The Wide Range of Off-label Uses of Zyprexa
Zyprexa (olanzapine) in oral tablet form was FDA-approved for the treatment of schizophrenia and the injectable form for agitated states in schizophrenia and bipolar. The oral tablet formulation was also approved for episodes of mania or depression in both adults and children diagnosed with bipolar conditions. In treatment-resistive depression, a combination of Zyprexa and Prozac was approved.1
However, Zyprexa has been increasingly used off-label for conditions like OCD (obsessive compulsive disorder), PTSD (post traumatic stress disorder), autism, Tourette’s syndrome, insomnia, anxiety, and for cancer patients who have difficulty tolerating the nausea and loss of appetite that typical cancer treatments frequently cause.7,21
This increased off-label use of Zyprexa was discovered to be a result of illegal marketing practices by the drugmaker who was sued for billions of dollars. But the practice goes on, as it is legal for a doctor to prescribe whatever they judge appropriate, whether it is FDA-approved or not.
Injectable Zyprexa Safety Signals
The long-acting injectable form of Zyprexa is sold under various other names, such as Relprevv and Zypadhera, The FDA has issued a safety warning on this form of Zyprexa for the potential of post-injection delirium and sedation syndrome (PDSS). These reported side effects resemble those of olanzapine overdose, and can occur days after injection. Two deaths were cited in the safety report some days after an injection of Zyprexa.
A person receiving injectable Zyprexa must be monitored at the place of treatment for 3 hours to ensure no major adverse effects occur, and must be driven back to their residence by someone.2,3
Did You Know about the Aspartame in Zyprexa?
The disintegrating oral tablet form of Zyprexa contains aspartame. Aspartame has generated much controversy since its coming to market advertised as a safe artificial sweetener.
However, since its release, studies have raised health concerns about regularly consuming aspartame, especially at high levels.
Safety concerns about aspartame include:
Neurotoxicity- Linked to liver damage and some cancers
- Disrupts insulin signalling
- Induces insulin resistance
- Disrupts the gut microbiome by increasing harmful bacteria and reducing good bacteria
- Elevates the risk of hypertension, heart disease, stroke, and diabetes
- Induces “leaky gut” allowing toxins to enter the bloodstream and cause inflammation
- Gastrointestinal discomfort
- Impaired glucose metabolism, causing increased deposits of fat leading to weight gain and obesity
Though the package insert describes aspartame as an “inert” ingredient, in light of the above concerns, that should be considered a questionable assertion.4,5
What Extrapyramidal Effects are Associated with Zyprexa?
Let’s define some terms. In medical jargon, pyramidal refers to the nerves associated with conscious control of movement. It’s called that because the part of the brain (medulla oblongata) that these nerves are connected to is triangular, shaped like a pyramid. Lifting your arm to drink your morning coffee is a pyramidal action. Bending down to pet your cat is a pyramidal action.
“Extra” here means outside of, or separate from. So extrapyramidal means outside of the nerves and fibers of the medulla. Extrapyramidal means those connecting nerves that reside within the brain stem. Antipsychotic medications cause these nerves and connecting muscles to induce abnormal involuntary movements. Examples of normal involuntary muscle movement include the beating of the heart, the lungs in respiration, and the movement of the muscles in the digestive tract and intestines.
Abnormal extrapyramidal movements mean involuntary movements, specifically if they are caused by antipsychotic or other medications. Sometimes these can be mild and short-lived. Sometimes they reverse on stopping the medication. And sometimes these conditions persist and worsen even when the medication has been stopped. Some of these side effects become irreversible.11,12
Examples of antipsychotic-induced extrapyramidal side effects:
- Tardive dyskinesia (repetitive or rhythmic muscle movements of the mouth, face, limbs, neck, which can occur in a single location or as a cluster)
- Dystonia (twisting or abnormal postures arising from involuntary muscle contractions)
- Jaw clenching
- Spasmodic or jerking motions
- Muscle stiffness, locked joints
- Rapid uncontrolled eye blinking
- Tongue rolling
- Cheek puffing
- Tics
- Convulsions
- Tremors
- Akathisia
Studies on drug-induced extrapyramidal side effects show that between 5.9% and 29% of patients taking antipsychotic medications will experience these types of side effects.6,10-12
Other Adverse Reactions of Concern: DRESS and NMS
What is DRESS?
DRESS is an acronym for Drug Reaction with Eosinophilia and Systemic Symptoms.
Eosinophils are immune cells, a type of white blood cell. Eosinophilia occurs when too many eosinophils (white blood cells) have started circulating in the blood. Because blood circulates throughout the body, many systems can be affected. In short, DRESS is an overstimulation of the immune system, which then starts attacking various systems in the body.
Drugs that can cause the reaction include antipsychotics, anticonvulsants, antibiotics, non-steroidal anti-inflammatories, and others.
The rate of DRESS associated with “atypical” antipsychotic medications was 9 times more than “typical” or first generation antipsychotics. Olanzapine is an atypical antipsychotic. One study found the average time it takes for DRESS to develop into visible symptoms is 42 days. The risk of DRESS was shown more likely if antipsychotics were taken at the same time as antibiotics, or if several antipsychotics were taken together.18,19
Symptoms of DRESS can include:
- Fever
- Higher than normal white blood cell count
- Rash
- Jaundice (yellowing skin)
- Swollen face
- Kidney and liver inflammation
- Liver necrosis (tissue death)
- Hepatitis
- Mucous membrane inflammation
- Other internal organ inflammation
- General malaise
- Enlarged lymph nodes
- Vomiting
- Chest pain
- Cough
- Trouble breathing
Though the severity of DRESS is very acute, the mortality rate is about 4%, especially when undiagnosed or untreated.
NMS — Neuroleptic Malignant Syndrome
Neuroleptic means a drug which alters or suppresses neurons and nerves. Neuro = nerves and neurons. Leptic is taken from the Greek “leptikos,” or to seize, capture. All antipsychotic drugs are classed as neuroleptics.
Malignant means injurious. Syndrome is a term used to describe a cluster of symptoms that are characteristic of a certain condition.
NMS is an antipsychotic-induced syndrome that typically develops within a few days or weeks of starting, stopping, switching to another antipsychotic drug, or after changing the drug dose. NMS mortality rate is estimated at about 6%. This condition is associated with any antipsychotic medication, or any medication that shuts down dopamine expression, and can occur at any dosage, but most cases occur at normal therapeutic doses. NMS can present more frequently when a person already suffers from some other acute health condition.20
Symptoms of NMS can include:
- Lead-pipe muscle stiffness
- Altered mental state, i.e., delusions, hallucinations, confusion, coma
- Sudden high fever
- Changing blood pressure
- Elevated heart rate
- Excessive sweating
- Rapid shallow breathing
With proper management in a hospital or ER setting most cases do recover completely.
Masking Symptoms vs Discovering & Addressing Root Causes
Holistic psychiatry has begun to implement strategies that rely less on medication to dampen symptoms of psychosis or mania or schizophrenia, opting for more drug-free approaches for relief.
ATMC has developed its program over the past nearly 2 decades so that these options are now available to persons looking for holistic treatment. First a thorough investigation must occur to pinpoint the causes for one’s symptoms. Then, a program can be designed to address these in a natural and therapeutic way.
One of the most frequent issues we find in testing is a toxic level of heavy metals and other intoxicants. These can be safely purged from the body, providing relief for insomnia, high levels of stress, and other unwanted symptoms. The science behind the process of detoxing is fascinating, which you can read more about on our holistic detox page.
Another pillar of inpatient treatment at ATMC is a complete overhaul of nutrition and diet. Again, testing helps determine what deficiencies or nutrients are out of balance that may need to be corrected. IV treatments can be life-changing in this regard as well.
Along with nutritional therapy, exercise is another proven pathway to recovering mental wellness naturally at ATMC, or indeed anywhere!. And counseling of a mild nature such as CBT has also proven successful in treating schizophrenia and a host of other problematic symptoms and conditions safely and gently, yet effectively.8,9,13-17
Where a person is already on a course of antipsychotics like Zyprexa, gentle tapering may be recommended to reduce the dosage, and in some cases can eliminate the drug entirely. This is a personalized treatment option that can only be determined on a case-by-case basis. Strong supports are put in place to ensure a gradual transition to less toxic methods can be successful and comfortable and are fully monitored by our medical staff.
Holistic Therapeutics at ATMC for Improving Mental Wellness
If a person is experiencing unwanted mental health symptoms, they may be looking for treatments that can help avoid harsh medication. And where antipsychotic medication resulted in side effects from long-term Zyprexa, or lowered quality of life, holistic inpatient treatment may be the option that can help you regain natural mental wellness. ATMC doesn’t treat “labels” but treats the whole person. A teamwork approach has been found most helpful, with joint meetings with care staff and clients to discuss progress, and provide feedback so that any adjustments needed can be made quickly and easily.
Please take time to review the broad range of the many holistic services provided at ATMC.
We urge you to give us a call or email us to arrange a personal consultation to discuss treatment options that may provide the type of help that you are seeking, whether for yourself or for a loved one. Call anytime 7 days a week for personal and professional help.
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