At first, the antipsychotic drug may have rescued John from his hallucinations and other symptoms of acute psychosis. But after taking olanzapine for five years, John gained some 80 pounds. His mother believes the weight he gained while on olanzapine contributed to the heart disease that killed him.

Olanzapine has been used for more than a decade to treat schizophrenia and bipolar disorder. However, the long-term physical effects of the medication are rarely addressed in a psychiatrist’s office. That becomes a problem for many patients who don’t know that antipsychotics like olanzapine can toy first with the body’s metabolism until their weight gain leads to potentially dangerous health issues.

If only that were the issue. Another concern is that olanzapine and other psychiatric drugs have a habit of finding their way onto the streets, where their sedating effects are open to abuse. Although olanzapine is not addictive, the body has a difficult time adjusting without it.

What is Olanzapine (Zyprexa)?

Olanzapine is a prescription drug that’s sold in the United States under the name Zyprexa. It’s in a class of medications called antipsychotics that are used to treat mental health issues that cause psychosis. Olanzapine is used to treat mental health problems like schizophrenia, bipolar disorder, and severe major depressive disorder. Psychosis can cause disturbing symptoms like hallucinations, delusions, uncontrollable movements, and other psychological symptoms. Olanzapine can help by alleviating some of these symptoms. 

Antipsychotics are separated into two categories: typical and atypical antipsychotics. Typical depressants are the first generation of antipsychotics that have been almost completely replaced by second-generation atypical antipsychotics. Typical antipsychotics work to block a chemical called dopamine from binding to receptors all over the brain. This helps alleviate symptoms like hallucinations and delusions, but it can make other symptoms like anhedonia, movement problems, and flat affect worse. 

Atypical antipsychotics, like olanzapine, interact with both dopamine and serotonin in the brain. This helps to mitigate some of the common side effects of antipsychotics and alleviates symptoms without making others worse. Still, olanzapine does have some common side effects. One of the main ones is that it causes drowsiness.

Does Olanzapine Cause Chemical Dependence?

Illicit and prescription drugs that cause the most uncomfortable withdrawal symptoms often have a high likelihood of causing chemical dependence. Dependence occurs when your brain adapts to the presence of a drug by changing your brain chemistry or structure in response to the presence of a drug. In many cases, your brain will increase or decrease the number of receptors on a nerve cell to counteract drugs that interact with chemical messengers like dopamine or serotonin. 

Olanzapine does cause some side effects that are similar to the effects of central nervous system depressants like alcohol and benzodiazepines. Drugs with these sedating effects are often misused to achieve a relaxing, alcohol-like intoxication. However, according to the U.S. Food and Drug Administration, olanzapine’s chemical dependence liability has been studied in animal tests. 

Tests on rats and monkeys have shown that the drug has very little potential for dependence and drug abuse. In humans, clinical trials didn’t show any drug-seeking behavior, but olanzapine hasn’t been systematically tested for its abuse potential in humans. Still, the FDA recommends that patients with a history of drug use problems should be monitored for tolerance and signs of chemical dependence. 

How Does Olanzapine Work?

Once ingested, olanzapine blocks receptors in the brain to balance the release of neurotransmitters, such as dopamine and serotonin. These neurotransmitters are stored in nerve cells, which travel to different sections of the brain to control the excessive activity associated with schizophrenia and mania.

In this way, olanzapine influences neurotransmitters to manage thinking, mood and behavior. Most people are prescribed olanzapine in small doses. Olanzapine can take weeks of regular use to have any effect on anxiety, depression, hallucinations or disturbing thoughts. Of course, the longer the period olanzapine is taken, the more patients become dependent on the drug to function normally.

Olanzapine may induce side effects before any of the benefits of the drug are realized. These side effects may include:

  • Weight gain, increased appetite
  • Headache, dizziness, drowsiness, tiredness or restlessness
  • Problems with speech or memory
  • Tremors, shaking, numbness or tingly feelings
  • Changes in personality
  • Dry mouth, or increased salivation

Olanzapine is said to have fewer side effects than older antipsychotic drugs. But, at some point, some of these side effects including the increased risk for stroke and diabetes may still outweigh the benefits of taking it. For patients who have taken olanzapine in larger doses for longer periods, the decision to stop taking the medication becomes that much more problematic.

What Is Olanzapine Withdrawal

Even though olanzapine doesn’t have a high likelihood to cause chemical dependence and substance use problems, it can cause some uncomfortable symptoms when you stop using it after using it for a while consistently.

For Olanzapine to work correctly, the pill or orally disintegrating tablet should be taken every day or as directed by a physician. When Olanzapine is first taken, the medication changes the neurotransmitter levels of dopamine, serotonin, histamine, and acetylcholine, blood flow and connectivity with the brain. For weeks, the brain adapts to a level of olanzapine and requires more of the drug to maintain a neurotransmitter balance. When dosages are skipped or reduced, withdrawal commences.

Since prescription drugs like olanzapine have complex effects on the brain and body, you may feel some effects when you stop using them. Withdrawal is fairly common with many prescription drugs. When you stop taking a drug, your brain takes time to readjust to life without it. Though your brain is adaptable, it can take a few days to a week to return to normal. Olanzapine withdrawal is typically mild, though it can be worse if you take the drug for a long time and quit abruptly. 

What Are Olanzapine Withdrawal Symptoms?

Withdrawal symptoms for olanzapine can be extremely harsh, especially if an individual decides to quit “cold turkey.” In this type of abrupt stoppage, individuals may find themselves struggling with severe symptoms as the brain attempts to adapt without the drug.

The exact number of symptoms, the nature of their severities and how long they persist will vary by individual. Some of these withdrawal symptoms may include:

  • Anger
  • Appetite change
  • Body aches
  • Dehydration
  • Depression
  • Difficulty concentrating
  • Excessive sweating
  • Fatigue
  • Feeling dizzy
  • Headaches
  • High anxiety
  • Insomnia
  • Irritability
  • Memory problems
  • Panic attacks
  • Restlessness
  • Sensory sensitivity
  • Sleep problems
  • Suicidal thoughts
  • Weight loss
  • Weird dreams 

The timeline and stages of olanzapine withdrawal can vary depending on the individual’s tolerance level, genetics, frequency of use and dosage. Whether or not olanzapine was used in combination with other drugs or alcohol will also factor in the withdrawal timeline.

For some individuals who have taken the drug for extended periods of time, withdrawal symptoms may linger for upward of 90 days or more. For others, the withdrawal may only persist for a couple of weeks.

By working with a healthcare provider to wean off olanzapine, individuals may not have any notable withdrawal symptoms at all. On the other hand, individuals who decide to quit “cold turkey” may find themselves really struggling with severe symptoms as their brain attempts to rewire itself to function without the drug.

If you’ve taken olanzapine for a while and you’d like to get off of the drug, it’s important to speak to a doctor. It’s a good idea to consult your doctor any time you’d like to change your dose or stop taking a prescription medication. Besides withdrawal symptoms, stopping olanzapine treatment can cause some symptoms of psychosis to return. Working with your doctor to come off of a medication is usually the best way to avoid serious withdrawal symptoms. 

The best method for treating olanzapine withdrawal is to taper off use gradually over time. Tapering off can take weeks. This process works best with the help of a doctor or substance abuse treatment provider, only when abuse of other drugs has ceased.

Why Should I Detox?

If you are abusing olanzapine, you are probably using the antipsychotic to self-medicate and relieve discomforting side effects from illicit drugs and alcohol. And the last thing you need is an adverse reaction to another drug. For this reason, individuals who wish to stop having to depend on olanzapine, alcohol or any street drugs should work with a substance abuse treatment provider. This type of supervision is typically found at a hospital or residential treatment facility, where certified medical professionals can manage the physical symptoms associated with antipsychotic drug detoxification. Here, in a safe and peaceful environment, olanzapine can be prescribed in gradually reduced dosages to alleviate any common discomforts related to the withdrawal process. Medical staff monitors progress and prevents any unwarranted complications. Detox is a highly recommended first step on a path toward recovery.

What Is the Next Treatment Step?

Detox is only one part of treating a drug addiction of any kind. Following successful detox from olanzapine and other associated addictions, any real chance at recovery and sustained sobriety will require determination, commitment and an extended stay at a residential substance abuse treatment facility. Here you will be fitted with a personalized recovery plan customized to address your issues and unique circumstances. To strengthen your resistance to relapse and to start feeling good about yourself, you will also be exposed to additional forms of treatment including group therapy, one-on-one counseling, educational lectures and workshops as part of your recovery program.

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