Olanzapine effects

Thienobenzodiazepine Olanzapine Effective against negative as well as positive symptoms little or no extrapyramidal system dysfunction Weight gain dose-related lowering of seizure threshold... 

Gessa GL, Devoto P, Diana M, Flore G, Melis M, et al. 2000. Dissociation of haloperidol, clozapine, and olanzapine effects on electrical activity of mesocortical dopamine neurons and dopamine release in the prefrontal cortex. Neuropsychopharmacology 22 642-649. 

Rosenheck R, Perlick D, Bingham S, Liu-Mares W, Collins J, Warren S, Leslie D, Allan E, Campbell EC, Caroff S, Corwin J, Davis L, Douyon R, Dunn L, Evans D, Frecska E, Grabowski J, Graeber D, Herz L, Kwon K, Lawson W, Mena F, Sheikh J, Smelson D, Smith-Gamble V, for the Department of Veterans Affairs Cooperative Study Group on the Cost-Effectiveness of Olanzapine. Effectiveness and cost of olanzapine and haloperidol in the treatment of schizophrenia. A randomized controlled trial. JAMA 2003 290 2693-702. 

Olanzapine suggested to be more cost-effective Five-year predictions based on... 

Side Effect Clozapine Risperidone Olanzapine Quetiapine Ziprasidone Aripiprazole Haloperidol... 

Current or past anti-cholinergic side effects Risperidone, quetiapine, aripiprazole ziprasidone Olanzapine (low dose)... 

These differences may become particularly germane if co-prescribing with some antipsychotics is undertaken. For example, in certain individuals, combinations of clozapine with benzodiazepines may lead to unexpected adverse events, including delirium and augmented respiratory depression (Jackson, Markowitz Brewer-ton, 1995 Grohmann et al, 1989). Presumably if there are additive or synergistic effects of ethnicity on clearance of one or both substances, adverse events may be enhanced. Similar interactions are theoretically possible with olanzapine, as adverse interactions have been described between olanzapine and benzodiazepines, at least in the elderly (Kryzhanovskaya etal, 2006). 

An, B. F., Zhang, M. L. Qi, S. G. (2006). Comparative study between the effect of olanzapine and quetiapine in first-episode schizophrenia. Chinese Journal of Clinical Psychiatry, 16(2), 84-5. 

Kong, Q. M., Si, T. M. 8c Shu, L. (2003). The effects of olanzapine on body weight liver functions blood sugar and cholesterol level. Chinese Journal of New Drugs, 12( 10), 847-9. 

Stroup, T. S., Lieberman, J. A., McEvoy, J. P. et al. (2006). Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. Am. J. Psychiatry, 163, 611-22. 

The answer is c. (Katzung, pp 485-486.) In addition to its antipsychotic action, olanzapine diminishes emotional bluntness and social withdrawl that are seen in schizophrenic patients, without significant anticholinergic and extrapy rami dal effects. 

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. 

Ari pi prazole, olanzapine, quetiapine, risperidone, and ziprasidone are effective as monotherapy or as add-on therapy to lithium or valproate for acute mania. Prophylactic use of antipsychotics can be needed for some patients with recurrent mania or mixed states, but the risks versus benefits must be weighed in view of long-term side effects (e.g., obesity, type 2 diabetes, hyperlipidemia, hyperprolactinemia, cardiac disease, and tardive dyskinesia). 

Valproate is as effective as lithium and olanzapine for pure mania, and it can be more effective than lithium for rapid cycling, mixed states, and bipolar disorder with substance abuse. It reduces the frequency of recurrent manic, depressive, and mixed episodes. 

Alternatively, the current antidepressant may be augmented (potentiated) by the addition of another agent (e.g., lithium, T3), or an atypical antipsychotic (e.g., risperidone). Risperidone has been shown to be effective in combination with fluvoxamine, paroxetine, or citalopram in treatment-resistant depression. Olanzapine and fluoxetine have been found to be safe and effective in treatment-resistant depression. 

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