Side Effects of olanzapine: A Synthesis of Findings from 20 Studies

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Original Abstract of the Article

Main Research Findings

Olanzapine, an atypical antipsychotic medication, has been associated with various metabolic side effects, including weight gain, elevated blood sugar, dyslipidemia, and insulin resistance. These side effects can be exacerbated by a high-fat diet (HFD) in patients with schizophrenia. 6 Studies have demonstrated that melatonin may effectively reduce these metabolic side effects. 18 Additionally, research has focused on the potential protective effects of thymoquinone, a compound found in black cumin seeds, in mitigating olanzapine-induced liver and metabolic side effects. 15 Furthermore, the endocannabinoid system and gut microbiome have been investigated for their roles in regulating metabolic side effects, with studies suggesting that olanzapine may impact these systems. 9

Reasons for Side Effects

The exact mechanisms underlying olanzapine-induced metabolic side effects are not fully understood. However, several hypotheses have been proposed, including disruptions in dopamine and serotonin neurotransmission, which may affect appetite and metabolism. 17 Additionally, olanzapine's potential to induce insulin resistance, impacting glucose metabolism, has also been investigated. 9 Moreover, studies suggest that olanzapine may directly influence the endocrine system and adipose tissue, contributing to metabolic alterations. 16

Common Side Effects

Weight Gain

Olanzapine is commonly associated with weight gain, a concern for many patients. 6 、 4 、 14 、 This side effect may be attributed to olanzapine's influence on appetite and metabolism.

Elevated Blood Sugar Levels

Olanzapine may lead to elevated blood sugar levels, potentially increasing the risk of developing diabetes. 14 、 5 、 8

Dyslipidemia

Olanzapine may cause dyslipidemia, characterized by abnormal cholesterol and triglyceride levels. 8 、 18 、 4 These lipid abnormalities can increase the risk of cardiovascular problems.

Insulin Resistance

Olanzapine can contribute to insulin resistance, a condition where the body does not respond properly to insulin. 6 、 14 、 9 This can further increase the risk of diabetes and cardiovascular disease.

Other Side Effects

In addition to the aforementioned metabolic side effects, olanzapine may also cause a range of other side effects, including constipation, dry mouth, drowsiness, dizziness, and movement disorders. 1 、 2 Rarely, more serious adverse events may occur.

Measures to Counteract Side Effects

Weight Gain

To address weight gain associated with olanzapine, lifestyle modifications are crucial. These include following a healthy diet plan and engaging in regular physical activity. In some cases, switching to a different antipsychotic medication or using medications specifically designed to reduce weight gain may be considered.

Elevated Blood Sugar Levels

Regular monitoring of blood sugar levels is essential for patients taking olanzapine. If elevated blood sugar levels are detected, the use of antidiabetic medications might be recommended.

Dyslipidemia

Lifestyle modifications, such as dietary changes and exercise, can play a significant role in managing dyslipidemia. In addition, the use of cholesterol-lowering medications may be considered as needed.

Insulin Resistance

Lifestyle changes and, if necessary, the use of medications that improve insulin sensitivity can help manage insulin resistance caused by olanzapine.

Comparison between Studies

Commonalities between Studies

Several studies consistently highlight the association of olanzapine with various metabolic side effects, including weight gain, elevated blood sugar, dyslipidemia, and insulin resistance. 6 、 14 、 4 、 17 、 9 、 16 、 7 、、、 10 、 12 、 19 、 20 、 18 、 5 、 13

Differences between Studies

Research findings vary regarding the severity and frequency of olanzapine's side effects, as well as the mechanisms underlying these effects. These differences may be attributed to variations in study populations, including age, sex, health status, dosage, treatment duration, and dietary habits.

Cautions Regarding Application to Real Life

Olanzapine is a valuable medication for managing mental illnesses, but patients need to be aware of its potential side effects, especially metabolic ones. Open and honest communication with a healthcare professional is essential. Regular health monitoring is crucial to identify any potential side effects early. Adopting healthy lifestyle habits, including balanced nutrition and regular exercise, can help manage the risk of side effects.

Limitations of Current Research

While research on olanzapine's side effects has provided valuable insights, there are still areas that require further investigation. For example, the extent to which individual differences influence side effect development and the specific factors that contribute to the onset of side effects require more research.

Future Research Directions

To advance our understanding of olanzapine's side effects, future research should focus on clarifying the mechanisms involved, identifying individual variations, and determining the factors that influence side effect development. Developing new therapeutic approaches or preventative measures to mitigate these side effects is also a critical area for research.

Conclusion

Olanzapine is a valuable medication for managing mental illnesses, but it can be associated with metabolic side effects. Open communication with a healthcare professional, regular health monitoring, and lifestyle modifications are crucial for managing these potential side effects. Further research is needed to improve our understanding and address these concerns.

Literature analysis of 20 papers
Positive Content
11
Neutral Content
1
Negative Content
8
Article Type
5
0
2
2
20
1.

Olanzapine for schizophrenia.

Author: DugganL, FentonM, DardennesR M, El-DosokyA, IndranS

Improved symptom response
Reduced extrapyramidal side effects
Weight gain

Olanzapine may be an effective antipsychotic for schizophrenia with fewer extrapyramidal side effects but with more weight gain compared to typical antipsychotics. Interpretation of results is difficult due to high attrition rates. Further large, long-term randomized trials are needed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

2.

Olanzapine for schizophrenia.

Author: DugganL, FentonM, DardennesR M, El-DosokyA, IndranS

Schizophrenia treatment
Weight gain

Olanzapine may offer antipsychotic efficacy with fewer extrapyramidal side effects than typical drugs, but more weight gain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

3.

A 12-week randomized clinical trial to evaluate metabolic changes in drug-naive, first-episode psychosis patients treated with haloperidol, olanzapine, or risperidone.

Author: Perez-IglesiasRocio, Crespo-FacorroBenedicto, AmadoJose Antonio, Garcia-UnzuetaMaria Teresa, Ramirez-BonillaMaria Luz, Gonzalez-BlanchCesar, Martinez-GarciaObdulia, Vazquez-BarqueroJose Luis

Metabolic disturbances
Weight gain

First- and second-generation antipsychotics were found to induce significant weight gain and metabolic disturbances in drug-naive patients with first-episode psychosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Metabolic risk with second-generation antipsychotic treatment: a double-blind randomized 8-week trial of risperidone and olanzapine.

Author: KellyDeanna L, ConleyRobert R, LoveRaymond C, MorrisonJohn A, McMahonRobert P

Psychotic treatment
Metabolic disturbances
Weight gain

This study examined weight and metabolic changes in patients treated with risperidone and olanzapine, two widely used second-generation antipsychotics. The study addressed the importance of early monitoring for metabolic side effects associated with these medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

A double blind, placebo-controlled, randomized crossover study of the acute metabolic effects of olanzapine in healthy volunteers.

Author: AlbaughVance L, SingareddyRavi, MaugerDavid, LynchChristopher J

Diabetes mellitus
Obesity

Atypical antipsychotics are known to cause metabolic side effects such as diabetes mellitus and obesity. These effects are preceded by acute worsening of oral glucose tolerance, reduced plasma free fatty acids, and leptin in animal models. It is unclear whether these acute effects occur in humans.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

HFD-exacerbated Metabolic Side Effects of Olanzapine Are Suppressed by ER Stress Inhibitor.

Author: ZuoYu-Feng, ZhangBao-Hua, GuoMing-Rui, LiBen-Ben, WangBao-Cui, DuanDeng, WangYu-Xin, XiJing, HeMeng, SunTao-Lei

ER stress
Metabolic disorders

This study investigated the deterioration of olanzapine-induced metabolic disorders in the presence of a high-fat diet (HFD), exploring the involvement of endoplasmic reticulum (ER) stress.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

The Influence of Substance Use on Side Effects of Olanzapine, Quetiapine, Risperidone, and Ziprasidone in Psychosis.

Author: AlisauskieneRenata, JohnsenErik, GjestadRolf, KrokenRune A, JørgensenHugo A, LøbergElse-Marie

Antipsychotic side effects

This study aimed to compare antipsychotic side effects in patients with psychosis with and without substance use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Comparative Study of Sexual Side Effects in Female Patients With Schizophrenia Receiving Risperidone or Olanzapine.

Author: KumarP N Suresh, RadhikaM K, SureshRohith, UvaisN A

Sexual dysfunction

This study aimed to determine the prevalence of sexual dysfunction in female patients with schizophrenia receiving olanzapine or risperidone and its relationship with other psychosocial variables.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Obesity exacerbates the acute metabolic side effects of olanzapine.

Author: TownsendLogan K, PepplerWillem T, BushNatasha D, WrightDavid C

Schizophrenia treatment
Olanzapine side effects

Olanzapine is an antipsychotic medication used to treat schizophrenia. This study found that olanzapine can worsen blood sugar control and insulin resistance in obese mice compared to lean mice. Olanzapine also reduced physical activity in both obese and lean mice. This suggests that olanzapine may have more severe side effects in people with obesity, a condition that is common among people with schizophrenia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

17.

Brain stem as a target site for the metabolic side effects of olanzapine.

Author: AnwarImran J, MiyataKayoko, ZsombokAndrea

Metabolic side effects

Olanzapine, an atypical antipsychotic, may cause metabolic side effects by hyperpolarizing neurons in the dorsal motor nucleus of the vagus nerve (DMV).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

18.

Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial.

Author: MostafaviAli, SolhiMahmoud, MohammadiMohammad-Reza, HamediMehdi, KeshavarziMaryam, AkhondzadehShahin

Metabolic side effects reduction

This study investigated the effects of melatonin on the metabolic side effects of olanzapine in children and adolescents with bipolar disorder. Melatonin was found to significantly inhibit the rise in total cholesterol levels and systolic blood pressure compared to placebo. Melatonin may be helpful in mitigating metabolic side effects associated with olanzapine treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Melatonin for prevention of metabolic side-effects of olanzapine in patients with first-episode schizophrenia: randomized double-blind placebo-controlled study.

Author: ModabberniaAmirhossein, HeidariParvaneh, SoleimaniRobabeh, SobhaniAbdolrasoul, RoshanZahra Atrkar, TaslimiShervin, AshrafiMandana, ModabberniaMohammad Jafar

Abdominal obesity reduction
Hypertriglyceridemia reduction
Psychosis treatment
Weight gain attenuation

This study investigated the efficacy of melatonin in preventing olanzapine-induced metabolic side effects in patients with first-episode schizophrenia. Melatonin was associated with significantly less weight gain, increase in waist circumference, and triglyceride concentration compared to placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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