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Olanzapine
๐ About
Always check the BNF link here or equivalent for up-to-date prescribing advice.
- ๐ Olanzapine is an atypical antipsychotic (second-generation).
- Used in schizophrenia, mania, and bipolar affective disorder.
- โ ๏ธ Avoid use in elderly patients with dementia-related psychosis due to โ mortality risk.
โ๏ธ Mode of Action
- Blocks Dโ receptors (reduces positive symptoms of schizophrenia).
- Blocks 5-HTโ receptors (helps with negative symptoms, fewer EPS).
- Also has antihistamine, ฮฑ-adrenergic blocking, and anticholinergic activity โ sedation, weight gain, constipation, hypotension.
- โฌ๏ธ Elevates prolactin (less than risperidone, but possible).
๐ Indications
- ๐ง Schizophrenia (acute & maintenance).
- ๐ Mania and bipolar disorder (acute mania, relapse prevention).
- ๐งพ May be used in combination with fluoxetine for treatment-resistant depression (specialist use).
๐ Dose (start low in elderly, avoid with other sedatives)
| Indication | Starting Dose | Target Dose | Route |
|---|---|---|---|
| Schizophrenia | 2.5โ10 mg OD | ~10 mg OD (titrate as needed) | PO |
| Acute Agitation | 2.5โ10 mg | As required | PO (dispersible) / IM |
๐ก IM olanzapine: do not combine with parenteral benzodiazepines โ risk of severe respiratory depression.
๐ Interactions
- โ Levels with ciprofloxacin (CYP1A2 inhibitor).
- Caution with fluoxetine (combined metaboli
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