, with the patient’s cooperation. Slow, guided tapering can help a person transition to drug-free living, or at least to the lowest point possible that still provides for a satisfying quality of life.
A note about choosing health care professionals to work with: there have been cases reported on health forums and social media sites such as going to the hospital with severe withdrawals from antipsychotic medication, but finding out that prescription medication withdrawals are often not recognized by emergency or other doctors. It is indeed unfortunate that medical school training does not include how to recognize withdrawal symptoms and how to help a person come off a potent drug such as Zyprexa. This can lead to such heartbreaking horror stories as the person being told they are imagining things, and just sending them home to suffer alone. We do need to be aware of what we are putting into our bodies, and we also need to know who we can trust and rely on for medical and mental health support.6
Zyprexa influences multiple types of neurotransmitters and receptors and even after a few weeks of being on Zyprexa, the shock that can ensue when the dose is even gradually reduced can result in some acute and intolerable symptoms that can affect the entire body.
The often-repeated warning, “Never abruptly stop taking antipsychotic medications” applies. It is much preferable to do a taper in an inpatient, fully supportive atmosphere, with trained professionals familiar with safe drug tapering, as the discomfort may be too great to bear on your own. Unfortunately, many people are forced to stay on the drug just to avoid getting too sick to function at work and cope with everyday life. Seek help from professionals who are familiar with safe prescription drug tapering.