Antipsychotic drugs olanzapine

The atypical antipsychotic drug olanzapine is also metabolized by CYP1A2. 

The authors of the second case stated that, in spite of decades of experience with haloperidol, an associated literature search has revealed only very rare instances of hemotoxicity, and since lorazepam is not known to cause leukopenia, olanzapine may have been the more likely offender the simultaneous effect of both antipsychotic drugs, olanzapine and haloperidol, is unknown. 

Finally, of 192 patients who had remained symptomatically stable for at least 1 month with another major second-generation antipsychotic drug, olanzapine (mean age 38 years 63% men), 70% completed a 6-month study with injectable risperidone treatment-related adverse events were reported by 121 patients (63%), mostly anxiety (12%), exacerbation of disease (10%), insomnia (9%), depression (6%), and akathisia (5%) (231). 

Thiophene seems to be very popular in Li Lilly drugs. Its dual selective serotonin and norepinephrine reuptake inhibitor (SSNRI) for depression, duloxetine (Cymbalta), contains a thiophene. And its atypical antipsychotic drug olanzapine (Zyprexa) has a fused thiophene as its core structure. 

Systematic reviews Amisulpride and other atypical antipsychotic drugs (olanzapine, risperidone, and ziprasidone) have been compared in people with schizophrenia and schizophrenia-like psychoses in an analysis of 10 short- to medium-term trials with 1549 participants [56 ]. The overall attrition rate was considerable (35%), with no significant difference between the groups. Amisulpride was as effective as olanzapine and risperidone and more effective than ziprasidone. Amisulpride caused less weight gain than risperidone and olanzapine. Olanzapine was associated with a greater rise in blood glucose. There were no differences in cardiac and extrapyrami-dal reactions. 

On the contrary, JNJ-37822681 (230) is a D2 highly selective receptor antagonist and hence acts in a mode analogous to that of most marketed antipsychotics [212], JNJ-37822681 is characterized by a rapid dissociation rate from the dopamine D2 receptor, which was hypothesized to confer antipsychotic efficacy and improved tolerability [213]. Clinical studies in patients with an acute exacerbation of schizophrenia showed that JNJ-37822681 had similar biological activity but lesser tendency to induce weight gain compared to a known antipsychotic drug. Olanzapine (242) [214] (Fig. 8). 

A search of Medline, EMBASE and PsycLIT was conducted in August 2000, using the following terms Amisulpride, clozapine, olanzapine, risperidone, sertindole, zotepine, ziprasidone, economics, healthcare, costs. All manufacturers of atypical antipsychotic drugs were contacted in April 2000 and asked to supply primary reference data on their product, and all companies had complied with this request by August 2000. A further manual search was conducted of files and journals kept in the National Centre for Information on Psychotropics at the Maudsley Hospital. Reference sections from all retrieved papers were scrutinized for further relevant references. 

Conventional antipsychotic drugs such as chlorpromazine and haloperidol have long been used in the treatment of acute mania. More recently, atypical antipsychotic drugs including aripiprazole, olanzapine, quetiapine, risperidone, and ziprasi-done have been approved for the treatment of bipolar mania or mixed mood episodes as monotherapy or in combination with mood-stabilizing drugs.25 Aripiprazole and olanzapine are also approved for maintenance therapy. The combination of olanzapine and fluoxetine is approved for treatment of bipolar depression. Quetiapine is approved for treatment of... 

Lee, C. et al. (2006). Treatment with olanzapine, risperidone or typical antipsychotic drugs in Asian patients with schizophrenia. Aust. N. Z. J. Psychiatry, 40, 437-45. 

Nevertheless, some atypical antipsychotic drugs, such as clozapine and olanzapine, have been linked to substantial weight gain, hyperlipidemia and type II diabetes, a new range of medically serious side-effects. 

Description Zeprexa (olanzapine) is an antipsychotic drug. The chemical formula is 2-methyl-4(4-methyl-l-piperazinyl)10H-thieno[-2-3-b][l,5] benzodiazepine. The molecular weight is 312.44Da. 

Another serious side effect of clozapine is a risk of seizures. This mainly occurs at higher doses of the drug, and having a seizure is not necessarily a sufficient reason to stop clozapine permanently. If the clozapine has been especially helpful, an anticonvulsant can be added to protect against further seizures. Valproate (Depakote) may be best in this regard because it not only provides protection from seizures but also may help to relieve some of the symptoms of schizophrenia. Recently, it has become clear that two atypical antipsychotic drugs, clozapine and olanzapine, are associated with an increased risk for the development of type II diabetes. 

Clozapine and olanzapine are atypical antipsychotic drugs used in the treatment of schizophrenia. Their strnctnres are depicted in Scheme 2.36. The use of clozapine and olanzapine, which are more effective than standard neuroleptic drugs in the treatment of refractory schizophrenia, is, however, limited becanse of their adverse effects. These adverse effects are ascribed to the formation of the corresponding cation-radicals in living organisms under oxidation by bone marrow cells. These cation-radicals eliminate protons from the NH fragments and generate their nitrenium cations. The nitreninm cations are covalently bonnd to the life-important proteins. This results in the toxic effects of clozapine and olanzapine (Sikora et al. 2007). 

Tardive dyskinesia refers to uncontrollable facial movements. It is more likely to occur in the elderly. Tardive dyskinesia is commonly associated with the use of antipsychotic drugs, such as haloperidol. The atypical antipsychotics, such as clozapine, olanzapine, risperidone and quetiapine are less likely to cause tardive dyskinesia. 

Prochlorperazine is a potent phenothiazine antipsychotic drug that is associated with a high risk of extrapyramidal side-effects, a low degree of sedation and of antimuscarinic side-effects. Chlorpromazine is less likely to induce extrapyramidal side-effects but has increased risks of inducing sedation and antimuscarinic side-effects. Olanzapine is classified as an atypical antipsychotic having characteristically much fewer incidences of extrapyramidal... 

Wilton LV, Heeley El, Pickering RM, et al. Comparative study of mortahty rates and cardiac dysrhythmias in post-marketing surveillance studies of sertindole and two other atypical antipsychotic drugs, risperidone and olanzapine. J Psychophar-macol 2001 15 120-6. 

Gl dysmotility Esophageal dysmotility and aspiration have been associated with antipsychotic drug use. Use quetiapine, ziprasidone, risperidone, olanzapine, aripiprazole, and others cautiously in patients at risk for aspiration pneumonia. Hypersensitivity reactions Patients who have demonstrated a hypersensitivity reaction (eg, blood dyscrasias, jaundice) with a phenothiazine should not be re-exposed to any phenothiazine unless the potential benefits of treatment outweigh the possible hazards. 

Antipsychotic drugs with strong sedative clinical effects (e.g. chlorpromazine. clozapine, olanzapine) produce subjective and objective sedation and impair most areas of performance in healthy volunteers, usually at doses far below those typically used in patients. Antipsychotic drugs with little sedative clinical action (e.g. pimozide, sulpiride, amisulpride) produce few subjective and objective effects in healthy... 

D2 receptor, albeit with different specificity. Older examples of dopamine antagonists are chlorpromazine, haloperidol and many derivatives of these prototype compounds. Newer antipsychotic drugs such as risperidone, olanzapine and quetiapine have retained this mechanism of action, although no longer exclusively. 

Fuller RW, Snoddy HD. Neuroendocrine evidence for antagonism of serotonin and dopamine receptors by olanzapine (LY170053), an antipsychotic drug candidate. Res Commun Chem Pathol Pharm 1992 77 87-93. 

Recently, a large study in the USA (CATIE) reported that perphenazine was as effective as atypical antipsychotic drugs, with the modest exception of olanzapine, and concluded that typical antipsychotic drugs are the treatment of choice for schizophrenia based on their lower cost. However, this study did not adequately consider the risk of tardivedyskinesia or the treatment history of patients in the design of this study. 

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