Can olanzapine be used for anxiety?

This blog post will explore whether Olanzapine can be used for treating anxiety.

We will also briefly discuss what Olanzapine is, what it is used for, side effects, precautions to take when using this drug, and how it should be used and administered. 

Can olanzapine be used for anxiety?

The answer to whether Olanzapine can be used for anxiety is still debated. 

While there has been some initial research done of the effects of olanzapine on anxiety disorders such as General Anxiety disorder and Panic disorders in diverse populations, the medication is yet to receive approval for the treatment of anxiety.

It is most likely that Olanzapine will not be a primary or first choice for the treatment of anxiety disorders unless it is considered as an off-label use as a last resort due to unresponsive treatment with other drugs. 

In a randomised trial to understand the effect of Olanzapine on general anxiety disorder symptoms, 46 patients who were under treatment for GAD with Fluoxetine were administered olanzapine and a placebo.

The particulates were individuals who were still symptomatic even after 6 weeks of fluoxetine pharmacological intervention and were switched to be administered Olanzapine for 6 weeks or a placebo.

The researchers of this study concluded that Olanzapine had some positive and health giving benefits when it came to anxiety symptoms related to Generalised anxiety disorder. 

In another study to understand the potential effectiveness of Olanzapine and it’s safety for the treatment of Panic disorder, researchers conducted a 10 week clinical trial on 10 individuals who had resistant-to-treatment panic disorder diagnosed as per the DSM- IV. 

For this study, data was collected related to baseline, in-treatment, and end-of-treatment panic attacks, anxiety, avoidance behaviours as well as impairment in major areas of day to day life functioning of the participants. 

The results of this trial showed that Olzapie was extremely effective in the treatment and management of Panic disorder symptoms. The number of panic attacks decreased from an average of 6 attacks per week to 1 attack per week by the end of treatment. 

When it came to anxiety related to anxitciation, there was a sharp decrease from 32% of the day to 8% of the day by the end of the trial. 

The researchers also concluded that fifty percent of the participants were panic free and 6 of 10 participants (60%) were free of anticipation related anxiety.

The participants were also observed to show significant improvements in terms of impairment over the course of the trial and 6 of 10 people gained weight as a side effect which was the most notable. 

The researchers concluded that Olanzapine is potentially effective, safe, and required more efforts to be taken to study the use of this drug with respect to anxiety disorders and to demonstrate effectiveness.

While these studies show that Olanzapine as a drug has been seen to be effective in treating and managing anxiety symptoms it has not yet been approved to be used in the context of anxiety. 

In a review conducted to explore the evidences of effectivity of olanzapine for Nausea, Delirium, Anxiety, Insomnia and Cachexia, researchers noted that its cost and potential barriers with use due to its side effects can pose as a threat and it’s costs would outweigh the benefits of this drug’s use in the case of anxiety for populations that involves palliative and long term care.

What is Olanzapine?

Olanzapine, known as Zyprexa as its brand name, is a second-generation (atypical) antipsychotic medication. 

It has been approved in the US by the FDA as a medication for schizophrenia for individuals above the age of 13 and bipolar disorder. 

Olanzapine also has approval for use for depression related to Bipolar disorder when it is used with fluoxetine, a selective serotonin reuptake inhibitor (SSRI) as well as for individuals who have treatment-resistant depression. 

Olanzapine helps to manage symptoms such as:

  • Hallucinations- seeing, hearing, feeling or believing things that others do not, 
  • Paranoia- feeling unusually suspicious or having muddled thoughts 
  • feeling agitated, elated, or impulsive 

Olanzapine does not cure mental disorders indefinitely but it can help manage symptoms as well as help to stop manic episodes from resurfacing. 

How does Olanzapine work?

Olanzapine works by exerting its action on dopamine and serotonin receptors as an antagonist and blocks dopamine from potential action at the receptor. 

This leads to a decrease in positive symptoms in schizophrenic patients such as decrease in hallucinations, delusions, and disorganised speech, thought, and behaviour. 

The drug also works in a similar fashion for serotonin which leads to a decrease in negative symptoms such as anhedonia, flat affect, alogia, and poor focus and attention. 

How should this medicine be used?

Olanzapine comes as a tablet that dissolves quickly in the mouth and should be taken once a day (usually) or as directed by your doctor. 

It is recommended that olanzapine is taken around the same time every day and can be swallowed with or without liquid.

It is usually the trend that your doctor might start you out on a low dose, check for it’s effects on you and your symptoms and gradually increase your dose.

It may take several weeks or longer before you feel the full benefit of the drug while for others it might take longer. Whatever the case, it is recommended that you do not stop using the drug and instead discuss with your doctor about its effects of lack of so as to change dosage or switch medications. 

What are the precautions to take when taking Olanzapine?

Some precautions that one should take when considering the use of Olanzapine include:

Olanzapine increases the risk of death in older adults with dementia-related psychosis so it is not recommended to be used nor is it approved to be used as treatment for such conditions and cases. 

People with the following conditions should proceed with caution ad must inform their doctor immediately:

  • liver disease;
  • heart disease, high or low blood pressure;
  • high cholesterol or triglycerides;
  • a stroke, including “mini-stroke”;
  • breast cancer;
  • a seizure;
  • Alzheimer’s disease;
  • diabetes or high blood sugar;
  • an enlarged prostate;
  • bowel problems; or
  • narrow-angle glaucoma.

It is also imperative that this particular drug should be taken with caution and the doctor informed if you are pregnant as it can cause feeding, breathing, and withdrawal problems when the individual is in the last stages of pregnancy. 

Olanzapine can pass into breast milk so tell your doctor immediately if you notice any side effects on your baby. 

What side effects can this medication cause?

Some common side effects of this drug include:

  • dizziness, feeling unsteady, or having trouble keeping your balance
  • restlessness
  • unusual behaviour
  • depression
  • difficulty falling asleep or staying asleep
  • weakness
  • difficulty walking
  • constipation
  • weight gain
  • dry mouth
  • pain in arms, legs, back, or joints
  • breast enlargement or discharge
  • late or missed menstrual periods
  • decreased sexual ability

Severe or serious side effects that require immediate medical attention include:

  • seizures
  • changes in vision
  • swelling of the arms, hands, feet, ankles, or lower legs
  • unusual movements of your face or body that you cannot control
  • falling
  • sore throat, fever, chills, and other signs of infection
  • very stiff muscles
  • excess sweating
  • fast or irregular heartbeat
  • rash that may occur with fever, swollen glands, or swelling of the face
  • skin redness or peeling
  • hives
  • difficulty breathing or swallowing

What to do if there is an Olanzapine overdose?

In case of overdose on Olanzapine, call the poison control or emergency services when you notice that individual has trouble breathing, cannot be roused, unconscious as well as other symptoms such as:

  • drowsiness
  • slurred speech
  • agitation
  • fast heartbeat
  • sudden movements that you cannot control
  • coma (loss of consciousness for a period of time)

What should I avoid while taking olanzapine?

Olanzapine can affect each individual differently, so some of the precautions and activities you should avoid include:

  • Driving or hazardous activity that involves machines since the side effects such as dizziness and sleepiness can cause accidents. 
  • Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
  • Avoid drinking alcohol. 
  • Avoid becoming overheated or dehydrated. Drink plenty of fluids.

Conclusion

This blog post has explored whether Olanzapine can be used for treating anxiety.

We have also briefly discussed what Olanzapine is, what it is used for, side effects, precautions to take when using this drug, and how it should be used and administered. 

FAQ related to Can Olanzapine be used to treat anxiety?

Is Olanzapine an antipsychotic?

Yes, olanzapine is an antipsychotic drug used for the treatment of schizophrenia symptoms and it is also used off-label for mood stabilising as it has amazing mood stabilisation qualities 

Can I take olanzapine for anxiety?

Research finds that Olanzapine is known to reduce many symptoms of anxiety but you should check with your mental health provider before taking any medication.

What are Olanzapine’s most common side effects to occur?

The most commonly occurring side effect is weight gain; all the others are less prevalent. 

How much does Olanzapine cost?

It is rather expensive than other antipsychotics and the average cost of 30 tablets will be more than 300 dollars. 

References

Olanzapine. Drugs.com. Retrieved on 5th january 2022. https://www.drugs.com/mtm/olanzapine.html

Olanzapine.NHS. Retrieved on 5th january 2022. https://www.nhs.uk/medicines/olanzapine/

Olanzapine. MedlinePlus. Retrieved on 5th January 2022. https://medlineplus.gov/druginfo/meds/a601213.html

Thomas K, Saadabadi A. Olanzapine. [Updated 2021 Aug 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532903/

Felton M, Weinberg R, Pruskowski J. Olanzapine for Nausea, Delirium, Anxiety, Insomnia, and Cachexia #315. J Palliat Med. 2016 Nov;19(11):1224-1225. doi: 10.1089/jpm.2016.0220. Epub 2016 Jun 6. PMID: 27267313.

Pollack MH, Simon NM, Zalta AK, Worthington JJ, Hoge EA, Mick E, Kinrys G, Oppenheimer J. Olanzapine augmentation of fluoxetine for refractory generalised anxiety disorder: a placebo controlled study. Biol Psychiatry. 2006 Feb 1;59(3):211-5. doi: 10.1016/j.biopsych.2005.07.005. Epub 2005 Sep 1. PMID: 16139813.

Hollifield M, Thompson PM, Ruiz JE, Uhlenhuth EH. Potential effectiveness and safety of olanzapine in refractory panic disorder. Depressed Anxiety. 2005;21(1):33-40. doi: 10.1002/da.20050. PMID: 15786486.

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