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Key takeaways
Seroquel, Abilify, Geodon, Latuda, and Depakote are some alternatives to olanzapine, for those who may be interested in a different medication due to issues such as troublesome side effects from olanzapine.
Each alternative medication has unique characteristics and potential side effects, such as lower risk of metabolic issues with Abilify and less risk of cardiovascular effects with Latuda.
Natural alternatives and dietary adjustments, like increasing omega-3 fatty acids, may complement antipsychotic medication for psychosis treatment.
Switching from olanzapine to an alternative requires careful consideration of risks and benefits and should be done under the guidance of a healthcare professional.
Olanzapine may serve as a pivotal piece of your mental health maintenance. By influencing the action of brain neurotransmitters, namely dopamine and serotonin, it can halt schizophrenia’s psychotic symptoms, like hallucinations, paranoia, and delusions, and bipolar disorder’s manic and depressive symptoms. Thereafter, olanzapine is often continued long-term for prevention of these problems. Your enthusiasm for its extensive benefits may be justifiably tempered by experiences with adverse effects. The side effects bothering you could be weight gain, diabetes, high cholesterol, dry mouth, constipation, low blood pressure, or others. If you find yourself in this situation with olanzapine, a thoughtful, cautious approach is needed to analyze the risks and benefits of the medication. Gather information and see your healthcare provider for medical advice before making any changes. Information on alternatives to olanzapine will be covered for you here.
What can I take in place of olanzapine?
Olanzapine is better known by its brand name, Zyprexa. The drug is considered an antipsychotic, more specifically a second-generation antipsychotic or atypical antipsychotic. This class has a number of members, each with its own unique characteristics. Just because Zyprexa does not work out for you does not mean that another second-generation antipsychotic will not.
Differences between them include side effect risk and drug interaction rates, so a switch to another member of the class could make sense for mood stabilization in bipolar disorder or for psychosis in schizophrenia and schizoaffective disorders. If not, other mood stabilizer options for bipolar are available. Lithium and antiepileptic drugs (seizure controllers) can be effective for bipolar control. While more limited options exist for schizophrenia, first-generation antipsychotic drugs are an alternative.
Compare olanzapine alternatives |
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|---|---|---|---|
| Drug name | Uses | Dosage | Savings options |
| Zyprexa (olanzapine) | Schizophrenia, bipolar 1 disorder mania or mixed or acute depressive, acute treatment-resistant major depressive disorder | 5 to 20 mg once daily | Zyprexa coupons |
| Zyprexa Relprevv (olanzapine) | Schizophrenia | 150 to 300 mg intramuscular (IM) injection every 2 weeks or 150 to 405 mg IM injection every 4 weeks | Zyprexa Relprevv coupons |
| Zyprexa Zydis (olanzapine) | Schizophrenia, bipolar 1 disorder mania or mixed or acute depressive, acute treatment-resistant major depressive disorder | 5 to 20 mg orally disintegrating tablet (ODT) once daily | Zyprexa Zydis coupons |
| Seroquel (quetiapine) | Schizophrenia, bipolar 1 disorder mania or acute depressive | 100 to 400 mg twice daily | Seroquel coupons |
| Seroquel XR (quetiapine extended-release) | Schizophrenia, bipolar 1 disorder mania or mixed or acute depressive | 300 to 800 mg once daily | Seroquel XR coupons |
| Abilify (aripiprazole) | Schizophrenia, bipolar 1 disorder mania or mixed, major depressive disorder adjunct to antidepressants | 2 to 15 mg once daily | Abilify coupons |
| Risperdal (risperidone) | Schizophrenia, bipolar 1 disorder acute mania or mixed | 1 to 6 mg once daily or divided into two doses | Risperdal coupons |
| Latuda (lurasidone) | Schizophrenia, bipolar 1 disorder acute depressive | 20 to 160 mg once daily | Latuda coupons |
| Geodon (ziprasidone) | Schizophrenia, bipolar 1 disorder mania or mixed | 20 to 80 mg twice daily | Geodon coupons |
| Clozaril (clozapine) | Schizophrenia | 150 to 300 mg twice daily | Clozaril coupons |
| Haloperidol | Psychosis, Tourette syndrome | 0.5 to 5 mg two to three times daily | Haloperidol coupons |
| Lithobid (lithium extended-release) | Bipolar 1 disorder maintenance and acute mania | 300 to 600 mg two to three times daily | Lithobid coupons |
| Depakote (valproic acid) | Bipolar disorder acute mania, complex partial seizures, absence seizures, migraine headache prophylaxis | 250 to 500 mg twice daily for bipolar disorder | Depakote coupons |
| Depakote ER (divalproex extended-release) | Bipolar disorder acute mania, complex partial seizures, absence seizures, migraine headache prophylaxis | 25 to 60 mg per kg of body weight once daily for bipolar disorder | Depakote ER coupons |
| Tegretol (carbamazepine) | Bipolar disorder (off-label), seizure disorder, trigeminal neuralgia | 800 to 1200 mg per day divided into two to four doses for bipolar disorder | Tegretol coupons |
| Lamictal (lamotrigine) | Bipolar 1 disorder maintenance, seizures | 100 to 200 mg once daily for bipolar disorder | Lamictal coupons |
Other alternatives to olanzapine
- Abilify Maintena (aripiprazole)
- Abilify MyCite (aripiprazole)
- Risperdal Consta (risperidone)
- Saphris (asenapine)
- Rexulti (brexpiprazole)
- Vraylar (cariprazine)
- Fanapt (iloperidone)
- Caplyta (lumateperone)
- Invega (paliperidone extended release)
- Invega Sustenna (paliperidone palmitate)
- Invega Trinza (paliperidone palmitate)
- Loxapine
- Chlorpromazine
- Perphenazine
- Fluphenazine
- Thioridazine
- Prochlorperazine maleate
- Thiothixene
Top 5 olanzapine alternatives
The following are some of the most common alternatives to olanzapine.
1. Seroquel
The compelling advantage of second-generation antipsychotics compared to their predecessors is the considerably lower risk of tremor, rigidity, akathisia (restlessness), and trouble swallowing. This array of side effects is termed extrapyramidal symptoms (EPS) or parkinsonism for its similarity to Parkison’s disease. Similarly, second-generation antipsychotics have a much lower incidence of the adverse effect called tardive dyskinesia (TD), typified by abnormal movements like lip smacking, tongue thrusting, extremity writhing, and facial grimacing. Although all members of the class have less EPS and TD than first-generation antipsychotics, Seroquel may be a better option than Zyprexa for those at highest risk of movement-related side effects. If you are having adverse effects on your movement, then a change could be sensible.
2. Abilify
The most troublesome constellation of side effects of second-generation antipsychotics is related to metabolic consequences. Weight gain, diabetes, and elevated cholesterol can all be experienced. The risk is large enough that regular monitoring is recommended during treatment. Warnings about sedation or sleepiness are also necessary with antipsychotic medication. If you have problems with adverse metabolic effects or sedation, Abilify has been found to have a lower incidence of these side effects than Zyprexa.
3. Geodon
Sexual side effects can also plaque users of antipsychotics. The effects can involve loss of libido, less arousal, and difficulty with orgasm. While any of the drug class members can be problematic in this way, about half of olanzapine users experienced sexual side effects compared to only a quarter of ziprasidone users in a study. Geodon is the brand name of ziprasidone. It is no guarantee that sexual dysfunction symptoms would resolve with a change to Geodon, but it may be worth considering.
4. Latuda
Cardiovascular risks are another concern for those taking antipsychotics. A change to electrical impulse conduction in the heart called QT prolongation can occur, and it is associated with dangerous, even fatal, heart rhythm problems. The likelihood of this serious side effect is low overall but is significant for those with heart problems or taking other medications that affect the QT interval of cardiac conduction. A healthcare professional can help assess your risk of QT prolongation. Besides this heart rhythm issue, second-generation antipsychotics can also provoke drops in blood pressure upon standing up, a condition called orthostatic hypotension. Conversely, one’s heart rate can jump up with position changes during drug therapy. The obvious concern is a risk of syncope (passing out) and falling with these blood pressure or heart rate changes. Latuda seems to have less risk of these different cardiovascular effects than Zyprexa.
5. Depakote
To this point, the discussion has focused on adverse effects as a reason to potentially seek an alternative to olanzapine. Efficacy could be the problem instead. If you are taking olanzapine for maintenance of bipolar disorder, you are probably doing so because it helped to get you controlled initially. Typically, whichever mood stabilizer drug helped to achieve control is the one to be continued. In the situation in which it stops working, finding another option may be necessary. Depakote is a common choice in this situation, although it should not be used if there is a chance of pregnancy, due to its adverse effects on the fetus.
In treatment of schizophrenia, the second-generative antipsychotics all have similar effectiveness, but clozaril has been found in clinical trials to be effective when other options have failed. Clozaril’s association with heart problems, blood cell disorders, and seizures has led to warnings about its use and keeps it from being a popular choice.
Finding an alternative when olanzapine is letting you down in terms of effectiveness will likely involve an in depth discussion with the prescribing provider. Each medication has its own unique advantages, pitfalls, and potential effects on quality of life.
Natural alternatives to olanzapine
Even natural options can have adverse effects, but regardless, there are many who gravitate toward these types of alternatives. Evidence to support dietary supplement use for psychosis is not robust, but as an add-on to antipsychotic medication, there are options that may be helpful. There is some supportive data for adjunctive use of glycine, sarcosine, N-acetylcysteine, ginkgo biloba, estradiol, and vitamin B6 for psychosis. Adjunctive use means they are used in addition to prescription antipsychotics. In addition, a healthy diet may help. For example, a reduction in refined sugars and an increase in omega-3 fatty acids are measures that seem beneficial.
How to switch to an olanzapine alternative
Taking a new dietary supplement or over-the-counter medication, changing one of your prescription drugs, and contemplating a new prescription alternative are all actions with substantial risk potential. Accordingly, they should only be done with the guidance of a healthcare professional. If cost is a main concern in seeking an alternative treatment, SingleCare can help. The information that you now have about alternatives to olanzapine can be brought up when you have your appointment. Collectively, you and your healthcare provider can decide on how to move forward with or without olanzapine.