Talk:Olanzapine/Archive 1

Archive 1

Human error in off-label uses section?

The "Off-label uses" section contains the following statement:

"Olanzapine is also used in many addiction clinics as a sleep aid (usually 2.5–5 mg) due to its low abuse profile and zero addictive properties."

Unfortunately the reference used to substantiate this statement is about Seroquel, which is a completely different drug. Either the statement or the reference is incorrect; possibly both. The problematic reference is:

url=http://www.forbes.com/2004/09/08/cx_mh_0908seroquel.html title=Antiphyscotic used as sleeping pill id=0028–0836 accessdate=2005-12-11 —Preceding unsigned comment added by 12.46.98.17 (talk) 14:17, 24 June 2010 (UTC)

Addiction centers do not use zyprexa anymore. It can cause dependence and severe withdrawal. This is well known in the field. They use seroquel. WWW.ASAM.org — Preceding unsigned comment added by 98.164.204.117 (talk) 07:37, 20 March 2012 (UTC)

Picture

I have just uploaded a picture of a Zyprexa box: http://commons.wikimedia.org/wiki/Image:Zyprexa.PNG Feel free to insert into article if useful. --Stonyroad (talk) 10:03, 27 December 2007 (UTC)

edits by 67.82.232.151

A certain user 67.82.232.151 has a clear bias against the Eli Lilly Corporation, and has single-handedly created the current 'Legal' section. Since one guy with a grudge has had such a huge effect on this page, I’m adding a POV tag. I know nothing about the industry myself, but until someone can verify this information we should let people know what’s what.

Here are some of his edits to the Eli Lilly page:

Eli Lilly has been known to engage in withholding internal information on medications, including Prozac, Thimerosal and Zyprexa in order to downplay side effects and adverse reactions in order to boost profits. [1]

Consequently, many critics claim that the FDA approval of duloxetine for Major Depressive Disorder (MDD) and diabetic neuropathy is irresponsible and intellectually dishonest, and is a case illustration of the agency's failure to prevent harmful drugs from being marketed in the name of big profits. [2]

In one of the only three cases to ever go to trial for SSRI indication in suicide, Eli Lilly was caught corrupting the judicial process by making a deal with the plaintiff's attorney to throw the case, in part by not disclosing damaging evidence to the jury. [3]

Over the last decade, the company spent millions of dollars lobbying Congress in hopes of extending its patent on Prozac and some lawmakers even attempted to insert last-minute provisions to omnibus spending bills to grant the company’s wish. Generic drugmakers prevailed, handing Eli Lilly one of its few legislative losses in recent memory. The company, which favors Republicans over Democrats with its contributions… [4]

This same user also started the ‘Controversy’ statement on the Duloxetine page, containing the following outsourced and obviously biased statements:

In the 1980s, [Eli] Lilly waged a successful campaign to get fluoxetine, brand name Prozac, through the FDA even though not a single study submitted to the agency showed the drug to be effective for depression when taken alone. …not only targets serotonin, it also impacts another important neurochemical, norepinephrine. This flatly contradicts the ‘serotonin/good, norepinephrine/bad’ story that launched the SSRI revolution that [Eli] Lilly started with fluoxetine. [5]

He started a ‘Legal’ section on the Olanzapine page with this:

…documents given to The Times by a lawyer representing mentally ill patients, show that [Eli] Lilly executives kept important information from doctors about Zyprexa’s links to obesity and its tendency to raise blood sugar — both known risk factors for diabetes. [6]

He adds this unsourced statement to the SSRI Discontinuation Syndrome page:

Data obtained from 9 clinical trials assessing the efficacy and safety of duloxetine in the treatment of major depressive disorder (MDD) by Lilly Research found that patients with discontinuation-emergent adverse events (DEAEs) were reported by 44.3% of duloxetine patients… No follow up was published by [Eli] Lilly stating the duration of DEAE's longer than one week ultimately persisted for. [7]

--70.17.209.58 09:17, 22 March 2007 (UTC)

Neither section you tagged here as "totally disputed" was not completely written by user 67.82.232.151. Looking at the history shows the writing of those sections has been a collaberative effort. user 67.82.232.151 hasn't edited this article for over two months, many changes have been made since then. The sections are heavily referenced and that one former author's edits to other articles are not relivant to gauging its factual accuracy. I'm removing the "totally disputed" templates from those sections because their factual accuracy is not disputed. Neitherday 12:05, 22 March 2007 (UTC)

Q How do you see/find out the IP or the name of person who writes material on the front/title page?--Mark v1.0 00:08, 1 June 2007 (UTC)

POV

I removed the reference from Prozacspotlight. If the site cites a scientific study that has been published in a peer-reviewed journal, then inserting a direct reference may be much more helpful than a link to a news article. I admit I haven't taken the time to find the proper reference in Pubmed. The prozacspotlight.org site looks positively doubtful. JFW | T@lk 23:20, 17 Jun 2004 (UTC)

It seems to be gone from prozacspotlight... Found the old version here: [8]. The quote from the article made me scratch my head: "In 1999, for example, Eli Lilly received a paper on olanzapine, the best-selling antipsychotic drug in America. The study showed that, contrary to Lilly's hopes, olanzapine was not useful in the treatment of Parkinson's symptoms. " I have no idea why a dopamine antagonist would be useful in treating Parkinson's symptoms - perhaps for Levadopa induced psychosis. Regardless, I don't feel its an important reference and I'm glad its gone. ElBenevolente 00:45, 18 Jun 2004 (UTC)

Could somebody advise me where to insert information about lactation? It's a little discussed side effect by the manufacturer, but a fairly common one in females on this drug.

In a section called "side-effects". Please link to galactorrhea. JFW | T@lk

The NIH CATIE study is mentioned in the adverse events section, but the results with regards to effectiveness outcomes are not mentioned. It would be nice to work those into the article somehow. In fact, it would be nice to work into the articles for all the atypicals that were evaluated.--Anastasis00 16:11, 14 March 2006 (UTC)

Agree with explicit inclusion of CATIE (2 back-to-back papers: 1. McEvoy JP, Lieberman JA, Stroup TS, Davis SM, Meltzer HY, Rosenheck RA, et al. Effectiveness of clozapine versus olanzapine, quetiapine, and risperidone in patients with chronic schizophrenia who did not respond to prior atypical antipsychotic treatment.[see comment]. American Journal of Psychiatry 2006;163:600-10, and 2. Stroup TS, Lieberman JA, McEvoy JP, Swartz MS, Davis SM, Rosenheck RA, et al. Effectiveness of olanzapine, quetiapine, risperidone, and ziprasidone in patients with chronic schizophrenia following discontinuation of a previous atypical antipsychotic. American Journal of Psychiatry 2006;163:611-22). Equally important is the CUtLASS study (Jones PB, Barnes TRE, Davies L, Dunn G, Lloyd H, Hayhurst KP, et al. Randomized Controlled Trial of the Effect on Quality of Life of Second- vs First-Generation Antipsychotic Drugs in Schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Archives of General Psychiatry 2006;63:1079-1087). Both studies were government funded and provide efficacy data challenging the widely advertised and hugely profitable superiority of atypical agents, including olanzapine, over older drugs. I wonder how to refer to these studies more elegantly. --Menkesd 03:26, 20 January 2007 (UTC)

I am not sure that this is the proper place to publish original case reports of adverse events associated with olanzapine, such as that inserted by 213.42.2.28 in edit dated March 17. If we want to reference case reports from the literature regarding suicidal ideation, altered sleep patterns, sedation, or other side effects I think that would be beneficial; however, I think comments such as "this drug was clearly and unambiguously to blame for the emotional horror" experienced during olanzapine treatment cannot be supported based on the information provided and are not appropriate in this setting. I am going to remove these additions to the adverse event section at this time.--Anastasis00 04:48, 29 March 2006 (UTC)

Zyprexa diabetes link

I took zyprexa starting in 1996 the year the FDA approved it, which was ineffective for my condition and gave me diabetes.

Zyprexa is the product name for Olanzapine,it is Lilly's top selling drug.It was approved by the FDA in 1996 ,an 'atypical' antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.Zyprexa has been linked to causing diabetes and pancreatitis.

Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly's $14.6 billion revenue last year.

Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta?

Yes! They sell a drug that can cause diabetes and then turn a profit on the drugs that treat the condition that they may have caused in the first place! I was prescribed Zyprexa from 1996 until 2000. In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.

All the psychiatrist I've interviewed and the information on line presents zyprexa as a worse offender than the other Atypicals such as seroquel.My doctor has stopped prescribing zyprexa altogether.

The PDR classifies zyprexa as 'severe' for causing weight gain and diabetes and seroquel as 'moderate'.

Of course the 50 year old Thorazine didn't cause diabetes and is many times cheaper but it could cause tardive dyskinesia.

Where Eli Lilly's negligence comes in,is their KNOWING and not informing consumers (black box warning) until the FDA demanded it.

Lilly's incentive not to readily disclose is they had billions coming in from state medicaid scripts.

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İf life were simple İ could just punch-out the inventor of this foul medicine, and the crazy psychiatrist who prescibed it (against my wishes). Law suits in the UK, especially by patients being prescribed this drug, are a waste of time and energy. The BMA rule. İt has taken me four years to recover from the six month`s İ was prescibed this poisonous substance. Wrongly diagnosed a bipolaric ( the `shrink` thought me grandiose that a beshevelled creature as İ was, really was a toxicologist, he later apologised for what it`s worth). Why are patients with psychiatric illness constantly having this and or other `atypical psychoptics rammed down their throat, or up their posterior. Why? Because psychiatric medicine is still 200 years behind physical medicine, along with all the stigma and abuse that goes with it. İ gained 25 - 30 kg in 4 month`s on Olanzapine, and diagnosed with diabetes (glucose: 38 mmol/L) anh hypertriglyceridaemia (28.8 mmol/L). İ had complained of feeling ill for 6 month`s but the physicians thought İ just wanted more diazepam (which İ did as it was made for the treatment of anxiety), from which İ have long suffered. On hearing the test results, İ realised İ should have probably died several month`s previously. İ left hospital on 2 x 60 units Novomix every day. İ broke my arm from being obese (my doctor had previously smirked this to me), and my testosterone level depleted. Fortune turned when İ managed to get Modafinil prescibed, which İ topped up to 1000mg/day (İ was 112 kg), with quite remarkable results. İ began to lose weight, my sleep normalised, and my brain function slowly retuned. Then,finding an ampule of Sustanon 250, İ noticed a few days after injection my diabetes improved. O.K. androgenic/anabolic steroids have this effect. However, my insulin requirements dropped dramatically. İ began to research further and decided to try Mesterelone. A dosage of 75mg/day soon had my insulin requirements down to 30 units a day total. İ took Mesterelone for 3 month`s and on stopping found my inslin requirements dıd not change. Now here`s the point İ have never disclosed before. İ required 240mg DHC daily for arthritis from my excessive sporting days, but changed to a tea of dried Opium Poppies. Why İ do not know but within a few weeks İ was down to a couple of units of insulin weekly. İ have followed this up with hCG injections (4 weeks), and my diabetes (though İ am 20 kg lighter) has all but gone, presently reqiring no insulin whatsoever (or opium tea). İ apologise for this diatribe, however, İ have tried to be as honest and factual as possible in the hope that Olanzapine İnduced Diabetes can hopefully be reversed. Profmad (talk) 13:37, 22 November 2008 (UTC)Professor Mad

İ realise for some Olanzapine can be a very therapeutic drug. However, if you have no alternative but to use this drug İ emplor you request regular glucose and lipid tests, as well as keeping a check on your weight. Use as low a dosage as possible! Profmad (talk) 14:34, 22 November 2008 (UTC)Professor Mad

Daniel Haszard http://www.zyprexa-victims.com

Zyprexa and diabetes? I use zyprexa and have used other anti-psychotics in the past (risperdal, haldol). I have found that zyprexa is the medicine which has the least side effects for me. Especially haldol was pure hell, risperdal made me shiver. So i am basically happy with zyprexa, but how great is the risk for diabetes. Should I be worried? When I was admitted to a psychiatric hospital and received zyprexa I did have some diabetic like symptoms. (Thirst, feeling dehydrated etc.), but I have not had similar complaints since and I have been taking it on and off for 3 years now.

I suspect the diabetes risk is mainly due to weight gain. But then again.. there have been no real studies about the onset of diabetes due to the antipsychotic. --Moop stick | (Talk) 16:01, 6 August 2006 (UTC)

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Christian: I've used Risperdal first to treat my psychosis/bipolar disorder and I experienced massive side-effects. I couldn't sleep, weight gain, zombie-tiredness, panics and more. When I changed to Zyprexa it was really nice cause I gave almost no side-effects after a first period in which I had thirst and dehydration. Zyprexa is really good to me can't say otherwise but I know it can cause diabetes in people, I was informed about this when I started so its real use to eat low-GI-food. Avoid sugars. Zyprexa is my less bad choice of medicine to survive

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I've had great results with Zyprexa and no diabetes after a year on it. I have, however, gained 40 pounds and will be discussing a switch with my Dr. I would consider Zyprexa Zydis which supposedly does not cause weight gain or Geodon which does not as well. I'm afraid the diabetes may result from excessive weight gain AND I seem to crave carbs (sugars).

Actually, the diabetes is caused from the fact that Zyprexa causes your blood sugar to go way up. Lady Galaxy 03:55, 3 September 2008 (UTC)

Aphilia

I removed the sentence on Aphilia for two reasons 1) it is not a recognized psychiatric symptom or diagnosis, and 2) olanzapine has no indication in treating it. Dr.JonathanCrane 03:50, 22 August 2006 (UTC)

"Judge Weinstein"

Judge Weinstein needs to be identified> I'd do it myself if I knew. Has essential information been suppressed here? --Wetman 09:56, 18 December 2006 (UTC)

I actually eat Zyprexa

I think most psychiatric patients (myself included) wants to be rid of mecication. Next, I think you guys got it all wrong. I myself have been chased by demons, heard the evil whispering of trees and the general "mind-read", and I also gained the "mandatory" 22-23 pounds, so I am now no longer underweight as I was before (I didn't feel the need to eat, it was a waste of time and inefficient). Now I am overweight, that's true, but I'd rather be "normal" eating my meds, without people reading my mind and the general deathwish. Next up, a big surprise, Diabetes (type 2) don't even need medication, just a regular ingestion of food. What did you imagine? I mean come on, a medication without sideeffects, please try to focus on BOTH sides. And if it was as toxic (like this single-sided article clearly suggests) I'd be long dead! --Eternalsleeper (talk) 07:19, 3 March 2008 (UTC)

Oh yes, and before you start a rant "Ooooh we have someone from Lilly in here!!!", please think twice, maybe consider a long chat with a shrink! Got to go and eat my beloved Zyprexa.

--ChrKrabbe 21:40, 10 January 2007 (UTC)

weight gain statistics?

was looking into the weight gain statistics her on this page, and haven't been able to find a verifiable source for 90% of users experience weight gain. only one article i've been able to access has any metrics as to the amount of weight gained, which still makes no mention of percentages of samples that gained weight. if someone could enlighten me as to where we are getting this numbers i would appreciate it, otherwise feel that the information is innacurate and should be removed. Acee2bee 13:12, 5 June 2007 (UTC)

Yeah, I'd never heard 90% but there is alot of disagreement, though all would agree it is significant. My bet would be to leave as "significant" unitl some consensus on numbers occurs.cheers, Cas Liber | talk | contribs 14:13, 5 June 2007 (UTC)

I know that Wikipedia is against original research but I know a psychiatrist who is vehemently against putting people on Zyprexa due to the massive amounts of weight the patients gain. I personally know someone who went 160 to 220 lbs on this horrid medication.

--Eternalsleeper (talk) 07:19, 3 March 2008 (UTC)

Really? Mine suggested it, said it helped with the evil voices in my head and worked well on most of his other patients. I've heard it makes you gain weight, true. But I got put on Zydis, the orally disintegrating tablets. I heard that Zydis actually makes you lose weight, and even this article suggests it might. So I'm not sure... Lady Galaxy 03:53, 3 September 2008 (UTC)

• Weight gain relates to maximal 10% of the users my doc told me yesterday. So it#s relevant but not quite normal in taking

this medicine.If there are general profit depending to 90%. The use isn#t real dangerous like it's written on the page, I Think you should balance the benifits and the danger in real coordinates!--Danaide (talk) 12:36, 17 April 2009 (UTC)

Gout?

Someone added to the list of side effects *Gout and similar symptoms. But gout is not a symptom, and gout is caused by hyperuricemia, which is not mentioned in this article. I have removed the suspect text. The claim that this drug causes gout needs supporting evidence. --Una Smith 18:26, 27 August 2007 (UTC)

anticholinergic antipsychotics

My brother has been on a antipsychotic medication [clozapine/Leponex (Clozaril in the US) and quetiapine/Seroquel] for many years. He has developed a serious urine retention problem which is a result of the weakening of the bladder muscle caused by the drugs. We therefore need to replace those drugs with others that have a comparably lower anti-cholinergic effect. I've read that Olanzapine/Zyprexa could be a solution. Is that accurate? What other drugs could help us avoid further bladder muscle damage? Many thanks —Preceding unsigned comment added by 94.68.151.237 (talk) 18:33, 19 March 2009 (UTC)

Etymologies and Neologisms

Dear All, Does somebody know the etymology of the word 'Zyprexa' - or, since there isn't going to be a traditional etymology, just how the neologism was coined? I hear these product names are invented by corporate brainstorming and with marketing criteria in mind, they always have a message or some idea behind them, or contained in the way they sound. I can't for the life of me think of anything in the case of Zyprexa. Anybody know? Also, 'Olanzapine'? Thanks! Fluttermoth (talk) 00:03, 1 May 2009 (UTC)

Side Effects

The side effect section has almost no citations at all. In fact, I've found other websites that considerably less people gain weight on this drug than what it says at 90%. This section should be better cited, because a lot of websites on the internet about this drug do not list some of the side effects. TheDude2006 (talk) 23:35, 13 September 2009 (UTC)

Dose Dependent

After the sentence 'The effect is not dose dependent.' in the Metabolic effects section, User:Terencetrifflewhinny pointed out the a reference was needed and that it may not be true. I moved Terencetrifflewhinny's comment here,

  THIS NEEDS A REFERENCE. IT ALSO MAY NOT BE TRUE -
  I WAS ONLY ABLE TO FIND ONE SOLID REFERENCE ONLINE,
  [9]
  WHICH READS, "Weight increased with olanzapine treatment in a
  dose-dependent manner in at least one study (Eli Lilly trial 982, p. 15)."

and inserted a dubious templage in the article. --Chuck369 (talk) 03:32, 27 February 2010 (UTC)

deleted spurious comment

deleted spurious comment: allegations have no citations, an unsubstantiated poorly-written rant

---

—Preceding unsigned comment added by Groovymaster (talk • contribs) 15:29, 6 June 2010 (UTC)

92.235.205.104 (talk) 03:23, 23 June 2010 (UTC)One thing that hasn't been mentioned on this page, I developed a sensitivity to sunlight after 4 years of taking Olanzapine. The skin on my face flaked really badly after exposure to sunlight and it was very distressing. The problem cleared up when I stopped taking the drug.

92.235.205.104 (talk) 03:23, 23 June 2010 (UTC)I found I gained weight very quickly on doses of more than 10mg per day or more. But I lost weight fast on a much smaller dose of 2.5mg every other day. —Preceding unsigned comment added by 92.235.205.104 (talk) 03:12, 23 June 2010 (UTC)

Symbyax

I don't think it's best the route 'Symbyax' just to this page. It could use a page of it's own, or at least being routed to a subsection, since it's a different thing. I might make a stub for this soon... Persephone12 (talk) 12:33, 13 July 2010 (UTC)

I made it a new article. Persephone12 (talk) 21:41, 17 July 2010 (UTC)

"Zombie Retardation"

Why is "Zombie Retardation" listed as an adverse reaction? Is this even a condition? This sounds like a horror movie, or a prank. If this is (by slim chance) a medical symptom, then I think it should link to an article or have an explanation. —Preceding unsigned comment added by 67.61.51.183 (talk) 06:11, 20 October 2010 (UTC)

Questionable citations

"Similarly to other antipsychotics prolonged use is often associated with permanent brain damage.[22]"

The link provided here is a text on Google Books - "Brain Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Psychopharmaceutical Complex".

This looks like highly biased, hysterical anti-medicine, anti-psychiatry "pharma conspiracy" content of questionable scientific integrity - like something we'd expect to see from the church of scientology or something. Just look at the title. I don't think it's a credible citation.

---

— Preceding unsigned comment added by 58.161.8.230 (talk) 10:37, 28 June 2011 (UTC)

Patent expiry

US patents expired 23 Oct 2011 : 5,229,382 5,817,657 5,627,178 5,229,382 5,817,656 5,817,655 5,229,382 5,229,382. - Rod57 (talk) 10:09, 25 October 2011 (UTC)

The Chemistry Section

Someone needs to explain in great detail using descriptive words to explain how this chemical is made or synthesized in language that the lay person can understand. A chart is not enough and the section alludes that there are many methods to synthesis this molecule so therefore all methods should be explained. 2602:306:C518:62C0:5C06:758E:E477:60D6 (talk) 23:18, 31 July 2012 (UTC)

what purpose would that serve? — Preceding unsigned comment added by 82.45.216.153 (talk) 00:34, 15 January 2013 (UTC)

dysarthria

Is "dysarthria" *just* an overdose symptom, or a symptom for those naive to the drug / general adverse effect, as well? I was given a liquid dose of this in a shot at a hospital due to a stimulant psychosis symptom, and for the next two days I couldn't get words out, I sounded as if I had a speech impediment. 65.102.28.192 (talk) 01:12, 15 December 2011 (UTC)

Dysarthria and other extrapyramidal side effects are generally a much less likely side effect with olanzapine than it is with drugs such as haloperidol or zuclopenthixol, or even newer drugs like risperidone. The Adverse effects section of this page needs to be rewritten to reflect the frequency of the different adverse effects as a list offers no information on this. One more task to do. Casliber (talk · contribs) 02:00, 15 December 2011 (UTC)

The Chemistry Section

Someone needs to explain in great detail using descriptive words to explain how this chemical is made or synthesized in language that the lay person can understand. A chart is not enough and the section alludes that there are many methods to synthesis this molecule so therefore all methods should be explained. 2602:306:C518:62C0:5C06:758E:E477:60D6 (talk) 23:18, 31 July 2012 (UTC)

what purpose would that serve? — Preceding unsigned comment added by 82.45.216.153 (talk) 00:34, 15 January 2013 (UTC)

Adverse effects (deli nk)

Why did you undo my edit? 78.156.109.166 (talk) 08:31, 28 April 2013 (UTC)

"Illegal promotion" paragraph removed

I've removed the paragraph below. I have no opinion on the drug or its use, or knowledge of the "qui tam" (class action) suits alleged, but it lacks clarity, citations, context, and doesn't make much sense. Please restore the paragraph if you have better sources and wording. 201.171.122.70 (talk) 09:13, 25 January 2013 (UTC)

===(removed paragraph) Illegal promotion in US===

The criminal information alleged that Zyprexa was promoted (1999-2003) in nursing homes and assisted-living facilities for the treatment of disorders such as dementia, Alzheimer’s dementia, depression, anxiety, and sleep problems, and behavioral symptoms such as agitation, aggression, and hostility. The qui tam lawsuits alleged that Zyprexa was promoted (1999-2005) for use in patients of all ages and for the treatment of anxiety, irritability, depression, nausea, Alzheimer’s and other mood disorders. Off-label promotion of pharmaceutical drugs is considered, by the U.S. Food and Drug Administration (FDA), to be a serious crime that undermines their role in drug regulation and public safety.

I am sorry I think this is very important, please put it back.Booklaunch (talk) 19:56, 12 May 2013 (UTC)

Related news

I would like to suggest something is said about newspapers headlines. Why? bacause I think the medical profession is biased and there should be a counterweight in order to guarantee neutral point of view at wikipedia. — Preceding unsigned comment added by Booklaunch (talk • contribs) 19:58, 12 May 2013 (UTC)

Lead

I am sorry i reverted you summary addition because I feel is completely off topic especially for the first paragraph, should be in later sectionsSevendigits (talk) 15:36, 13 May 2013 (UTC)

In 2002, British and Japanese regulatory agencies warned that Zyprexa may be linked to diabetes. The FDA issued a similar warning in 2003, but Lilly did not publicly disclose their own findings. Eli Lilly agreed in 2007 to pay up to $500 million to settle thousands of lawsuits from people who claimed they developed diabetes or other diseases after taking Zyprexa. In January 2009 Eli Lilly pled guilty to a criminal misdemeanor charge of illegally marketing Zyprexa for off-label use, and agreed to pay $1.4 billion. Although Lilly had evidence that it is not effective for dementia, Zyprexa was marketed for elderly Alzheimer's patients. The drug carries an F.D.A. warning that it increases the risk of death in older patients with dementia-related psychosis.

I was expanding the lead to provide a better summary of article, per WP:Lead. A one paragraph lead is too short, and the notable regulatory aspects of this drug, discussed in the body of the article, needs to be mentioned in the intro. Johnfos (talk) 06:52, 15 May 2013 (UTC)

Accidental injury?

What's up with that? Pubserv (talk) 19:28, 25 August 2013 (UTC)

NMS

Someone add Neuroleptic Malignant Syndrome to the side effects. Also, why does the Zyprexa talk page have so few entries compared to the Risperdal talk page? 78.156.109.166 (talk) 08:34, 24 October 2013 (UTC)

Zyprexa in popular culture

I added a rubric about zyprexa in popular culture like lithium and prozac have but it was deleted straightaway — Preceding unsigned comment added by 217.231.152.138 (talk) 14:49, 8 April 2014 (UTC)

It's just trivia that is not relevant to the article content and therefore inappropriate include. -- Ed (Edgar181)

Hello to anyone! And I am using olanzapine but this medicine has destroyed my whole dreams. What can I? Do you help me?--213.74.88.251 (talk) 15:01, 2 October 2014 (UTC)

Possible Vandalism by a troll

This quote is possible vandalism by a troll because Olanzapine is first line in anorexia nervosa - "Evidence does not support the use of atypical antipsychotics including olanzapine in eating disorders." 182.255.99.214 (talk) 08:32, 25 February 2015 (UTC)

Ref says "For eating disorder patients specifically, evidence shows that atypicals are do not cause significant weight gain." [10] So looks fine. Here are our referencing requirements if you are interested WP:MEDRS Doc James (talk · contribs · email) 09:00, 25 February 2015 (UTC)

What are the Yanks doing for Tx of AN? Only SSRI's and Maudsley? This is more so the regime for BN 182.255.99.214 (talk) 10:30, 11 March 2015 (UTC)

IP address, is there a treatment guideline you are aware of, that says this? quite often with psych drugs, all options are poor, and treatment guidelines are what guide doctors and patients through the morass. Jytdog (talk) 13:15, 25 February 2015 (UTC)

Best Practice BMJ: "Atypical antipsychotics have been used in the treatment of AN. A double-blind placebo-controlled study has shown that adult patients receiving olanzapine attain ideal body weight slightly more rapidly than those receiving placebo, with a slightly greater reduction in obsessive compulsive symptoms in the olanzapine-treated group. [82] There are very few reports of the use of olanzapine in adolescents. [82] Care should be taken to decrease and discontinue treatment when the patient is near ideal body weight. Atypical antipsychotics - particularly ziprasidone, but perhaps the other atypicals as well - can be associated with prolonged QTc interval. [83] Thus, prior to use of olanzapine, an ECG should be performed and repeated periodically during treatment."

NHS has suggested that in the UK olanzapine is second line after SSRI's, but the reality is that first presentation for AN is usually in ED, where electrolytes are rebalanced... and of course an antipsychotic is introduced. It's rare practitioners will wait 8 weeks for an SSRI to kick in (http://www.nhs.uk/Conditions/Anorexia-nervosa/Pages/Treatment.aspx) 182.255.99.214 (talk) 10:26, 11 March 2015 (UTC)

I've confirmed with a pediatric consultant at John Hunter Hospital who is a specialist in Eating disorders who has confirmed Olanzapine is used in AN. Interested to find out what others are doing? 182.255.99.214 (talk) 05:16, 14 March 2015 (UTC)

Which BMJ paper is that? Doc James (talk · contribs · email) 05:34, 14 March 2015 (UTC)

182.255.99.214 thanks for contributing but neither your word, nor your claim that someone else made a claim, is really useful here. This whole place is predicated on anonymity of contributors, and building the encyclopedia based on reliable sources, so that the content can be verified; no "original research" is allowed. Relevant policies are no original research and verifiability; the guideline for sourcing for health content is WP:MEDRS. So per Doc James, we do need published sources that comply with MEDRS. But really, thanks! Jytdog (talk) 11:37, 14 March 2015 (UTC)

Best Practice is subscription only access to doctors, and is widely used in the UK and Australia in medical practice. It is considered "best practice" in the UK and Australia. The website is located here. It indicates what is first line, second line, adjunct, etc. It's what all practitioners use. This isn't predicated only upon my own experience, or that of the consultant. It's what is considered best practice here in Australia 182.255.99.214 (talk) 11:22, 18 March 2015 (UTC)

thanks for getting us to the site at least. ok, here is the actual source. It says Olanzapine is an additional first line treatment for AN but only with OCD; not generally. Jytdog (talk) 12:51, 18 March 2015 (UTC)

Yes and for OCD we say "Atypical antipsychotics such as quetiapine may be useful when used in addition to an SSRI in treatment-resistant cases" Doc James (talk · contribs · email) 16:29, 18 March 2015 (UTC)

Alright, all I can mention is the Tx guideline here in Australia, I can't speak for overseas. The point is, that for the Tx guideline, Olanzapine is used as a Tx. However, there is a quote saying "Evidence does not support the use of atypical antipsychotics including olanzapine in eating disorders". As you mentioned because of WP:NOR and WP:VERIFY, this assertion, requires justification. It's difficult to prove because it is a negative assertion. Nonetheless, there is no citation that mentions that evidence doesn't support olanzapine. In fact, the only evidence presented above is that it is used in eating disorders (even if, for overseas localities, there are qualifications - e.g. only in +OCD) 182.255.99.214 (talk) 06:24, 19 March 2015 (UTC)

I've asked several other Consultants what's the go with Olanzapine, and I can confirm that it is usual practice to use Olanzapine in Australia - even if it is not in other jurisdiction. UpToDate (another resource which is behind a paywall - most quality medical resources are), states the following:

Randomized trials show that antipsychotics (eg, olanzapine) may possibly be useful for restoring weight [14,15]. However, many other psychotropic drugs have demonstrated little or no benefit for weight gain and other indications [1-4,16,17].

There are several possible explanations for the general lack of demonstrated efficacy of pharmacotherapy in anorexia nervosa. One is that relatively few rigorous trials have been conducted [1,18]. Also, many patients refuse to participate in randomized pharmacotherapy trials or drop-out after enrollment; these problems make it difficult to interpret the results and to demonstrate a beneficial effect [7]. As an example, a one-year randomized trial with 122 patients found that 55 percent dropped out, and much of the attrition occurred within the first five weeks.

Antipsychotics — Adjunctive treatment with antipsychotics has little to no benefit in restoring weight in patients with anorexia nervosa, based upon pooled results for different drugs that were evaluated in small randomized trials:

●A meta-analysis of seven trials compared the effect of various antipsychotics with placebo upon body weight in 195 patients; the duration of treatment ranged from 7 to 12 weeks. Patients were assigned to olanzapine (n = 51), quetiapine (n = 15), risperidone (n = 16), sulpiride (n = 9), placebo (n = 86), or treatment as usual in the one open label trial (n = 18) [6]. The analysis found a clinically modest benefit with a statistical trend favoring antipsychotics over placebo/usual care; there was little to no heterogeneity across studies.

●A meta-analysis of six trials (166 patients) compared second generation antipsychotics (olanzapine or risperidone) with placebo and found that the effects upon body mass index were comparable [20]

Olanzapine — For acutely ill patients not gaining weight with nutritional rehabilitation plus psychotherapy, we suggest adjunctive treatment with olanzapine 2.5 mg to 10 mg per day. Olanzapine has been more widely studied for treatment of anorexia nervosa than any other antipsychotic [15,21,22]. A meta-analysis of four randomized trials compared olanzapine with placebo in 106 patients with anorexia nervosa, and found that weight gain was comparable [6]. However, only one trial yielded a point estimate that favored placebo, and this trial had the fewest number of patients (n = 19) and thus the least precision in its estimate of treatment effects [23]. Although the pooled trials showed no benefit to prescribing olanzapine, in our clinical experience it is reasonable to try the drug for patients who do not gain weight despite first line treatment with nutritional rehabilitation and psychotherapy.

The primary adverse effect during short-term treatment of anorexia nervosa with olanzapine is sedation. In a meta-analysis of three homogeneous randomized trials (68 patients with anorexia nervosa), drowsiness occurred in more patients who received olanzapine than placebo (89 versus 3 percent) [6]. This is consistent with a review of randomized trials and observational studies that found olanzapine (and other second-generation antipsychotics) often caused somnolence, but were otherwise safe and well tolerated in patients with anorexia nervosa [24]. Nevertheless, the published experience is limited and there are concerns about metabolic complications and other problems that may arise with long-term treatment.

Their final recommendation is as folloows:

For acutely ill patients not gaining weight with nutritional rehabilitation plus psychotherapy, we suggest adjunctive treatment with olanzapine 2.5 mg to 10 mg per day, rather than other medications (Grade 2C). (See 'Olanzapine' above and 'Other pharmacologic agents' above.).

There you also have justification of why there is general lack of demonstrated efficacy of pharmacotherapy in AN (i.e. refusal to participate, drop out), and even then, meta-analysis shows that there is "clinically modest benefit" of "favoring antipsychotics over placebos" in a meta anlysis of 7 trials, and may "possibly be useful for restoring weight", cf. other psychotropic drugs with little/no benefit. As the article mentions, you use olanzapine 2.5mg-10mg/day. The article does mention "Although the pooled trials showed no benefit to prescribing olanzapine, in our clinical experience it is reasonable to try the drug for patients who do not gain weight despite first line treatment with nutritional rehabilitation and psychotherapy". Again, because I work in pediatrics I can only say what we do - and we use Olanzapine, which is contradictory of the statement in the article, that "Evidence does not support the use of atypical antipsychotics including olanzapine in eating disorders", where the onus is placed on the author to justify their position. And this resource confirms that Olanzapine is clinically used whether or not it is justified in research - and that research has some justification, although because of the small sample size, may not be representative. It is also mainstay as part of Maudsley FBT (Maudsley Family Therapy). 182.255.99.214 (talk) 11:30, 19 March 2015 (UTC)

Pharmaceutical product

I do not like Wikipedia publicising such topics in a bad light. :-) Thank you. — Preceding unsigned comment added by Vijay Chary (talk • contribs) 06:08, 21 November 2015 (UTC)

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NYT

Here's an important article that just came out in the NY Times http://www.nytimes.com/2006/12/18/business/18drug.html?hp&ex=1166504400&en=abbfa89f1f363c93&ei=5094&partner=homepage — Preceding unsigned comment added by 71.206.230.233 (talk)

The article has been incorporated in the "Controversy and litigation" section. Thanks!―Biochemistry🙴❤ 07:56, 3 June 2018 (UTC)

Overdose

The listed effect of Overdose is a company line, in the real world a person can expect cold flashes, followed shortly by tiredness leading to sleep — Preceding unsigned comment added by 101.174.224.200 (talk) 10:53, 16 March 2018 (UTC)

Personal experiences are not useful sources of encyclopedic information.―Biochemistry🙴❤ 07:58, 3 June 2018 (UTC)