Olanzapine is an antipsychotic drug used to treat the symptoms of schizophrenia and bipolar disorder.
It is sold under a variety of brand names including Zyprexa, Zolafren and Zydis.
The exact mechanism by which olanzapine works is unknown but some people believe it can be used to change the levels of dopamine and serotonin in the central nervous system.
It is sometimes used to treat problem behaviours in autistic people, including hyperactivity, aggression, and self-injurious behaviours.
There is some very limited research evidence to suggest that olanzapine may be beneficial for the short term treatment of significant problems faced by autistic people, including hyperactivity, aggression, and self-injurious behaviours.
However there are many potential side effects, especially significant weight gain in all who take it, as well as increased appetite and increased drowsiness in some. The implications of these side effects are unknown. For these reasons, it is important to use the lowest effective dose
There is probably more weight gain with olanzapine than with other atypical antipsychotics. It is therefore not the first choice and caution is needed.
Further research should be undertaken into the use of olanzapine and other antipsychotics for the treatment of specific, severe symptoms, as each has a different side effect profile, and so might suit some people better.
Please read our Disclaimer on Autism Interventions
The exact mechanism by which olanzapine works is unknown but some people believe it can be used to change the levels of dopamine and serotonin in the central nervous system. They believe that this will have beneficial effects, including a reduction in hyperactivity, aggression, and repetitive behaviours.
There have been various claims made for olanzapine as a treatment for autistic people. For example,
According to American Society of Health-System Pharmacists (2013)
“Olanzapine is used to treat the symptoms of schizophrenia in adults and teenagers 13 years of age and older. It is also used to treat bipolar disorder in adults and teenagers 13 years of age and older.”
Olanzapine is also sometimes used to treat autistic people who also have specific, severe symptoms including mental health problems and behaviour problems.
Olanzapine is a type of atypical antipsychotic drug, which is sold under a variety of brand names including Zyprexa, Zydis and Zolafren.
Antipsychotic drugs are used to treat the symptoms of a range of conditions including schizophrenia and bipolar disorder. They work by changing the activity of certain natural substances in the brain, although the exact mechanism is unclear. Atypical anti-psychotic drugs are newer than older, typical anti-psychotic drugs and are believed to be better tolerated, with less side-effects.
Olanzapine comes in a variety of forms, including as a tablet and as an intra-muscular injection.
You will need to consult a psychiatrist, GP, or other suitably qualified medical practitioner, for the latest information on specific formulations and doses
Olanzapine is more expensive than older antipsychotic drugs, such as haloperidol or chlorpromazine. However within the UK, it is available free of charge via the National Health Service.
In the UK medications such as olanzapine are available free of charge to patients within the NHS. In other countries the costs may be covered by some insurance policies.
Olanzapine is usually taken once a day with or without food at around the same time every day, although it is also available as a depot (long lasting) injection.
Parental involvement in the use of olanzapine is minimal since the autistic person usually takes it once a day.
Olanzapine has been shown to produce a number of side effects in some people. For example, according to the American Society of Health-System Pharmacists (2013) it can cause
More seriously, it can also cause
In addition
‘Studies have shown that older adults with dementia … who take antipsychotics (medications for mental illness) such as olanzapine have an increased chance of death during treatment.’
Please note that olanzapine can, if taken with certain other drugs, increase, decrease or alter the effect of those other drugs.
Research has shown that olanzapine can produce some side effects in autistic people, including
Olanzapine should be used cautiously with people who are
Olanzapine is a powerful drug with many potential side effects and contraindications. For this reason it should only be obtained on prescription from either a psychiatrist, or from a GP on the advice / recommendation of a psychiatrist.
Olanzapine was developed and is currently marketed by the pharmaceutical company Eli Lilly and Company. It was approved by the United States Food and Drug Administration (FDA) in 1996 for the treatment of schizophrenia, acute mania in bipolar disorder, agitation associated with schizophrenia and bipolar disorder, and as maintenance treatment in bipolar disorder and psychotic depression.
We have identified nine scientific studies of olanzapine used to treat autistic people published in peer-reviewed journals. The studies included more than 100 individuals, aged from six years old to adult.
There are a number of limitations to all of the research studies published to date. For example
For a comprehensive list of potential flaws in research studies, please see Why some research studies are flawed
This page provides details of ongoing research into olanzapine and autistic people.
There is some evidence that olanzapine may be beneficial for the treatment of various problems faced by autistic people, including hyperactivity, aggression, and self-injurious behaviours.
There is almost no research evidence to suggest that aripiprazole may be beneficial for the treatment of these behaviours in autistic adults.
There are a few anecdotal reports which suggest that aripiprazole may be beneficial for some autistic children and/or adults.
There is some research evidence of significant side effects of olanzapine in some autistic children and young people. Those side effects may include weight gain, increased appetite and increased drowsiness.
There is also some research which suggests that some antipsychotics, such as olanzapine, can actually increase hyperactivity through akathisia (a movement disorder characterised by a feeling of inner restlessness and a compelling need to be in constant motion).
As always a judgement should be made by the clinical team as to whether the symptoms or behaviours arise from a reaction of the autistic person to stressors in the social or wider environment or whether they related to an underlying psychiatric disorder in the true sense. The treatment approach will differ accordingly with the former less likely to respond to psychotropic drug-based interventions alone.
Further, large-scale, randomised, double-blind trials of the effects of olanzapine should be carried out on autistic individuals to determine their effectiveness and safety.
These studies should investigate issues such as
This section provides details of scientific studies into the effectiveness of this intervention for people with autism which have been published in English-language, peer-reviewed journals.
If you know of any other publications we should list on this page please email info@informationautism.org
Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.
This section provides details of other publications on this topic.
You can find more publications on this topic in our publications database.
If you know of any other publications we should list on this page please email info@informationautism.org
Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.
The National Institute for Health Care Excellence has provided clinical guidance on the use of pharmacological interventions (such as olanzapine) for behaviour that challenges in autistic children and young people.