Depression Symptoms Treatment

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Olanzapine is authorised in the world under the following brand names: Olansek, Symbyax, Zydis, Zyprexa, Zyprexa Intramuscular, Zyprexa Zydis.

Introduction

Bipolar disorder is a lifelong psychiatric disorder that features mood swings between mania and depression, and afflicts some 4 million Americans. Although lithium, valproate, carbamazepine, and antipsychotics have been prescribed to treat the disorder, many patients do not respond to these treatments or stop taking them due to unwanted side effects. Now there is another drug available for these patients: Eli Lilly received FDA approval to market Zyprexa (olanzapine) – a drug originally approved for schizophrenia – for the treatment of manic depression.

How It Works

Zyprexa is an antipsychotic drug. Although the exact mechanism of action is unknown, it is proposed that the drug’s activity is mediated through a combination of dopamine and serotonin type 2 (5-HT2) antagonism, as well as antagonism at other receptors with similar affinities.

Zyprexa (olanzapine): Clinical Study Results

A randomized, double-blind, placebo-controlled study was conducted over a 3-week period in patients with acute mania. Clinical response was compared between 70 patients who received 10 mg Zyprexa once daily and 69 patients who received placebo. After the first day of treatment, the Zyprexa dose was adjusted upward or downward, as clinically indicated, by one capsule, within the permitted range of one to four capsules. Clinical response was defined as a decrease of 50% or more in the Young Mania Rating Scale total score, from baseline to endpoint. At the end of the study period, significantly more patients taking Zyprexa (48.6%) showed clinical improvement than those taking placebo (24.2%). Although somnolence, dry mouth, dizziness and weight gain occurred more often with Zyprexa than with placebo, no patients discontinued treatment due to these side effects.

What the Patient Should Know

As with other antipsychotic drugs, Zyprexa (olanzapine) is associated with several side effects. Since orthostatic hypotension has been reported with Zyprexa, patients who experience this effect should be advised to avoid standing up too quickly. Because somnolence and dizziness have been associated with Zyprexa, patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that they will not experience these effects. Patients should not breast-feed during Zyprexa treatment and should inform their physicians if they become pregnant while on the treatment. They should also avoid alcohol and tell their physicians if they are taking other medications, since Zyprexa may interact with other drugs (for example, it may potentiate the effect of antihypertensive drugs and antagonize those of levodopa and dopamine agonists). Since Zyprexa may elevate transaminase levels, it should be used with caution in patients with hepatic impairment. Patients with a history of seizures should tell their physicians, since Zyprexa may increase the risk of seizures. Other side effects associated with Zyprexa (olanzapine) include restlessness, constipation, dry mouth, and weight gain.