Olanzapine, an antipsychotic drug used for dementia.


Olanzapine (Zyprexa) belongs to a newer group of antipsychotics called atypical antipsychotics. These types of drugs are considered better options for people with Alzheimer's than older antipsychotic drugs. However, Zyprexa is not approved by the US Food and Drug Administration for the treatment of psychosis in older adults with dementia .

Olanzapine belongs to the category of psychotropic drugs : drugs that affect consciousness. Antipsychotic drugs are psychotropic drugs that treat symptoms of schizophrenia such as hallucinations , paranoia, and delusions .

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What are atypical antipsychotics?

Atypical antipsychotics are named to distinguish between these newer antipsychotics and other traditional antipsychotics such as chlorpromazine (thorazine, ormazine) and haloperidol (galdol). Atypical antipsychotic drugs were first introduced in the 1980s. Zyprexa was approved by the Food and Drug Administration (FDA) in 1996 .

Atypical antipsychotic drugs have several clear differences and are marketed as drugs with fewer serious neurological side effects, such as extrapyramidal symptoms and low rates of tardive dyskinesia. Atypical antipsychotics are approved for the treatment of schizophrenia, but they are also prescribed for people with bipolar disorder and for the treatment of agitation and psychosis in dementia .

Zyprexa side effects

Common side effects include:

  • Cold or cough
  • Diarrhea
  • Dizziness
  • Drowsiness or excessive sedation
  • Dry mouth
  • Increased appetite or weight gain.
  • Nausea or vomiting

The most serious neurological side effects include:

  • Extrapyramidal symptoms : tremor, dystonia, parkinsonism, akinesia (loss of voluntary movements), akathisia (anxiety, agitation).
  • Tardive dyskinesia: involuntary movements of the mouth, tongue, face, trunk and extremities. The risk increases with prolonged use.

Zyprexa administration options

Zyprexa tablets are available as tablets once daily in doses of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, and 20 mg. The medicine can be taken with or without food. A regular blood check is not required.

Zyprexa is also available as a buccal solution in doses of 5, 10, 15 and 20 mg, as well as intramuscular injection (injection).

Be sure to read the prescription instructions carefully. Ask your pharmacist or doctor about anything you are not sure about.

Alert for Zyprex and people with dementia

People with dementia who take antipsychotic medications, including Zyprexa, are at increased risk of sudden death. Studies have shown that most of these deaths were due to cardiovascular disease (heart failure) or infections (pneumonia). However, prescribing these drugs may be appropriate for patients who are dangerous to themselves or others and who are deeply disturbed .

Although Zyprexa is not approved for the treatment of older people with dementia-associated psychosis, it is sometimes prescribed off-label (not FDA approved) to reduce severe behavior problems or psychosis. If antipsychotic medications are used in this situation, then this should be done after trying other non-drug approaches and after confirming that the behavior is dangerous for the person with dementia or those around them, or that their paranoia and delusions do bother them.

Other atypical antipsychotic drugs

Other atypical antipsychotics include the following:

  • quetiapine (quetiapine)
  • risperidone (risperdal)
  • aripiprazole (Abilify)
  • clozapine (Clozaril)
  • pimavanserin (nuplazid )

Each of these drugs has different effects and side effects for the general public, as well as for those with Alzheimer's disease.

General conclusions

It is generally accepted that while more research is needed, when Zyprexa is prescribed to people with dementia, it should be avoided or used under close medical supervision .

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