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Olanzapine tablets are usually taken 1 time per day with or without food. A health care professional will keep you in a setting where you can be observed for at least 3 hours after each injection What Happens If I Miss A Dose Of Olanzapine.

If you miss a dose of olanzapine, take it as soon as you remember, unless it is closer to the time of your next dose. What Should I Avoid While Taking Olanzapine.

What Happens If I Overdose With Olanzapine. A specific treatment to reverse the effects of olanzapine does not exist.

What Are Possible Side Effects Of Olanzapine. Are There Any Risks For Taking Olanzapine For Long Periods Of Time. Cigarette (and other types of) smoke can decrease levels of olanzapine. How Long Does It Take For Olanzapine To Work. Hallucinations, disorganized thinking, and delusions may improve in the first 1-2 weeks Sometimes these symptoms do not completely go away Motivation and desire to be around other people can take at least 1-2 weeks to improve Symptoms continue to get better the longer you take olanzapine It may take 2-3 months before you get the full benefit of olanzapine Summary of FDA Black Box Warnings Increased mortality in elderly patients with dementia-related psychosis Both first generation (typical) and second generation (atypical) antipsychotics are associated with an increased risk of mortality in elderly patients when used for dementia related psychosis.

Although there were multiple causes of death in studies, most deaths appeared to be due to cardiovascular causes (e. Antipsychotics are not indicated for the treatment of dementia-related psychosis. This has not been reported with olanzapine tablets. Zyprexa Relprevv (olanzapine long-acting injection) must be given at a registered healthcare facility with access to emergency response services.

S80925 Editor who approved publication: Dr Roger PinderRayees Ahmad Wani, Mansoor Ahmad Dar, Rajesh Kumar Chandel, Yasir Hassan Rather, Inaamul Haq, Arshad Hussain, Altaf Ahmad MallaDepartment of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, IndiaBackground: Patients with schizophrenia suffer high rates of metabolic derangements on some antipsychotic medications that predispose them to cardiovascular diseases.

Keeping this fact in mind, we planned this open-label study to see the effect on various metabolic parameters after switching stable schizophrenia subjects, who had developed metabolic syndrome on olanzapine, to aripiprazole. Methods: Sixty-two patients with schizophrenia who were stable on olanzapine and were fulfilling modified National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III) criteria for the presence of metabolic syndrome were enrolled on the study. Patients were randomly assigned either to switch to aripiprazole or to stay on olanzapine, on a 1:1 basis.

Cross-tapering over a period of 1 month was done while switching patients to aripiprazole. Results: All parameters of metabolic syndrome (waist circumference, blood pressure, triglyceride level, fasting blood glucose, and high-density lipoprotein cholesterol) kept deteriorating in the stay group, compared with a continuous improvement in the switch group over time.

Keywords: metabolic syndrome, olanzapine, aripiprazole, schizophrenia, switchingCorrigendum has been published for this paperMetabolic syndrome is a complex disorder comprising a set of cardiovascular risk factors, including obesity, dyslipidemia, deranged glucose metabolism, insulin insensitivity, and hypertension. Studies show that metabolic syndrome is associated with twofold to threefold increased risk of cardiovascular morbidity. These metabolic abnormalities are further aggravated by antipsychotic medications.

Aripiprazole has a unique mechanism of action among second-generation antipsychotic medications: it is a partial agonist at D2 dopamine and 5-HT1A serotonin receptors and an antagonist at 5-HT2A serotonin receptors. We hypothesized that switching to aripiprazole would result in an improvement in metabolic measures, compared with staying on olanzapine.

We were also interested in determining if switching to aripiprazole would be accompanied by any clinical destabilization. Earlier, Fleischhacker et al30 in their study comparing the efficacy and tolerability of aripiprazole with olanzapine in patients with schizophrenia found that olanzapine had a statistically significant efficacy advantage over aripiprazole, with more reduction in Positive and Negative Syndrome Scale (PANSS) total score.

Pae et al31 found that patients switched to aripiprazole, with sudden discontinuation of the previous antipsychotic medication, showed an increase in symptom severity during first week of switching. Moreover, few studies have been done in this field,32,33 and none has been from our Kashmir region. The study was carried out at the outpatient unit of a tertiary care psychiatry hospital in North India (Kashmir) from June 2011 to May 2014, after seeking permission from the IEC of the government medical college, Srinagar.

Participants were individuals with schizophrenia who had achieved clinical stability with olanzapine and who were assessed as having metabolic syndrome using modified National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III) criteria.

The patients entered the study in order to improve their metabolic risk profile. Informed consent was obtained from each patient after fully explaining the study procedures. Individuals assigned to stay on olanzapine remained on their prestudy dosage, with adjustments only as clinically indicated. PANSS was used at baseline and 24 weeks, while the Clinical Global Impressions severity subscale (CGI-S) was used at baseline and the Clinical Global Impressions improvement subscale (CGI-I) was used at 24 weeks.

The addition of lithium, valproate, statins, or drugs prescribed for weight loss was not allowed during the study. Those who were taking these medications during the prestudy phase were allowed to continue without dose adjustments.

All other medications except for nonstudy antipsychotic drugs were allowed. The waist circumference was measured in a horizontal plane, midway between the inferior margin of the ribs and the superior border of the iliac crest. The measurements were taken thrice and the mean was computed in all cases.

Systolic and diastolic blood pressure were measured twice at an interval of 3 minutes in the sitting position after a 15-minute rest, and the mean was computed. Metabolic syndrome was diagnosed using modified NCEP ATP-III criteria for the Asian population.

Assessment for any clinical destabilization was done using the PANSS and CGI scales. Continuous variables were summarized as mean and standard deviation.

Categorical variables were summarized as percentages. CGI-I and CGI-S were summarized as median and interquartile range. Repeated-measures analysis of variance was used to analyze the difference in the values of a continuous variable over time.

The proportion of metabolic syndrome across time was tested using the Cochran Q-test. The progression of the two groups through the study is shown in Figure 1. Table 1 summarizes the sociodemographic characteristics of the participants. Table 2 shows both intergroup and within-group trends in various metabolic and clinical variables.

Last observation carried forward was employed for data imputation. Among the various parameters of metabolic syndrome, waist circumference, blood pressure, triglyceride level, and fasting blood glucose kept increasing in the stay group, while HDL level showed a decreasing trend. In the switch group, waist circumference, blood pressure, triglyceride level, and fasting blood glucose kept decreasing, while HDL level increased with time. Table 3 shows the analysis of completers versus noncompleters of the study.

Two patients from both groups experienced efficacy failure (ie, they were hospitalized).