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Even though the population with diabetic complications at baseline was small in this study, we did not highlight that treatment with rapid-acting IM olanzapine potentially increased the risk of diabetes-related adverse events. As previously recommended, it can be useful to monitor patients who are at a higher risk of developing diabetes during treatment with antipsychotics such as olanzapine.

Previous studies have shown that IM olanzapine is effective without the addition of benzodiazepines 22 and that coadministration of IM olanzapine with benzodiazepine may increase the risk of somnolence.

Although there were no remarkable serious cases in this PMS, it is important to use much caution when treating agitated patients concomitantly with parental benzodiazepines. There are various limitations in the interpretation of results from this PMS study.

Owing to the noninterventional observational nature of this study, baseline characteristics varied among participants, and it is possible that many unrecognized confounding factors, such as concomitant medications, may have affected the results of the analyses, thus making it challenging to determine a potential increase in risk following treatment with the study drug.

In addition, it is common to have missing values in an observational study. Another major limitation is the lack of a control group and the presence of only one cohort in which patients were not randomized. This study confirms the safety and effectiveness of rapid-acting IM olanzapine, administered daily, in the treatment of schizophrenia patients with agitation, providing valuable information from real-world clinical settings.

The authors would like to thank all patients, physicians, and paramedics who participated in this study. This study was sponsored by Eli Lilly Japan K. All the authors are employees of Eli Lilly Japan K. The authors report no other conflicts of interest in this work. National Center for Biotechnology Information , U. Journal List Neuropsychiatr Dis Treat v. Neuropsychiatr Dis Treat. Published online Jan Author information Copyright and License information Disclaimer.

This work is published and licensed by Dove Medical Press Limited. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. This article has been cited by other articles in PMC.

Abstract Objective The objective of this study was to evaluate the safety and effectiveness of rapid-acting intramuscular IM olanzapine in the treatment of acute agitation associated with schizophrenia in real-world clinical settings in Japan.

Methods In this multicenter, postmarketing surveillance PMS study, patients with acute agitation associated with schizophrenia were treated with IM olanzapine daily in a daily clinical setting. Results The safety analysis set included patients, and the initial dose of 10 mg was administered to patients. Conclusion The results of this Japanese PMS study demonstrated that IM olanzapine is safe and has a favorable effectiveness profile in the treatment of schizophrenia patients with acute agitation.

Video abstract Download video file. Introduction Schizophrenia is a chronic, remitting, and relapsing psychiatric disorder that is associated with significant dysfunction and increased mortality.

Methods Study design This was a multicenter PMS study with a 3-day observation period that included the initial day of administration. Study population The participants were patients with schizophrenia who had psychomotor agitation and had received the rapid-acting IM injection formulation of olanzapine.

Statistical analysis Patient characteristics were summarized by frequency tables with summary statistics. Results Baseline patient characteristics A total of 1, case report forms were collected from patients, and the safety analysis set included patients, of whom were included in the effectiveness analysis set Figure 1. Open in a separate window. Figure 1. Disposition of patients. Table 1 Patient baseline characteristics. Abbreviation: SD, standard deviation.

Table 2 Administration information of rapid-acting IM olanzapine. Abbreviation: IM, intramuscular. Safety evaluation TEAEs were reported in 28 patients 36 events among patients in the safety analysis set. Table 4 Safety summary by injection pattern. Table 5 TEAEs by concomitant use of benzodiazepine and antipsychotic drugs.

Figure 2. Discussion This postmarketing study confirms the safety and effectiveness of rapid-acting IM olanzapine in treating schizophrenia patients with agitation in real-world clinical settings. Conclusion This study confirms the safety and effectiveness of rapid-acting IM olanzapine, administered daily, in the treatment of schizophrenia patients with agitation, providing valuable information from real-world clinical settings.

Acknowledgments The authors would like to thank all patients, physicians, and paramedics who participated in this study. References 1. It may take a few weeks to get to the right dose that works for you. If you forget a dose of olanzapine, take it as soon as you remember, unless you only remember the next day.

In this case, skip the missed dose and take your next dose at the usual time. If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. Call or visit Get someone else to drive you or call for an ambulance. Take the olanzapine packet or leaflet inside it, plus any remaining medicine with you. Take the olanzapine packet or leaflet inside it plus any remaining medicine with you.

Like all medicines, olanzapine can cause side effects, although not everyone gets them. These common side effects may affect up to 1 in 10 people. Tell your doctor if these side effects bother you or do not go away:. Call or go to In rare cases, it's possible to have a serious allergic reaction anaphylaxis to olanzapine.

These are not all the side effects of olanzapine. For a full list see the leaflet inside your medicines packet. Olanzapine can be taken during pregnancy and is not thought to be harmful to your baby.

Your mental health and wellbeing are important. If you become pregnant while taking olanzapine, speak to your doctor. You will be reviewed in a specialised antenatal clinic and you can discuss your medicine with the doctors in the clinic.

If your doctor or health visitor says your baby is healthy, you can take olanzapine while breastfeeding. Olanzapine passes into breast milk in very small amounts and has been linked with side effects in very few breastfed babies. Many people have used it while breastfeeding without any problems. It's important to keep taking olanzapine to keep you well. Breastfeeding will also benefit both you and your baby. If you notice that your baby is not feeding as well as usual, seems unusually sleepy or seems irritable, or if you have any other concerns about your baby, talk to your health visitor, midwife, pharmacist or doctor as soon as possible.

Cannabidiol also known as CBD might affect how olanzapine works. Do not take cannabidiol while you are taking olanzapine. There might be a problem taking some other herbal remedies and supplements with olanzapine, especially ones that make you feel sleepy or dizzy.

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. Olanzapine belongs to a group of medicines called antipsychotics. It does not cure your condition, but it can help to improve the symptoms of mental health conditions. Olanzapine works by affecting naturally occurring chemical messengers in your brain neurotransmitters , like dopamine. If you have too much dopamine it can make you see or hear things that are not there hallucinations , or think things that others do not delusions.

Dopamine is also involved in muscle movements, so too much of it can affect your muscles. Olanzapine also works on other neurotransmitters such as serotonin and noradrenaline. Olanzapine rebalances these to improve your mood and behaviour. Taking olanzapine will not change your personality and it is not addictive.

Olanzapine, like many medicines, does not work straight away. It can take a few weeks to get the dose right for you. It may take several days or even weeks for some of your symptoms to get better. Carry on taking your medicine for as long as your doctor tells you to, even if you feel better.

Do not stop taking your medicine without talking to your doctor first. When you first start taking olanzapine, it may make you feel more relaxed and calm. Orally disintegrating olanzapine induces less weight gain in adolescents than standard oral tablets. Eur Psychiatry. Chawla B, Luxton-Andrew H. Long-term weight loss observed with olanzapine orally disintegrating tablets in overweight patients with chronic schizophrenia.

A 1 year open-label, prospective trial. Orally disintegrating and oral standard olanzapine tablets similarly elevate the homeostasis model assessment of insulin resistance index and plasma triglyceride levels in 12 healthy men: a randomized crossover study. Short-term treatment with olanzapine does not modulate gut hormone secretion: olanzapine disintegrating versus standard tablets.

Eur J Endocrinol. Effects of orally disintegrating vs regular olanzapine tablets on body weight, eating behavior, glycemic and lipid indices, and gastrointestinal hormones: a randomized, open comparison in outpatients with bipolar depression. Ann Clin Psychiatry. Listing of metabolic changes in healthy volunteers receiving orally dissolving olanzapine or oral olanzapine: data from a clinical study that was terminated early.

Int J Clin Pract. Kassirer JP. New Engl J Med. Preferences for medical collaboration: patient-physician congruence and patient outcomes. Patient Educ Couns. Identifying modifiable risk factors for rehospitalization: a case-control study of seriously mentally ill persons in Mississippi.

Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care. A longitudinal study of medication nonadherence and hospitalization risk in schizophrenia.

Medication adherence levels and differential use of mental-health services in the treatment of schizophrenia. BMC Res Notes. The cost of relapse and the predictors of relapse in the treatment of schizophrenia. BMC Psychiatry. Predictors and clinical consequences of non-adherence with antipsychotic medication in the outpatient treatment of schizophrenia.

Psychiatry Res. Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Medication compliance and comorbid substance abuse in schizophrenia: impact on community survival 4 years after a relapse. Effectiveness of atypical antipsychotic medications in reducing violent behavior among persons with schizophrenia in community-based treatment.

Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia. Adherence and persistence to typical and atypical antipsychotics in the treatment of schizophrenia.

All-cause treatment discontinuation in schizophrenia during treatment with olanzapine relative to other antipsychotics: an integrated analysis. The number needed to treat for all-cause medication discontinuation in the treatment of schizophrenia: consistency across world geographies and study designs. Antipsychotic treatment discontinuation in previously untreated patients with schizophrenia: month results from the SOHO study.

J Psychiatr Res. Olanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial. Olanzapine versus ziprasidone: results of a week double-blind study in patients with schizophrenia. Long-term antipsychotic monotherapy for schizophrenia: disease burden and comparative outcomes for patients treated with olanzapine, quetiapine, risperidone, or haloperidol monotherapy in a pan-continental observational study.

A week, randomized, double-blind study of olanzapine versus aripiprazole in the treatment of schizophrenia. Discontinuation of treatment of schizophrenic patients is driven by poor symptom response: a pooled posthoc analysis of four atypical antipsychotic drugs. BMC Med. Longer time to antipsychotic treatment discontinuation for any cause is associated with better functional outcomes for patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder.

Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatr Serv. Using drug claims data to assess the relationship of medication adherence with hospitalization and costs. An economic review of compliance with medication therapy in the treatment of schizophrenia.

Articles from Patient preference and adherence are provided here courtesy of Dove Press. Support Center Support Center. External link. Please review our privacy policy. Chue et al Pilot intervention study, open-label, 7 days follow-up. Safety: adverse events Acceptance: questionnaire. Kinon et al Interventional study, open-label, 6 weeks follow-up. Dardennes et al Van Heeringen et al Retrospective observational, previous 2-month period.

ODO monotherapy or combination therapy, 2. Hori et al Interventional study, open-label, 4 weeks follow-up. Damodaran et al Prospective observational study, 1 week follow-up.

Czekalla et al Prospective observational study, 2 weeks follow-up. ODO 2. Pascual et al Prospective observational study, 6 hours follow-up. ODO 20 mg single dose , conventional oral therapy. Arranz et al Posthoc analysis, prospective, openlabel, randomization to antipsychotic and chronological sequential assignment to SOT and ODO, 6 weeks follow-up.

Hatta et al Pseudorandomized, open-label, measurements recorded every 15 minutes for 1 hour. Japan, multicenter, psychiatric emergency departments. Kuramochi et al Posthoc analysis of postmarketing surveillance prospective observational study, 6 weeks follow-up.

Karagianis et al Intervention study, randomized, doubleblind, double-dummy, 16 weeks follow-up. Canada, the US, the Netherlands, and Mexico, multicenter, outpatient. Bitter et al Intervention study, randomized, openlabel, crossover, 6 weeks follow-up per treatment 12 weeks total.

Turkey, Israel, Romania, Mexico, Brazil, multicenter, outpatient. Chartier et al Prospective observational study, 1 year follow-up. Greece, France, Germany, multicenter, outpatient.

It is usually recommended to take olanzapine at bedtime because it can cause sleepiness as a side effect. However, it is important to choose a time of day to take it that you can easily remember, which could be bedtime, a mealtime, or when you brush your teeth. For the plain-coated tablets, swallow them whole with a drink of water - if you chew them, they taste bitter.

Put orodispersible tablets melts on your tongue and let them dissolve there. You can also dissolve these in a glass of water, orange juice, apple juice or milk and then drink it all down.

A doctor or nurse can give you an injection in your bottom that provides a long-lasting dose of olanzapine, lasting for two or four weeks. You may need to take tablets alongside the injection, especially while the dose builds up.

Every time you have the injection, you will be asked to wait at the centre for at least three hours so that they can check that the injection is not giving you too much olanzapine in one go.

It is slowly working in your body all the time between injections. If you forget to take it by bedtime, just start again on the next day. Do not take a double dose. If it is less than 12 hours before your next dose of olanzapine, then do not take the missed dose because taking the doses too close together could cause more side effects. If you miss your appointment for your injection, contact your doctor or nurse straight away to make another appointment. If you forget to take your tablets for a while, or you miss an injection, you may start getting your old symptoms back.

You should talk to your doctor if this happens. Once you start taking an antipsychotic, the brain adjusts to having a new level of dopamine around. If you stop taking the antipsychotic all at once, the balance starts to change again. You could get your old symptoms back. Stopping this medicine quickly, or reducing the dose too much at once, may cause your old symptoms to come back, or cause you some withdrawal effects.

You may get your old symptoms back if you stop olanzapine for a while. You can also get withdrawal effects, including:.

It is better to agree stopping with a doctor who will reduce your dose gradually. This is likely to take a few weeks.

You will probably go for checks with your doctor after you stop olanzapine to check that you still feel better. If you have taken more olanzapine than the dosage recommended by the doctor who prescribed it to you, you must get medical help immediately — even if you do not feel any different. Olanzapine can sometimes cause serious side effects.

Tell your doctor immediately if you experience unusual movements mainly of the face or tongue. Go to hospital immediately if you think you may have developed a blood clot symptoms are usually swelling, pain and redness in the leg - a clot may travel through blood vessels to the lungs causing chest pain and difficulty breathing. Also go to hospital and tell the doctor you are taking olanzapine if you develop a combination of fever, faster breathing, sweating, muscle stiffness or drowsiness.

Stopping olanzapine suddenly can cause withdrawal effects and stopping it too early could cause your illness to come back. See your doctor if you want to stop taking olanzapine because it is better to come off it gradually. You might feel sleepy or dizzy in the first few days after taking olanzapine.

Do not drive a car, ride a bike or operate machines until you see how this affects you. If you are pregnant, or thinking of becoming pregnant, please read the pregnancy section under the 'Side Effects' tab because olanzapine may affect the developing baby. Take your medicine with you to show to the doctors. Tell them how much you have taken. Get a friend to go with you, if you can, just in case you feel ill on the way.

Go to a doctor or hospital straight away if you get any of the following symptoms while taking olanzapine:. You need to talk to your doctor or pharmacist before starting treatment with olanzapine if any of the following apply to you:.

You should have your weight, blood sugar, blood fats, blood pressure and pulse measured regularly during early treatment, then at least every six months to a year after that, depending on your age. You should also have your blood sugar tested when you start, after one month, and then every four to six months after that. The doctor might also check your heart with an electrocardiogram ECG and check your blood pressure.

They might also check your height and development. If you have periods, they may also check whether they are regular. Please do not be worried by the side effects listed on this page. Some people take olanzapine without any side effects or with only a few mild side effects. Some side effects wear off after a few days or weeks. If you think you might be getting a side effect from olanzapine, then you should discuss this with your doctor, nurse, or pharmacist.

Do not stop taking the tablets until you talk to your doctor, or you may get withdrawal symptoms as well. Olanzapine use has been linked to an increased risk of developing diabetes among some young people.

Symptoms include:. If you already have diabetes, you may need to increase the amount of medication you take for this alongside taking olanzapine. We use cookies We use cookies on this website to store user preferences, aid in accessibility and analyse our traffic. Read our cookie policy. Accept all cookie usage. Update cookie preferences. Open guide menu Skip to guide menu. I am a young person I am a parent I work with young people. Open site search Open main navigation.

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