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ZYPREXA

ZYPREXA
Zyprexa

DESCRIPTION / DEFINITIONS: Zyprexa® (olanzapine) is a atypical antipsychotic. Zyprexa is a drug prescribed for the treatment of schizophrenia and the treatment of bipolar depression and mania.

ADDICTION / DEPENDENCE: Half life and metabolism, Black Box Warning.

SIDE EFFECTS: Death, hostility, diabetes, panic attacks, paralysis (see list below).

WITHDRAWAL SYMPTOMS: Insomnia, symptoms of schizophrenia (such as hallucinations or delusions), bipolar disorder symptoms (such as mania or depression).

TREATMENT: Medical detoxification.

DESCRIPTION / DEFINITIONS

Zyprexa (olanzapine) is prescribed for the treatment of schizophrenia, bipolar depression and mania. According to its label, “The mechanism of action of olanzapine, as with other drugs having efficacy in schizophrenia, is unknown. However, it has been proposed that this drug’s efficacy in schizophrenia is mediated through a combination of dopamine and serotonin type 2 (5HT2) antagonism. The mechanism of action of olanzapine in the treatment of acute manic episodes associated with Bipolar I Disorder is unknown.”

ADDICTION / DEPENDENCE

HALF LIFE AND METABOLISM

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of Zyprexa is between 21 and 54 hours.

Zyprexa is mainly metabolized through the P450 pathway in the liver and the enzymes primarily handling the metabolism is CYP1A2 and CYP2D6.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

BLACK BOX WARNING

The Food and Drug Administration (FDA) has decided that some drugs pose very serious risks and have required these drugs have what is called a black box warning. Zyprexa has a black box warning. Here is the warning.

WARNING

Increased Mortality in Elderly Patients with Dementia–Related Psychosis — Elderly patients with dementia–related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. Analyses of seventeen placebo–controlled trials (modal duration of 10 weeks) in these patients revealed a risk of death in the drug–treated patients of between 1.6 to 1.7 times that seen in placebo–treated patients. Over the course of a typical 10–week controlled trial, the rate of death in drug–treated patients was about 4.5%, compared to a rate of about 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. ZYPREXA (olanzapine) is not approved for the treatment of patients with dementia–related psychosis (see WARNINGS).

SIDE EFFECTS

The following information is taken from the Seroquel label:

  • abdomen enlarged

  • abnormal dreams

  • abnormal ejaculation

  • abnormal gait

  • abnormal vision

  • abnormality of accommodation

  • acidosis

  • acne

  • akathisia

  • akinesia

  • albuminuria

  • alcohol misuse

  • alkaline phosphatase increased

  • alopecia

  • amblyopia

  • amenorrhea

  • amnesia

  • anemia

  • antisocial reaction

  • apathy

  • aphthous stomatitis

  • apnea

  • arteritis

  • arthritis

  • arthrosis

  • articulation impairment

  • asthenia

  • asthma

  • ataxia

  • atelectasis

  • atrial fibrillation

  • back pain

  • bilirubinemia

  • blepharitis

  • bone pain

  • bradycardia

  • breast enlargement

  • breast pain

  • bursitis

  • cataract

  • cerebrovascular accident

  • chills

  • circumoral paresthesia

  • cns stimulation

  • cogwheel rigidity

  • coma

  • confusion

  • congestive heart failure

  • conjunctivitis

  • constipation

  • contact dermatitis

  • corneal lesion

  • cough increased

  • cyanosis

  • cystitis

  • deafness

  • decreased menstruation

  • dehydration

  • delirium

  • delusions

  • dementia

  • dental pain

  • depersonalization

  • depression

  • diabetes mellitus

  • diabetic acidosis

  • diplopia

  • dizziness

  • dry eyes

  • dry mouth

  • dry skin

  • dysarthria

  • dysmenorrheal

  • dysphagia

  • dyspnea

  • dysuria

  • ear pain

  • eczema

  • emotional lability

  • encephalopathy

  • enteritis

  • epistaxis

  • eructation

  • esophageal ulcer

  • esophagitis

  • euphoria
  • eye hemorrhage

  • eye inflammation

  • eye pain

  • face edema

  • facial paralysis

  • fatalities

  • fecal impaction

  • fecal incontinence

  • female lactation

  • fever

  • flatulence

  • flu syndrome

  • gastritis

  • gastroenteritis

  • gingivitis

  • glaucoma

  • glossitis

  • glycosuria

  • goiter

  • gout

  • gynecomastia

  • hangover effect

  • heart arrest

  • heart failure

  • hematuria

  • hemoptysis

  • hemorrhage

  • hepatitis

  • hiccup

  • hirsutism

  • hypercholesteremia

  • hyperglycemia

  • hyperkalemia

  • hyperlipemia

  • hypernatremia

  • hyperprolactinemia

  • hypertonia

  • hyperuricemia

  • hyperventilation

  • hypesthesia

  • hypoglycemia

  • hypokalemia

  • hypokinesia

  • hyponatremia

  • hypoproteinemia

  • hypotension

  • hypotonia

  • hypoventilation

  • hypoxia

  • ileus

  • impotence

  • incoordination

  • increased appetite

  • increased menstruation

  • increased salivation

  • insomnia

  • intentional injury

  • intestinal obstruction

  • joint stiffness

  • keratoconjunctivitis

  • ketosis

  • laryngitis

  • leg cramps

  • leukocytosis

  • leukopenia

  • libido decreased

  • libido increased

  • liver fatty deposit

  • lower extremity edema

  • lung edema

  • lymphadenopathy

  • macular hypopigmentation

  • maculopapular rash

  • malaise

  • manic reaction

  • mastitis

  • melena

  • menorrhagia

  • metrorrhagia

  • migraine

  • miosis

  • moniliasis

  • mouth ulceration

  • myasthenia

  • mydriasis

  • myopathy
  • nausea

  • neck pain

  • neck rigidity

  • neuralgia

  • neuroleptic malignant syndrome (nms)

  • neuropathy

  • normocytic anemia

  • nystagmus

  • obsessive compulsive symptoms

  • ocular muscle abnormality

  • oliguria

  • oral moniliasis

  • osteoporosis

  • pallor

  • palpitation

  • paralysis

  • paresthesia

  • pelvic pain

  • periodontal abscess

  • personality disorder

  • pharyngitis

  • phobias

  • photosensitivity reaction

  • pigment deposits lens

  • polyuria

  • postural hypotension

  • premenstrual syndrome

  • pruritus

  • pulmonary embolus

  • pustular rash

  • pyuria

  • rectal hemorrhage

  • rheumatoid arthritis

  • rhinitis

  • schizophrenic reaction

  • seborrhea

  • seizures

  • skin discoloration

  • skin ulcer

  • somatization

  • somnolence

  • speech disorder

  • stimulant misuse

  • stomatitis

  • stridor

  • stroke

  • stupor

  • stuttering

  • subarachnoid hemorrhage

  • sudden death

  • suicide attempt

  • sweating

  • tardive dyskinesia

  • taste perversion

  • thirst

  • thrombocythemia

  • thrombocytopenia

  • tinnitus

  • tobacco misuse

  • tongue discoloration

  • tongue edema

  • tooth caries

  • transient ischemic attack

  • tremor

  • twitching

  • upper extremity edema

  • urinary frequency

  • urinary incontinence

  • urinary retention

  • urinary tract infection

  • urinary urgency

  • urination impaired

  • urticaria

  • uterine fibroids enlarged

  • vaginal hemorrhage

  • vaginitis

  • vasodilatation

  • ventricular extrasystoles

  • vertigo

  • vesiculobullous rash

  • voice alteration

  • vomiting

  • water intoxication

  • weight gain

  • withdrawal syndrome

WITHDRAWAL SYMPTOMS

Zyprexa can be a very difficult drug to stop taking.

  • agitation

  • anorexia

  • anxiety

  • bipolar disorder symptoms

  • diarrhea
  • emesis (vomiting)

  • insomnia

  • itching

  • muscle pain

  • nausea
  • restlessness

  • rhinorrhoea (runny nose)

  • sweating

  • symptoms of schizophrenia

TREATMENT

Withdrawal from Zyprexa should only be done under the care of a health practitioner. The safest way is to withdraw at an inpatient medical detox facility. At an inpatient medical detox facility with a protocol that includes hydration, vitamins and supplements, most patients can safely stop taking Zyprexa in about seven days. Patients can withdraw from Zyprexa on an outpatient basis but it will normally take at least four weeks.
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