Back to Browse Journals » Neuropsychiatric Disease and Treatment » Volume 6 » Issue 1

Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder in adolescent patients

Authors Ann E Maloney, Linmarie Sikich

Published Date November 2010 Volume 2010:6(1) Pages 749—766


Published 10 November 2010

Ann E Maloney1,2, Linmarie Sikich3
1Maine Medical Center Research Institute, Scarborough, ME, USA; 2Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA; 3Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Background: Severe and persistent mental illnesses in children and adolescents, such as early-onset schizophrenia spectrum (EOSS) disorders and pediatric bipolar disorder (pedBP), are increasingly recognized. Few treatments have demonstrated efficacy in rigorous clinical trials. Enduring response to current medications appears limited. Recently, olanzapine was approved for the treatment of adolescents with schizophrenia or acute manic/mixed episodes in pedBP.
Methods: PubMed searches were conducted for olanzapine combined with pharmacology, schizophrenia, or bipolar disorder. Searches related to schizophrenia and bipolar disorder were limited to children and adolescents. The bibliographies of the retrieved articles were hand-checked for additional relevant studies. The epidemiology, phenomenology, and treatment of EOSS and pedBP, and olanzapine’s pharmacology are reviewed. Studies of olanzapine treatment in youth with EOSS and pedBP are examined.
Results: Olanzapine is efficacious for EOSS and pedBP. However, olanzapine is not more efficacious than risperidone, molindone, or haloperidol in EOSS and is less efficacious than clozapine in treatment-resistant EOSS. No comparative trials have been done in pedBP. Olanzapine is associated with weight gain, dyslipidemia, and transaminase elevations in youth. Extrapyramidal symptoms, neuroleptic malignant syndrome, and blood dyscrasias have also been reported but appear rare.
Conclusions: The authors conclude that olanzapine should be considered a second-line agent in EOSS and pedBP due to its risks for significant weight gain and lipid dysregulation. Awareness of the consistent weight and metabolic changes observed in olanzapine-treated youth focused attention on the potential long-term risks of atypical antipsychotics in youth.

Keywords: early-onset schizophrenia, pediatric bipolar disorder, antipsychotic

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at:

Readers of this article also read:

Nanofibrous poly(lactide-co-glycolide) membranes loaded with diamond nanoparticles as promising substrates for bone tissue engineering

Parizek M, Douglas TEL, Novotna K, Kromka A, Brady MA, Renzing A, Voss E, Jarosova M, Palatinus L, Tesarek P, Ryparova P, Lisa V, dos Santos AM, Bacakova L

International Journal of Nanomedicine 2012, 7:1931-1951

Published Date: 17 April 2012

Quantum dot-based quantitative immunofluorescence detection and spectrum analysis of epidermal growth factor receptor in breast cancer tissue arrays

Yang XQ, Chen C, Peng CW, Hou JX, Liu SP, Qi CB, Gong YP, Zhu XB, Pang DW, Li Y

International Journal of Nanomedicine 2011, 6:2265-2273

Published Date: 11 October 2011

Radio electric asymmetric brain stimulation in the treatment of behavioral and psychiatric symptoms in Alzheimer disease

Mannu P, Rinaldi S, Fontani V, Castagna A

Clinical Interventions in Aging 2011, 6:207-211

Published Date: 26 July 2011

Evidence to practice: treatment of anxiety in individuals with autism spectrum disorders

Russell Lang, Richard Mahoney, Farah El Zein, et al

Neuropsychiatric Disease and Treatment 2011, 7:27-30

Published Date: 25 January 2011

Plasmid DNA delivery into MDA-MB-453 cells mediated by recombinant Her-NLS fusion protein

Sivakumar Jeyarajan, Jennifer Xavier, N Madhusudhana Rao, et al

International Journal of Nanomedicine 2010, 5:725-733

Published Date: 21 September 2010

Profile of olanzapine long-acting injection for the maintenance treatment of adult patients with schizophrenia

Rosaria Di Lorenzo, Alice Brogli

Neuropsychiatric Disease and Treatment 2010, 6:573-581

Published Date: 1 September 2010

Changes in six-minute walking distance during pulmonary rehabilitation in patients with COPD and in healthy subjects

Imen Ben Cheikh Rejbi, Yassine Trabelsi, Afef Chouchene, et al

International Journal of Chronic Obstructive Pulmonary Disease 2010, 5:209-215

Published Date: 7 July 2010

Health literacy and health seeking behavior among older men in a middle-income nation

Paul A Bourne, Chloe Morris, Christopher AD Charles, et al

Patient Related Outcome Measures 2010, 1:39-49

Published Date: 26 May 2010

Defect of alveolar regeneration in pulmonary emphysema: Role of lung fibroblasts

Laurent Plantier, Jorge Boczkowski, Bruno Crestani

International Journal of Chronic Obstructive Pulmonary Disease 2007, 2:463-469

Published Date: 16 January 2007