Question about olanzapine

toolbeltexpert

My dw has been on olanzapine which is zyprexa for about a month and a half, she take 7.5 in the morning, 2.5 at noon and 7.5 at night. I am noticing her sundowning is getting a little worse. Every thing I have read said 20mg is the daily max. Is anybody out there giving more than that? I am worried that if they need to give her more there's not much room to go higher. 

Thanks

Stewart

Ed1937

Stewart, this is from drugs.com. You can get more info there if you want.

• There is a higher chance of death in older adults who take this medicine (olanzapine tablets) for mental problems caused by dementia. Most of the deaths were linked to heart disease or infection. This medicine is not approved to treat mental problems caused by dementia.

Ed1937

I put the last sentence in bold. It was not like that on the site.

dayn2nite2

Her dose is still under 20.  Was this medication prescribed in the hospital or after she was placed?

You also need to take into consideration that she has just been moved into care and we are on the downside of summer, with the days becoming shorter.

I wouldn't worry about dosage, if they need to try something else then they will need to do that.

How are the behaviors that started all of this?  Is she generally better?

Jeff86

Most atypical antipsychotic drugs have similar warnings and, in fact, Zyprexa’s manufacturer Eli Lilly was fined for marketing it for use with AD patients.

In 2009, Eli Lilly pleaded guilty to a US federal criminal misdemeanor charge of illegally marketing Zyprexa for off-label use and agreed to pay $1.4 billion. The settlement announcement stated "Eli Lilly admits that between September 1999 and March 31, 2001, the company promoted Zyprexa in elderly populations as treatment for dementia, including Alzheimer’s dementia. Eli Lilly has agreed to pay a $515 million criminal fine and to forfeit an additional $100 million in assets."[127

That said, many neurologists do, in fact, prescribe it for AD patients to treat anxiety and delusions.  My DW took it for a couple of years.  It was discontinued because of long term side effects, manifested in DW’s case as decreased mobility and less appetite.

I do not recall the dosage but am sure it wasn’t more than 20 mg.  More likely 10.

Ernie123

I can share my experience. My DW has been taking Olanzapine for about  2 years. It replaced Risperidone which initially had helped her but after a year or so no longer alleviated her symptoms of paranoia and delusions. The Olanzapine was a big improvement. Over the last two years her dosage has been adjusted up to where now she gets 7.5 mg AM and 5 mg PM. My understanding is that when antipsychotics are used off label for dementia patients the usual  dosage is lower than when used for other illness like Schizophrenia. Overall it has been very effective for her, but the doctor stressed with me that every dementia patient is different and often meds need to be changed or dosages adjusted as the disease progresses. What works for one patient won’t necessarily work for another. My opinion is that if you have an experienced geriatric psychiatrist, they will know if and when a change is needed. Trust their advice.

toolbeltexpert

Day, the olanzapine was prescribed at the geripsych, her behaviors are generally  better. It's the sundowning, it starts later in the day, but before she gets her evening dose. In the last week she has been up late several times, one night till 3am walking the halls,  That is much  worse than before. Today marks the one week mark at the nhf.  Ed from my studying all the 2nd generation antipsychotics that are used off label have that type of warning ,that's not to say there isnt one that doesn't.

Jeff and Erie thanks for your experience, that is helpful. 

When she was at the geripsych, the psych doctor said he had to add a 2.5 dose at noon the help her get thru the afternoon sundown. It maybe just getting acclimated I hope.

I'll get thru this too, sometimes I sweat the details too much. Like I said I was just wondering if anyone here had their lo on a higher than 20mg a day.

Thanks everyone.

Joydean

My dh also takes olanzapine at bedtime because of his paranoia. He was always sure something was going to fall on his head. We had to take the ceiling fan down, all pictures off the walls and his bed is in the center of the bedroom. His psychiatrist tried other meds but nothing worked. He has been on olanzapine for a year. We see his psychiatrist every 3 months and he constantly monitors dh’s meds. Dh gets a good nights rest and no longer paranoid. He does not take more than 20.

Scooterr

Stewart here's my two cents, I've noticed since the daylight hrs. are getting shorter, she is starting to struggle a little bit more earlier in the evening more than normal. Me personally with my wife (who also struggles with sundowners) I'm correlating it with the start of less daylight. She has also started getting up earlier and it may also be time to up her dose of medication.

toolbeltexpert

Joydean that sounds hard to deal with, we have ceiling fans in every room, well except the bathrooms. I am hoping that too will pass.

Scooterr thank you, you're right,I just didn't correlate it. Just wish it wouldn't, she is needing to feed the cats again. So much going on for her,new environment, and soon she'll have a room mate. The first 2 weeks are private.