Olanzapine withdrawal from

Each of the analyses reported outcomes for patients responding to and continuing treatment after the original 6-week clinical trial that is, after the exclusion of patients withdrawing from the original trial for whatever reason (e.g. poor tolerability, lack of response). This probably introduced bias in favour of haloperidol, since there were significantly more responders to olanzapine. 

Nonetheless, some studies continue to crop up, and concerns continue to be expressed. Llorca et al. (2001) described a case of supersensitivity psychosis following abrupt olanzapine withdrawal. Lu et al. (2002) reported two cases of older patients who developed hallucinations and delusions following withdrawal from metoclopramide (Reglan). 

In a 3-week double-blind study patients with mild to moderate mania were randomized to divalproex (n = 201 500-2500 mg/ day), olanzapine (n = 205 5-20 mg/day), or placebo (n = 105) [343 ]. Those who completed the first part of the study continued with a 9-week double-blind extension. Olanzapine was significantly more efficacious than placebo at 3 weeks and significantly more efficacious than divalproex at 12 weeks. Adverse effects caused withdrawal from the study in 13% (28/215) of those who took olanzapine and 9.5% (19/ 201) of those who took divalproex. Significantly more of those who took olanzapine reported weight increase and somnolence compared with divalproex or placebo. Significantly more of those who took divalproex reported nausea and insomnia compared with olanzapine. Those who took... 

Risperidone and olanzapine have been widely used in patients with dementia exhibiting behavioural problems. Following the withdrawal of thioridazine from the market, old age psychiatrists and GPs were increasingly atypical antipsychotics, in particular risperidone as it was the only atypical which had been examined in randomised clinical trials (RCTs) with the elderly. In 2004, the advised that both risperidone... 

Melkersson K, Hulting AL. Recovery from new-onset diabetes in a schizophrenic man after withdrawal of olanzapine. Psychosomatics 2002 43(l) 67-70. 

Furthermore, at the times they were being evaluated, the patients continued to take the olanzapine, which, like all neuroleptics, suppresses the appearance of TD symptoms while at the same time causing or worsening the underlying disorder (see subsequent section). Therefore, the only way to determine an accurate rate of TD is to withdraw the patients from the offending drug before the final evaluation. In this study, the actual rate of TD would have been much higher than 3% per year if the patients had been withdrawn from the olanzapine before the final TD evaluation. 

This infant s symptoms were similar to those described in other neonates whose mothers took SSRIs shortly before delivery, although in this case a contributory effect from olanzapine was also possible. The authors made the point that it can be difficult to decide from the clinical presentation whether neonatal problems, such as those described above, represent SSRI withdrawal (5HT deficiency) or SSRI toxicity (5HT excess). The fact that no paroxetine was detected in the infant s plasma led them to conclude that SSRI withdrawal was responsible for the symptoms in this case. 

A 65-year-old man who had had primary insomnia for 20 years, was given olanzapine 2.5 mg/day at nighttime because of lack of response to various anxiolytics he developed fecal incontinence during the 20 days of olanzapine treatment in combination with two anxiolytic drugs. The frequency of incontinence varied from 1 to 3 times a day, and withdrawal of olanzapine resulted in complete recovery. 

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