Overall, olanzapine is well tolerated and free from hematological side effects. Dose-related side effects include somnolence, orthostatic hypotension, dry mouth, constipation, tremor, akathisia and weight gain. Weight gain is one of the most problematic adverse effects, especially in younger patients who tend to be more image conscious. Weight gain after 28 weeks of treatment was 4.1 kg with olanzapine compared with 2.3 kg with risperidone. Managing weight gain with long term treatment can be challenging. As early as possible, diet and exercise counselling should be stressed, with emphasis on establishing a health-promoting routine. buy diabetes drugs
Dosing should be guided by clinical trial results with awareness that delusions and hallucinations often take several weeks to improve significantly. Olanzapine can be started at 5 to 10 mg/day. The initial target maintenance dose should be 10 to 15 mg/day and can be achieved within two weeks . If there is minimal improvement after three to four weeks the dose can be increased to the maximum recommended dose. However, if the patient is improving, albeit gradually, it is recommended to maintain the same dosage and allow for the amelioration of symptoms to continue without increasing the risk of side effects. Rapidly increasing olanzapine dosage as a means of behaviour control is not recommended.