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.
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:
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.
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:
Please be aware that withdrawals from Zyprexa can be notoriously harsh. These can include:
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.
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.
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.
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.