Olanzapine Alcohol

Olanzapine Alcohol Olanzapine is a second generation antipsychotic used to treat schizophrenia and mania related to bipolar disorder. Olanzapine binds neurotransmitter receptors of several classes including dopaminergic, adrenergic, and serotonergic receptors [249, 250]. 

A Phase II study was recently completed whereby Org-25935 was compared against placebo for the ability to improve negative symptoms in 246 subjects maintained on a stable dose of an atypical antipsychotic (data not disclosed) [46]. A second Phase II study in progress (200 patients) is designed to assess the efficacy of Org-25935 as a stand-alone therapy versus placebo, using olanzapine as the active control [46]. Org-25935 is also being investigated in separate Phase II studies as a treatment for panic disorder and for recidivism in subjects with alcohol dependence [46]. 

Recently, three papers have reported the determination of risperidone and its active metabolite 9-hydroxyrisperidone using LLE and SPE technologies. The analytical columns used to separate these compounds were C4 or C18 bonded phases of 3 pm or 5 pm particle sizes with UV/VIS detection. Mobile phases consisted of phosphate bufiers (pH 3-4) in acetonitrile. The sample volumes used ranged from 200 pi to 1 ml, with extraction recoveries averaging 90%. The limits of quantitation ranged from 0.5 to 10 ng/ml in human plasma (Nagasaki et al., 1999 Avenso et al., 2000 Titier et al., 2002). A study by Titier showed the simultaneous determination of clozapine, olanzapine, haloperidol, risperidone, and its active metabolites by RP-HPLC in human plasma. The assay involved LLE with a hexane/isoamyl alcohol mixture... 

Drugs that may be affected by SSRIs Drugs that may be affected by SSRIs include alcohol, benzodiazepines, beta blockers, buspirone, carbamazepine, cisapride, clozapine, cyclosporine, diltiazem, digoxin, haloperidol, hydantoins, lithium, methadone, mexiletine, nonsedating antihistamines, NSAIDs, olanzapine, phenothiazines, phenytoin, pimozide, procyclidine, ritonavir, ropivacaine, sumatriptan, sulfonylureas, sympathomimetics, tacrine, theophylline, tolbutamide, tricyclic antidepressants, and warfarin. 

Smoking cessation, with or without nicotine substitutes, may alter response to concomitant medication in ex-smokers. Smoking may affect alcohol, benzodiazepines, beta-adrenergic blockers, caffeine, clozapine, fluvoxamine, olanzapine, tacrine, theophylline, clorazepate, lidocaine (oral), estradiol, flecanide, imipramine, heparin, insulin, mexiletine, opioids, propranolol, catecholamines, and cortisol. 

In a randomized double-blind study there was weight gain in nine of 29 patients with alcohol dependence treated with olanzapine versus four of 31 taking placebo (886). 

Guardia J, Segura L, Gonzalvo B, Iglesias L, Roncero C, Cardus M, Casas M. A double-blind, placebo-controlled study of olanzapine in the treatment of alcohol-dependence disorder. Alcohol Clin Exp Res 2004 28 736-45. 

Olanzapine has been compared with placebo in different mental disorders, including the non-approved indications of psychotic depression, Alzheimer s disease, obsessive-compulsive disorder, and alcohol dependence. 

Snoddgrass PL, Labbate LA. Tardive dyskinesia from risperidone and olanzapine in an alcoholic man. Can J Psychiatry 1999 44(9) 921. 

Clinically important, potentially hazardous interactions with alcohol, cimetidine, CNS depressant, erythromycin, ethanol, ketoconazole, nefazodone, nelfinavir, olanzapine, rifampin, ritonavir, tricyclic antidepressants... 

DRD4 Dopamine receptor D4 Exon 3 VNTR Alcohol Olanzapine... 

Hutchison KE, Wooden A, Swiff RM, Smolen A, McGeary J, Adler L, Paris L (2003) Olanzapine reduces craving for alcohol a DRD4 VNTR polymorphism by pharmaco-therapyinteraction. Neuropsychopharmacology 28 1882-1888... 

Hutchison KE, Swiff R, Rohsenow DJ, Monti PM, Davidson D, Almeida A (2001) Olanzapine reduces urge to drink affer drinking cues and a priming dose of alcohol. Psychopharmacology (Berl) 155 27-34... 

For treatment-resistant patients who do not respond to SSRIs or TCAs, or to the combination of TCAs/SSRIs with benzodiazepines, other antidepressants have shown at least some beneficial effects in alleviating PD symptoms (e.g. mirtazapine, moclobemide, nefazodone, phenelzine, reboxetine, and venlafaxine). Other agents have also been reported to exert beneficial effects in PD, especially when combined with SSRIs/TCAs (lithium, pindolol, and propranolol). In cases where all treatments have failed, valproate or olanzapine should be considered.2 - ° In order to optimize treatment, patients should avoid or reduce the consumption of compounds that could potentially induce/exacerbate panic attacks (e.g. caffeine, alcohol, and nicotine) and should exercise regularly. i... 

Postural hypotension and possibly drowsiness may be increased when alcohol is given with olanzapine. 

The manufacturer says that patients taking olanzapine have shown an increased heart rate and accentuated postural hypotension when given a single-dose of alcohol. In a study, 9 of 11 subj ects experienced orthostatic hypotension when they drank alcohol one hour after taking olanzapine 10 mg7 No pharmacokinetic interaction has been seen. " In practical terms this means that patients should be warned of the risk of faintness and dizziness if they stand up quickly. The manufacturers also say that drowsiness is a common adverse effect of olanzapine, and they warn about taking other products that can cause CNS depression, including alcohol. The US manufacturer says that patients should not drink alcohol with olanzapine because of the potential drowsiness that would result. 

Higher medication doses can often be used in fit younger adults, e.g. haloperidol 5 mg, olanzapine 5 mg, lorazepam 1-2 mg. Take extra care with antipsychotics if you suspect a postictal state, or alcohol withdrawal, as they lower the seizure threshold. 

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