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Zyprexa (Olanzapine) Side Effects, Withdrawal and FAQs

Zyprexa (olanzapine) is an SGA or second generation atypical antipsychotic medication.
Drug-makers note that the drug changes chemicals in the brain but more needs to be known about how this medication works exactly. Zyprexa is prescribed to treat psychosis and schizophrenia symptoms.
Drug-makers note that the drug changes chemicals in the brain but more needs to be known about how this medication works exactly. Zyprexa is prescribed to treat psychosis and schizophrenia symptoms.

The FDA Black Box warnings on virtually all antipsychotic medications in use today apply to Zyprexa as well as its extended release injectable versions, and any compounds that have olanzapine as an ingredient in them. Be safe and find out about a medication before you begin a prescription, to make sure it is the best choice for you, and also when deciding to stop a medication.

Please note that an elderly patient with signs of dementia related psychosis should not be prescribed olanzapine because of the increased risk of death.

Below are various topics that are frequently asked about Zyprexa, its effects, characteristics of withdrawal, and other information that may help contribute to making an informed decision regarding starting or stopping this medication.

What is Zyprexa (Olanzapine) Used For?

Zyprexa is an antipsychotic medication which 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 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 behaviours, 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 have 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, note some are off-label uses:

  • Agitated State
  • Anxiety disorders
  • Eating disorders such as anorexia, anorexia nervosa
  • Insomnia
  • 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 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 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 some documents leaked from Eli Lily were revealed by the New York Times in 2006. These documents described illegal marketing practices, specifically that the company downplayed the side effects of Zyprexa in order to prevent a drop in sales. (2)

Below is a list of known side effects, generally starting with the most severe of these:

  • Tardive dyskenisia, 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 and unable to stop moving, 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, acts done while sleeping including walking, talking, running, shopping, driving, having sex, moving possessions, the patient wakes up confused and does not recall these actions.
  • Pavor nocturnes, night terrors, usually involve screaming, flailing, kicking, panic and terror when still asleep.
  • Headache
  • Tiredness
  • Pain on swallowing, difficulty in closing the throat muscles.
  • Drooling
  • Dry mouth
  • Weight gain especially in teens
  • Uncontrolled urination
  • Restlessness
  • Dizziness
  • 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:

  • Psychosis
  • Suicidality
  • Schizophrenic-like symptoms, even in healthy patients with no such symptoms before taking the drug
  • Hallucination
  • Bipolar symptoms, manic/depressive swings
  • Crying spells, mood swings, can be rapidly changing
  • Diabetes
  • Tachycardia
  • Motor movement disorders
  • Intense nausea, vomiting that persists over days and weeks
  • Headache
  • Weakness
  • Insomnia, can last for days or weeks or longer
  • Memory loss
  • Panic attacks
  • Dizziness
  • Shaking
  • Profuse sweating
  • Diarrhea
  • Constipation
  • Confusion
  • Fatigue
  • Depression
  • Anxiety
  • Depersonalization
  • Irritability
  • 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 resistive 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 admission 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 an 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 often 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 every day life.  Seek help from professionals who are familiar with safe prescription drug tapering.

Zyprexa (Olanzapine) FAQs

Below are a number of topics that may be helpful in researching more about Zyprexa, including what Zyprexa does to the brain, interactions with other drugs, and more.

What Does Zyprexa Do to the Brain?

Zyprexa has a known chemical structure which determines or models how the drug is manufactured in the lab. It has a molecular weight of 312.44 and a specific combination of atoms. But beyond the recipe as such, there is little known about how exactly the drug works within the brain and central nervous system.

We do know that Zyprexa is a member of a class of drugs called thienobenzodiazepines. This tells us that Zyprexa is an antipsychotic medication that is similar to benzodiazepines, both being gabaminergic in effect. However, Zyprexa additionally deflects or blocks many other types of brain chemicals besides GABA, including dopamine, allowing numerous types of neurotransmitters to accumulate at receptor sites. (4)

More research needs to be done to understand the mechanisms of action of drugs like Zyprexa more thoroughly.

What Other Medications Interact With Olanzapine?

When a person begins a prescription of Zyprexa, the central nervous system and the brain will undergo some changes and reactions influencing certain natural chemicals that the body creates called neurotransmitters. There is little known about exactly how Zyprexa impacts these factors. The same can be generally said regarding every other drug that is on the market today.

According to the National Alliance of Mental Health, combining two or more drugs can compound certain risks and the end result can be unpredictable. There are some drugs which are known to cause harmful and undesirable interactions when taken along with Zyprexa. (3)

These are some to be aware of:

  • Medications prescribed for Parkinson’s disease, includes a large number of prescription drugs, including levodopa or carbidopa, trade name Sinemet, bromocriptine, pramipexole, brand name Mirapex, ropinirole, brand name Requip, and many others. Talk with your prescribing doctor about these possible interactions.
  • Medications to control high blood pressure, i.e., Inderal or Propranolol and others.
  • Sedatives, hypnotics, anxiolytics, such as diazepam, brand name Valium, lorazepam, brand name Ativan, and hundreds of similar drugs in this category should be discussed with your prescribing physician before combining with Zyprexa. Note that when Zyprexa or any of the above is given in the injectable form, these effects are enhanced and can significantly increase the risks of interaction.
  • Luvox, generic fluvoxamine and Cipro, generic ciprofloxacin are two examples of drugs that may enhance the effects of olanzapine.
  • Tegretol, generic carbamazepine is one of a number of drugs that may reduce the efficacy of olanzapine due to the way these drugs interact.

Before combining drugs, always discuss the matter with your physician.

How Long Does Zyprexa (Olanzapine) Stay in Your System?

After ingesting Zyprexa, metabolites can test positive in the urine for approximately 4-10 days.

However, this time period may have little relation to the time it may take to fully adjust to being off Zyprexa. There is a high probability that affected receptors upregulated themselves, in response to the drug. (7)

It would follow that a person could experience some degree of over-stimulation, including manic symptoms, as a result of the neuroadaptive characteristics induced by the drug. The time needed for these receptors to return to normal is indefinite, depending on such factors as genetics, length of use, dietary habits including caffeine or other stimulants, and could take months to years.

How Long Does Zyprexa Withdrawal Last?

A person should never abruptly stop taking Zyprexa as the shock to the body can be severe and intolerable. Even with a slow taper, especially without proper support, withdrawals can tend to be long-lasting, and near to impossible to tolerate.

Where the drug was taken long-term, seek professional help to avoid lingering withdrawals. These can last for weeks, months or even years without adequate support and tapering protocols in place. Sometimes withdrawals can be severe and last for weeks or months, even after only a few weeks of taking Zyprexa.

Treatment for Zyprexa (Olanzapine) Abuse and Addiction?

Zyprexa affects a wide number of neurotransmitter receptors in the body, and may have an initial effect of sedation or calming, and for those with depression, perhaps a lift or rise in mood. However, the central nervous system can become altered after regular use of such a drug, resulting in dependence. The side effects that can present with Zyprexa can also be challenging, and a person may opt to come off the drug where benefits of the medication are not out-weighing the negatives. When this occurs, especially when disadvantaged with multiple health challenges, there could be quite a challenge to come off the drug.

Families often are hit the hardest when a loved one is experiencing such difficulties. There may be a better choice than continuing on a path where hope is all but lost and the pain and suffering seems to go on without abatement. It is difficult to watch a loved one suffer.

Enrolling at the Alternative to Meds Center provides stress-free, top-notch care for anyone seeking to recover from Zyprexa side effects and withdrawals. Our center is staffed with medical professionals and caregivers who understand medication withdrawal and the depth and breadth of the challenges. Compassionate and efficient care is the hallmark of our center.

Using lab testing, nutritional support with a clean diet and food grade supplementation, heavy metal removal, nebulized glutathione treatments, physical therapies such as massage, Reiki, and many other methods, we prepare a person for the taper, and then gently guide the person along to a successful conclusion.

Contact us for more information about the protocols used in our slow tapering programs, individually tailored, for Zyprexa cessation.

This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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