9 Olanzapine Side Effects You Should Know About
Key takeaways:
Olanzapine (Zyprexa) is an atypical antipsychotic medication that’s FDA-approved to treat bipolar disorder and schizophrenia.
Some of olanzapine’s most common side effects are drowsiness, constipation, and dry mouth. Weight gain is also a frequent complaint.
More serious side effects can also occur. If you notice symptoms like movement problems or abnormal changes in mood or behavior, contact your healthcare provider right away.
Throughout life, it’s important to seek treatment for you or a loved one’s mental health when it’s needed. Many health conditions, life events, and other stressors can all take a toll on our well-being, leading us to seek advice from health experts.
Self-care techniques, support groups, therapy, and other non-medication-based interventions are preferred ways to manage our symptoms when possible. They’re often free — or side effect free — ways to make progress toward our health goals. But in many cases, medication is a necessary way to improve the situation that’s complicating our lives.
When it comes to treating health conditions like bipolar disorder, schizophrenia, or even chemotherapy-induced nausea and vomiting, olanzapine (Zyprexa) is a common resource. And while it’s a useful medication, it has several risks and side effects to be aware of. Read more like this
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What is olanzapine?
Olanzapine is a once-daily oral medication that’s FDA-approved to treat bipolar disorder and schizophrenia in people ages 13 and older. It’s a type of atypical antipsychotic that comes in several forms:
A traditional tablet (Zyprexa)
A fast-acting, as-needed injection (Zyprexa)
A tablet that dissolves on your tongue (Zyprexa Zydis)
A long-lasting injection that’s dosed every 2 to 4 weeks (Zyprexa Relprevv)
A combination pill that contains olanzapine and fluoxetine (Symbyax)
A combination pill that contains olanzapine and samidorphan (Lybalvi)
How does olanzapine work for schizophrenia and bipolar disorder?
As mentioned, olanzapine is an atypical antipsychotic, also known as a “second generation” antipsychotic.
The exact way olanzapine works to promote healthy thought and behavior changes isn’t proven. But it’s thought to do so by balancing dopamine and serotonin levels in your brain. Changes in these hormone levels are thought to play a key role in bipolar disorder and schizophrenia.
9 side effects of olanzapine (and when to seek help)
Many of olanzapine’s side effects are mild and/or manageable, but others can be more severe. Some are also life-threatening in certain situations, so some people should avoid olanzapine altogether. For instance, older adults with dementia-related psychosis shouldn’t take olanzapine — it can cause severe brain-related side effects and a higher risk of death.
Otherwise, if you or a loved one are new to olanzapine, it’s helpful to know what to expect. This isn’t an exhaustive list, but here are nine key side effects to keep in mind while taking oral olanzapine.
1. Feeling more or less sleepy than normal
There’s a chance that olanzapine may interfere with your sleep schedule. But the specific way it does so varies for everyone.
Drowsiness (or sleepiness) is one of olanzapine’s most common side effects. This can also have an affect on your mental alertness or judgment. But on the other end of the spectrum, insomnia is another common side effect.
If you feel tired after taking olanzapine, ask your healthcare provider about taking olanzapine around bedtime. And if you think olanzapine is contributing to a late night under the covers, ask them if it’s better to take your daily dose soon after waking up. Drowsiness also appears to be dose-related, so you could ask them if a lower olanzapine dose may be better.
2. Constipation
Medications like olanzapine have anticholinergic properties, meaning they can have a “drying” effect throughout your body. Constipation is one possible outcome of this.
If you develop constipation from olanzapine, certain dietary changes can help. Try to drink more water or eat foods that are high in fiber, such as whole grains, fruits, and vegetables. When needed, several over-the-counter medications for constipation are also available to consider.
3. Dry mouth
Many medications can cause dry mouth, including olanzapine. This is likely due to its anticholinergic nature.
There are many ways you can try to treat dry mouth on your own. Drinking more water or improving salivation by sucking on ice chips, rinsing with cold water, or chewing sugarless gum can all help. But you could also ask your healthcare provider about saliva substitutes or possibly lowering your olanzapine dose, as dry mouth is more likely to happen with higher doses.
4. Headache or dizziness
Headache and dizziness are also common side effects of olanzapine. If you experience them, they should get better as your body gets used to the medication. But if they don’t go away or get worse at any point, contact your healthcare provider for guidance.
5. Weight gain (alongside higher cholesterol and blood sugar)
Olanzapine can cause metabolic changes, meaning it can worsen your blood sugar and cholesterol levels. It can also lead to a bigger appetite than normal. These can come together to contribute to weight gain.
This can become problematic, so your healthcare provider will likely monitor your blood sugar while you’re taking olanzapine, especially if you’re living with diabetes. They should also monitor your cholesterol levels and body weight over time.
Lifestyle changes, like diet and exercise, can help combat this. But if these changes become bothersome or severe, talk to your healthcare provider. They may switch you to another medication.
6. High prolactin levels
In a complex way, olanzapine can raise prolactin levels. It does this by the way it impacts dopamine. Prolactin is a natural hormone that’s found in our bodies, but too much of it can lead to side effects.
Common side effects of too much prolactin include a lower sex drive, menstrual irregularities, and mood changes. Gynecomastia (male breast development), nipple discharge, and fertility problems are also possible.
Olanzapine’s effect on prolactin doesn’t appear to get better the longer you take olanzapine, so let your healthcare provider know if any of these symptoms are affecting you. They could change your medication routine or offer others ways to help manage these symptoms.
7. Movement problems
Olanzapine can impact your body movements. It most often leads to shakiness or inability to sit still, but more serious risks are also possible.
Although rare, olanzapine may cause tardive dyskinesia (TD). TD can cause uncontrollable muscle movements, mostly of the face and tongue. Neuroleptic malignant syndrome is also possible, and it can be life-threatening. It can cause rigid muscles, fever, and confusion.
If you notice any signs of unusual body movements, let your healthcare provider know as soon as you can. These symptoms can be hard to get rid of — especially if left untreated — so they may tell you to stop taking olanzapine. But if your symptoms feel severe, it’s better to seek medical attention right away.
8. Behavioral changes
It’s possible to experience changes in mood or behavior while taking olanzapine. Some of this is intended — olanzapine aims to promote positive behavioral changes by the way it works. But some of these changes can be unintentional or negative.
It’s possible to experience new or worsening depression, especially within the first few months of starting olanzapine. Thoughts of suicide have also been reported. If you develop any feelings like these, make sure to contact your healthcare provider right away. You could also call 988 for immediate support.
9. Serious skin rashes
Although very rare, olanzapine can cause serious skin rashes. It’s been linked to a condition called drug reaction with eosinophilia and systemic symptoms (DRESS). This typically starts as a rash, but it can cause fever and swelling throughout your body. If left untreated, DRESS can lead to organ damage and become fatal.
Because of this, if you develop a fever with symptoms like a rash, facial swelling, or swollen lymph nodes, seek medical help right away.
When should I contact my healthcare provider about side effects from olanzapine?
If you notice any serious side effects — such as movement problems, changes in mood or behavior, or substantial weight gain — make sure to contact your healthcare provider. You should also contact them for any other side effects that are bothersome or don’t go away.
However, if your symptoms are accompanied by confusion, a high fever, facial swelling, or anything that feels severe, it’s better to seek medical attention as soon as you can.
The bottom line
Olanzapine
is a prescription medication that treats bipolar disorder and
schizophrenia. There are many side effects to keep in mind while taking
olanzapine. Common ones are drowsiness, dry mouth, and constipation. But
in many cases, there are different approaches to managing side effects.
It’s important to let your healthcare provider know about any
olanzapine side effects that you experience.
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