Olanzapine (Zyprexa) is a second-generation (“atypical”) antipsychotic that can be administered as an oral disintegrating tablet (ODT) or intramuscular (IM) injection. Like most antipsychotics, olanzapine works by blocking postsynaptic dopamine (D2) and serotonin (5HT2) receptors in the central nervous system and is helpful in treating schizophrenia and bipolar disorder. Common side effects include weight gain, dizziness, constipation, and dry mouth.

As an intensivist, I minimize polypharmacy by utilizing a single medication to help with multiple issues. I use olanzapine for sedation, anxiolysis, and to smooth out hyperactivity. It’s also a great anti-emetic and, like mirtazapine, an appetite stimulant! The ODT/IM routes are helpful for patients with dysphagia. Remember that olanzapine’s efficacy can be reduced by cigarette smoking – a consideration important for when patients go home. Plasma level monitoring can be helpful!

Drop me a comment below with your experience regarding olanzapine!

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