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Olanzapine Alternatives

Last Updated on December 20, 2023 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Rarely can you find one medical professional, let alone a whole team, who has the expertise needed to find workable and effective olanzapine alternatives and for planning long-term treatment that doesn’t sacrifice a person’s quality of life.

Olanzapine alternatives at Alternative to Meds Center are well worth considering, given the potential toxicity of olanzapine (Zyprexa®), which can cause dramatic side effects and rarely, death.

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Olanzapine Alternatives vs Long-Term Antipsychotic Use

A prescription for antipsychotics, even if indicated during a time of unquestionable crisis, does not always mean that a person’s only option is to remain medicated for life. Olanzapine users should not have to suffer drastic and harsh symptoms when less harmful olanzapine alternatives are available. We have clinically proven ways to reduce, soften and eliminate adverse effects and symptoms allowing them to fade away. Alternative to Meds Center has shown that there are many other techniques that result in feeling well and engaged in life. We provide our clients with proven olanzapine alternatives to this end.

In general, atypical antipsychotics are not recommended for long-term use once any initial crisis point has well passed. In the treatment of schizophrenia, olanzapine was only approved for short-term use. Perhaps this is why the drug manufacturer began promoting the drug for off-label uses such as insomnia and depression, for which activity the company was sued for $1.415 billion by the US Dept of Justice for breaking the law.2

Olanzapine clinical trials were very short (3-4 weeks) even for the approved uses of the drug, and long-term use was not well explored in any of the pre-approval trials done on olanzapine according to the FDA drug label.1

Once a psychotic episode has ceased, this may be an opportunity to gently transition to less toxic treatment measures after short-term use of olanzapine. Sadly, most prescriptions for mental health reasons are written by physicians who are untrained in tapering methods and a lot of patients fall through the cracks. We are here to help.

Risks of Extended Use of Antipsychotic Medications

As with almost any medication, antipsychotics may relieve certain symptoms, but aggravate or contribute to other symptoms or pathologies, and the side effects can begin to significantly outweigh any perceived benefits of continued drug therapy. For example, an extensive article published in JAMA concluded that in animal and human studies, brain volume, both grey matter and white matter, shrinks with the long-term use of antipsychotic medications.8

These are good reasons to think about olanzapine alternatives, especially where olanzapine or similar drugs do not produce the desired results in treatment, and where side effects have made life difficult.

Antipsychotics and Off-Label Uses

olanzapine black box warningFor elderly dementia patients, olanzapine was once aggressively promoted “off label” for dementia-related behavior problems, but this practice has largely disappeared since too many deaths resulted. After the company plead guilty to illegal promotion tactics, Eli Lilly stopped their ad campaign that targeted elderly rest homes and other off-label markets. In addition to the fines, the FDA put a black box label on the packaging of olanzapine or brand name Zyprexa, warning of increased mortality when prescribed to elderly dementia patients. Olanzapine is FDA-approved for the short-term treatment of schizophrenia, manic episodes of bipolar, and psychosis.3

Off-label use of virtually all of the atypical antipsychotics has become too common, and in fact, the practice of doing so reportedly doubled between 1995 and 2008 according to a massive review article published in the Journal of American Medicine. Drugs like olanzapine, risperidone, paliperidone, Clozaril®, etc., are prescribed for many issues that are not FDA-approved including PTSD, depression, eating disorders, OCD, insomnia, movement disorders, aggressive behaviors, and many others. The study found that all antipsychotic medications had risks of sudden cardiac death and that the risk increased with the dose. The study also found there was no evidence of efficacy in the use of antipsychotic medication for eating disorders, or for substance abuse or insomnia. There was strong evidence for olanzapine and weight gain over and above all the other antipsychotics in the comparative study.4,8

Olanzapine Alternatives for Schizophrenia and Other Conditions

Whether or not one was prescribed for the treatment of depression, schizophrenia, OCD, PTSD, an eating disorder, aggressive behavior, or insomnia, evidence of the efficacy of using atypical antipsychotics for off-label use is poor. Alternative treatments which are non-pharmaceutical can be extremely effective for a wide array of disorders and symptoms.

For anyone prescribed antipsychotics for schizophrenia, psychosis, mania, etc., there may have been a dire need to dampen the symptoms during a time of crisis. However, once the crisis has passed, it may be advantageous to consider alternative treatments that will produce better results and less harm for sustainable mental stability and wellness without heavy drugs.

Improve Diet — An Effective Alternative Therapy

nutrition effective alternative to olanzapineOne example of alternative treatments found effective for schizophrenic symptoms is upgrading one’s diet.

A comprehensive review of studies published by the World Journal of Psychiatry has shown a dramatic reduction in auditory hallucinations, a dramatic reduction in delusions, psychosis, improved cognition, and other desirable and documented outcomes in patients with schizophrenia from changing the diet alone.5-7

A ketogenic diet featuring low carbohydrates and high fats has been shown effective in relieving symptoms that medication was not able to dampen adequately. It is suggested that this type of diet change increases the synthesis of GABA, a natural suppressor of excitatory neurotransmitters.9

One can seek guidance from a qualified naturopath or other nutritionally knowledgeable physicians for nutritional therapies that have proven helpful for the reduction of symptoms of psychosis or schizophrenia.

There are many other alternative therapies and strategies besides adding more drugs to one’s daily regimen. The list below is an abbreviated sampling of strategies to coordinate with your prescribing physician or holistic health care professionals.

Alternatives to olanzapine include:
  • Test for and remove neurotoxic accumulations such as heavy metals, organophosphates, drug residues, etc.21,22
  • Modify the diet, for reduced symptoms and weight control 5-7,9
  • natural, evidence-based alternativesCBT can effectively reduce symptoms in schizophrenic patients 10
  • Other forms of cognitive therapy for schizophrenia can be explored.*
  • Support gut microbiome health with fermented foods, yogurt, prebiotics, and probiotics, which can profoundly improve neurotransmitter health 11
  • Exercise 12
  • Abstain from recreational drug and alcohol use 13,14
  • Avoid caffeine as it can worsen psychosis symptoms 18
  • Avoid gluten-laden foods.22
  • Supplement with omega-3 polyunsaturated fatty acids and fish oils as red blood cells in schizophrenia patients typically show reduced levels of this protective nutrient in cell membranes 15,16
  • Many natural medicines have shown efficacy for psychotic disorders such as vitamin C, B3, B6, B9 (folate), B12, ginkgo Biloba (particularly for dyskinesia and akathisia), glycine, sarcosine, NAC, melatonin (attenuates dopamine), and Ayurvedic herbal remedies 17
  • GABA suppresses dopaminergic transmission 19
  • EPA (eicosapentaenoic acid) trials demonstrated superior results in reducing symptoms in schizophrenia 20

*A study in the Lancet showed CT significantly reduced psychiatric symptoms and stated counseling was “a safe and acceptable alternative for people with schizophrenia spectrum disorders who have decided not to take antipsychotic drugs.”

Notes on Coming Off Antipsychotic Medication

However necessary it may have been to begin taking medication, coming off a drug like olanzapine must be accompanied by informed help and guidance from knowledgeable practitioners who are familiar with the tapering roadmap, and in any case, should never be done abruptly.5

Always seek guidance and competent help for planning your gradual discontinuation of heavy pharmaceutical drugs such as olanzapine, or similar antipsychotics.

Alternative to Meds Center Offers Olanzapine Alternatives

healthy tapering withdrawal sedona drug rehabAt Alternative to Meds Center, we specialize in getting to the root causes of symptoms a person is troubled with and seek to remedy these using scientific, effective, and safe methods. Along with safe tapering programs, holistic protocols are used to eradicate the underlying reasons for problems such as insomnia, eating disorders, or other symptoms. In documenting our successes, we know how well our clients have responded to sound and natural (non-drug-based) protocols. Our facility is beautiful, relaxing, and welcoming and our clients appreciate the nurturing atmosphere and support provided.

The center is nestled near Sedona’s majestic Red Rocks, where there are ample opportunities for outside walks and hikes, fresh air and sunshine, as well as Equine-assisted therapy and trainer-led exercise, yoga, and Qi Gong. Orthomolecular medicine is the basis of menu planning, lovingly presented in delicious meals, snacks, and smoothies by our awesome organic-specialty chef. CBT and other personal counseling are provided, as well as IV and NAD treatments, art therapy, massage, acupuncture, neurotoxin removal, colon hydrotherapy, and many other holistic treatments.

Rather than being stuck on heavy medications for a lifetime, there are olanzapine alternatives that can be accessed at Alternative to Meds in a compassionate and friendly setting. We encourage anyone interested in finding out more about our inpatient programs utilizing olanzapine alternatives to contact us and we are happy to speak with you or your loved one about the program, insurance coverage, and any other questions you may have.


1. Gerber JE, Cawthon B. Overdose and death with olanzapine: two case reports. Am J Forensic Med Pathol. 2000 Sep;21(3):249-51. doi: 10.1097/00000433-200009000-00013. PMID: 10990286. [cited 2022 June 27]

2. Report from US Justice Dept #09-038: Eli Lilly amd Company Agrees to Pay $1.415 Billion to Resolve Allegations of Off-label Promotion of Zyprexa published 2009 [cited 2022 June 27]

3. FDA ZYPREXA (Olanzapine) label [cited 2022 June 27]

4. Alicia Ruelaz Maher, Margaret Maglione, Steven Bagley, Marika Suttorp, Jian-Hui Hu, Brett Ewing, Zhen Wang, Martha Timmer, David Sultzer, Paul G. Shekelle. Efficacy and Comparative Effectiveness of Atypical Antipsychotic Medications for Off-Label Uses in Adults: A Systematic Review and Meta-analysis. JAMA, 2011; 306 (12): 1359-1369 [cited 2022 June 27]

5. Aucoin M, LaChance L, Clouthier SN, Cooley K. Dietary modification in the treatment of schizophrenia spectrum disorders: A systematic review. World J Psychiatry. 2020 Aug 19;10(8):187-201. doi: 10.5498/wjp.v10.i8.187. PMID: 32874956; PMCID: PMC7439299. [cited 2022 June 27]

6. Aucoin M, LaChance L, Cooley K, Kidd S. Diet and Psychosis: A Scoping Review. Neuropsychobiology. 2020;79(1):20-42. doi: 10.1159/000493399. Epub 2018 Oct 25. PMID: 30359969. [cited 2022 June 27]

7. Głąbska D, Guzek D, Groele B, Gutkowska K. Fruit and Vegetable Intake and Mental Health in Adults: A Systematic Review. Nutrients. 2020;12(1):115. Published 2020 Jan 1. doi:10.3390/nu12010115 [cited 2022 June 27]

8. Ho BC, Andreasen NC, Ziebell S et al., “Long-term Antipsychotic Treatment and Brain Volume” JAMA [online] Feb 2011 [cited 2022 June 27]

9. Włodarczyk A, Wiglusz MS, Cubała WJ. Ketogenic diet for schizophrenia: Nutritional approach to antipsychotic treatment. Med Hypotheses. 2018 Sep;118:74-77. doi: 10.1016/j.mehy.2018.06.022. Epub 2018 Jun 20. PMID: 30037619. [cited 2022 June 27]

10. Rathod S, Phiri P, Kingdon D. Cognitive behavioral therapy for schizophrenia. Psychiatr Clin North Am. 2010 Sep;33(3):527-36. doi: 10.1016/j.psc.2010.04.009. PMID: 20599131. [cited 2022 June 27]

11. Severance EG, Yolken RH, Eaton WW. Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling. Schizophr Res. 2016;176:23–35. [cited 2022 June 27]

12. Ganguly P, Soliman A, Moustafa AA. Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment. Front Public Health. 2018;6:166. Published 2018 Jun 7. doi:10.3389/fpubh.2018.00166 [cited 2021 Dec 7]

13. Moore E, Mancuso SG, Slade T, Galletly C, Castle DJ. The impact of alcohol and illicit drugs on people with psychosis: the second Australian National Survey of Psychosis. Aust N Z J Psychiatry. 2012 Sep;46(9):864-78. doi: 10.1177/0004867412443900. Epub 2012 Apr 3. PMID: 22472772. [cited 2021 Dec 7]

14. Hasan A, von Keller R, Friemel CM, Hall W, Schneider M, Koethe D, Leweke FM, Strube W, Hoch E. Cannabis use and psychosis: a review of reviews. Eur Arch Psychiatry Clin Neurosci. 2020 Jun;270(4):403-412. doi: 10.1007/s00406-019-01068-z. Epub 2019 Sep 28. PMID: 31563981.[cited 2021 Dec 7]

15. Peet M. Omega-3 polyunsaturated fatty acids in the treatment of schizophrenia. Isr J Psychiatry Relat Sci. 2008;45(1):19-25. PMID: 18587166. [cited 2021 Dec 7]

16. Assisi A, Banzi R, Buonocore C, Capasso F, Di Muzio V, Michelacci F, Renzo D, Tafuri G, Trotta F, Vitocolonna M, Garattini S. Fish oil and mental health: the role of n-3 long-chain polyunsaturated fatty acids in cognitive development and neurological disorders. Int Clin Psychopharmacol. 2006 Nov;21(6):319-36. doi: 10.1097/01.yic.0000224790.98534.11. PMID: 17012979. [cited 2021 Dec 7]

17. Hoenders HJR, Bartels-Velthuis AA, Vollbehr NK, Bruggeman R, Knegtering H, de Jong JTVM. Natural Medicines for Psychotic Disorders: A Systematic Review. J Nerv Ment Dis. 2018;206(2):81-101. doi:10.1097/NMD.0000000000000782 [cited 2021 Dec 7]

18. Hedges DW, Woon FL, Hoopes SP. Caffeine-induced psychosis. CNS Spectr. 2009 Mar;14(3):127-9. doi: 10.1017/s1092852900020101. PMID: 19407709.[cited 2021 Dec 7]

19. Levy MI, Davis BM, Mohs RC, Trigos GC, Mathé AA, Davis KL. (1983) Gamma-hydroxybutyrate in the treatment of schizophrenia. Psychiatry Res 9:1–8. [cited 2021 Dec 7]

20. Peet M, Brind J, Ramchand CN, Shah S, Vankar GK. Two double-blind placebo-controlled pilot studies of eicosapentaenoic acid in the treatment of schizophrenia. Schizophr Res. 2001 Apr 30;49(3):243-51. doi: 10.1016/s0920-9964(00)00083-9. PMID: 11356585. [cited 2021 Dec 7]

21. Morris JA. Schizophrenia, bacterial toxins and the genetics of redundancy. Med Hypotheses. 1996 Apr;46(4):362-6. doi: 10.1016/s0306-9877(96)90188-7. PMID: 8733166. [cited 2021 Dec 7]

22. Al Osman M, Yang F, Massey IY. Exposure routes and health effects of heavy metals on children. Biometals. 2019 Aug;32(4):563-573. doi: 10.1007/s10534-019-00193-5. Epub 2019 Apr 2. PMID: 30941546.[cited 2021 Dec 7]

23. Ergün C, Urhan M, Ayer A. A review on the relationship between gluten and schizophrenia: Is gluten the cause? Nutr Neurosci. 2018 Sep;21(7):455-466. doi: 10.1080/1028415X.2017.1313569. Epub 2017 Apr 9. PMID: 28393621. [cited 2022 June 27]

Originally Published Feb 12, 2020 by Diane Ridaeus

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

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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