A current review of olanzapine's safety in the geriatric patient: From pre-clinical pharmacology to clinical data

John S. Kennedy, Frank P. Bymaster, Leslie Schuh, David O. Calligaro, George Nomikos, Christian C. Felder, Mark Bernauer, Bruce J. Kinon, Robert W. Baker, Donald Hay, H. John Roth, Martin Dossenbach, Christopher Kaiser, Charles M. Beasley, John H. Holcombe, Mark B. Effron, Alan Breier

Research output: Contribution to journalReview article

47 Scopus citations

Abstract

Objective: Olanzapine (OLZ) is unique among currently available antipsychotic medications in its antagonism of a range of receptor systems including dopamine, norepinephrine, serotonin, acetylcholine, and histamine. Olanzapine's mechanistic complexity provides a broad efficacy profile in patients with schizophrenia and acute, pure or mixed mania. Patients experience symptomatic relief of mania, anxiety, hallucinations, delusions, and agitation/aggression and reduced depressive, negative, and some cognitive symptoms. This paper will review the safety profile of OLZ, focusing on the elderly, where data are available. Method: Preclinical and clinical studies of OLZ are reviewed, with emphasis on its possible effects on the cholinergic system and the histamine H1 receptor. Weight change and related metabolic considerations, cardiac and cardiovascular safety, and motor function during treatment with OLZ are also reviewed. Results and Conclusion: In vitro receptor characterization methods, when done using physiologically relevant conditions allow accurate prediction of the relatively low rate of anticholinergic-like adverse events, extrapyramidal symptoms, and cardiovascular adverse events during treatment with OLZ. Currently available clinical data suggest olanzapine is predictably safe in treating adult patients of any age with schizophrenia and acute bipolar mania, as well as in treatment of patients with some types of neurodegenerative disorders.

Original languageEnglish (US)
Pages (from-to)S33-S61
JournalInternational Journal of Geriatric Psychiatry
Volume16
Issue numberSUPPL. 1
DOIs
StatePublished - Jan 1 2001

Keywords

  • Alzheimer's dementia
  • Bipolar disorder
  • Dementia
  • Diabetes
  • Geriatric
  • Olanzapine
  • Receptors
  • Safety
  • Schizophrenia

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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    Kennedy, J. S., Bymaster, F. P., Schuh, L., Calligaro, D. O., Nomikos, G., Felder, C. C., Bernauer, M., Kinon, B. J., Baker, R. W., Hay, D., Roth, H. J., Dossenbach, M., Kaiser, C., Beasley, C. M., Holcombe, J. H., Effron, M. B., & Breier, A. (2001). A current review of olanzapine's safety in the geriatric patient: From pre-clinical pharmacology to clinical data. International Journal of Geriatric Psychiatry, 16(SUPPL. 1), S33-S61. https://doi.org/10.1002/1099-1166(200112)16:1+<::aid-gps571>3.0.co;2-5