New antipsychotics eg, risperidone risperdal , olanzapine zyprexa , quetiapine seroquel may be safer for demented patients than the traditional drugs.
Information about Olanzapine.
Olanzapine is not recommended for use in patients with dementia-related psychosis and/or behavioural disturbances because of an increase in mortality and the risk of cerebrovascular accidentIn placebo-controlled clinical trials6-12 weeks durationof elderly patientsmean age 78 yearswith dementia-related psychosis and/or disturbed behavioursthere was a 2-fold increase in the incidence of death in olanzapine-treated patients compared to patients treated with placebo3.5vs1.5respectivelyThe higher incidence of death was not associated with olanzapine dosemean daily dose 4.4 mgor duration of treatmentRisk factors that may predispose this patient population to increased mortality include age65 yearsdysphagiasedationmalnutrition and dehydrationpulmonary conditionse.gpneumoniawith or without aspirationor concomitant use of benzodiazepinesHoweverthe incidence of death was higher in olanzapine-treated than in placebo-treated patients independent of these risk factors.
Bipolar I DisorderManic or Mixed EpisodesOlanzapine as Adjunct to Lithium or ValproateIn a study of patients who were already tolerating either lithium or valproate as monotherapydiscontinuation rates due to adverse reactions were 11for the combination of oral olanzapine with lithium or valproate compared to 2for patients who remained on lithium or valproate monotherapyDiscontinuations with the combination of oral olanzapine and lithium or valproate that occurred in more than 1 patient weresomnolence3weight gain1and peripheral edema1
SEARCH STRATEGYThe reviewers undertook electronic searches of Biological Abstracts1980-1999The Cochrane LibraryIssue 21999The Cochrane Schizophrenia Group’s RegisterSeptember 1999EMBASE1980-1999MEDLINE1966-1999and PsycLIT1974-1999References of all identified studies were searched for further trialsand the reviewers contacted relevant pharmaceutical companies and authors of trials.
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i have now been off olanzapine for just over 4 months and i still have nausea and vomiting.
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