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Olanzapine: Is Zyprexa Safe for Teens?

A Comprehensive Guide for Families

Author:
Irene Lopez
Irene Lopez
MBA
Editor:
Emma Loker
Emma Loker
B.S.
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Coping with intense mental health challenges like schizophrenia, bipolar disorder, or other severe mood disorders can be incredibly difficult for a teen. It can also be tough for a parent to witness – and understand how to help.

If you’re the parent of a teen with a severe mental health condition, you may have heard your provider mention olanzapine, commonly known by its brand name, “Zyprexa.” 

Olanzapine is an FDA-approved medication that can help relieve some of the symptoms of mental health issues. It may be able to help your teenager think clearer thoughts and feel more emotionally stable and like themselves. But all medications come with potential side effects, and it’s normal for parents and caregivers to have questions and even concerns about how taking this medication will affect a teen. 

The choice to treat with medications is not one to take lightly. At Mission Prep Healthcare, we understand how hard it can be to find factual, evidence-based, and trustworthy information on medications. For this reason, this article covers:

  • What olanzapine is and how it works for teen mental health
  • Conditions olanzapine is used to treat
  • Olanzapine dosage guidelines
  • Olanzapine side effects 
  • Ways of stopping Zyprexa safely for teens
  • Zyprexa vs. other antipsychotics for teens
  • Frequently asked questions about olanzapine
  • Where to find professional support for teen mental health conditions
Is Olanzapine (Zyprexa) Safe for Teens?

What Is Olanzapine (Zyprexa) & Why Does My Teen Need It?

Olanzapine, more well-known by its brand name Zyprexa, is a type of medication called an “atypical antipsychotic” or “second-generation antipsychotic” (SGA for short).¹ When we hear terms like “atypical antipsychotic,” it can feel like a lot to take in, but we’ll break this down so it’s easier to understand. 

Everyone has chemical messengers, or “neurotransmitters,” in the brain that help manage the way we think, feel, and behave. When teenagers have mood disorders, these chemical messengers can become out of balance. 

From what we know, antipsychotics work on these chemical messengers, helping teenagers feel less overwhelmed and more stable and in control of their lives. 

Physicians don’t usually prescribe medicine, especially for adolescents, unless it’s absolutely necessary. Typically, they first consider psychotherapy, such as cognitive behavioral therapy (CBT) and skills training, like learning to identify negative thought patterns. They may also talk about anger management for teens to be able to better deal with situations that provoke them. 

So, if your teen has been recommended olanzapine, it’s because a provider has determined that that’s the best treatment choice at this time. They may have decided this based on your teen’s medical history, condition and symptoms, current state of health, and response to other treatments, among other things. 

How Olanzapine Can Help Your Teen

The good news is that antipsychotics like olanzapine can provide some powerful benefits for adolescent mental health treatment, helping to reduce symptoms such as the following:1,2
  • Hallucinations:  When someone has a hallucination, they may see, hear, taste, feel, or experience the touch of things that aren’t there. 
  • Delusions: A delusion is when someone believes something that’s not true. They may also not want to change these beliefs, even when confronted with the truth.
  • Disorganized thoughts, behaviors, and actions: A lack of focus, attention, and concentration, which can lead to reduced academic performance, emotional outbursts, and distress.
  • Loss of interest: Anhedonia is a condition in which teens find it hard to enjoy things they once did, or they lack the energy to partake in them.
  • “Flat” affect: Sometimes, due to mental health issues, a teenager might not be able to show any or much emotion in their facial expressions or behaviors, even though they feel everything on the inside. 
  • Inability to express oneself: Alogia is a medical condition in which someone doesn’t feel capable of talking much. For instance, they may give brief answers or struggle with finding the right words and starting conversations. Alogia isn’t the same as being naturally less talkative. 
  • Lack of motivation: Low motivation or an inability to work towards goals can make starting or completing any task hard. 

Olanzapine has been shown to improve these symptoms in many teens, but its effectiveness can vary from person to person. Let’s discuss the conditions it can work for next.  

What Conditions Does Olanzapine Treat in Teens?

The FDA has approved olanzapine, or Zyprexa, for the following conditions in teens:3

  • Zyprexa for treating schizophrenia in teens above 13 years of age
  • Zyprexa for teenage bipolar disorder in teens above 13 years of age. 
  • Depression in children above 10 years of age, sometimes in combination with another drug called “fluoxetine.” Using Zyprexa for anxiety in teens is also not uncommon.

More rarely, a doctor may prescribe olanzapine “off-label.” Off-label usage may benefit a teen when they’ve tried other treatments with no success, or there isn’t any other treatment that can help. For instance, a provider may prescribe off-label for the following issues: 

  • Acute agitation: In acute agitation, there can be very intense symptoms such as anxiety, restlessness, hostility, and suspiciousness. Olanzapine is typically only prescribed for agitation when it’s an emergency situation.
  • Delirium: When someone suddenly feels confused and disoriented and isn’t able to think or remember clearly. 
  • Nausea and vomiting: Olanzapine can be prescribed for these symptoms when they’re caused by chemotherapy. 

Zyprexa Dosage for Adolescents and Guidelines

The last thing any parent or caregiver wants for their child is unnecessary medications. At Mission Prep, we understand your concerns. For this reason, we monitor dosage and reactions closely throughout treatment, listening to parents’ and teens’ voices each step of the way. 

We usually start teens off at the lowest olanzapine dose possible – but only after carefully reviewing their medical information and weighing benefits vs. side effects. The FDA recommends 2.5 mg as the safest starter dose for teens.4 For schizophrenia and bipolar disorder I, the range is 2.5-5 mg. 

A provider should record a teenager’s weight, blood glucose levels, and lipid profiles before and during treatment to keep a close eye out for any developing side effects. This way, dosage can be adjusted as needed to promptly manage any negative reactions. 

We cover more about potential olanzapine side effects next. 

Common Olanzapine Side Effects for Teens

The biggest benefit of taking olanzapine is that it can work for managing symptoms that are hard for a teenager to deal with on their own. Having said as much, all medications carry some risks, and it’s important to know what these are so you can be fully informed and discuss any worries with your provider. 

It’s good to note that side effects can vary from one person to the next, so not everyone will react the same way to the same medication. The following are some of the more common olanzapine side effects in teenagers. 

Olanzapine and Weight Gain in Teenagers

One of the side effects to be aware of with olanzapine is the possibility of weight gain. For instance, one study showed that adolescents could potentially gain an average of 16.2 kg (approximately 35.7 lbs) over 45 weeks of treatment.5 

Additionally, adolescents may also experience metabolic changes. Or, in other words, an increase in levels of cholesterol and triglycerides – a type of fat. These have been linked to an increased risk of developing cardiovascular issues.6 

Weight gain is one of the reasons why your teen’s provider will closely monitor for changes in blood glucose levels and lipid profiles. Early intervention can help control weight gain, so a provider may give lifestyle recommendations to help your teen manage their physical well-being during treatment. 

Olanzapine and the Risk of Diabetes in Teens

As olanzapine can lead to weight gain, long-term olanzapine treatment could also increase the risk of developing type 2 diabetes. For example, one study points out that olanzapine increases the risk of developing diabetes by up to 71%.7 For this very reason, a provider will keep a close eye on any physical responses to treatment.

Zyprexa and Sleep Disturbances in Teenagers

Zyprexa can sometimes cause difficulties falling or staying asleep. These issues should ease after a couple of weeks, but it’s important to notify your teen’s provider if your teen continues to struggle with sleep issues.8 

Other Common Olanzapine Side Effects

  • Dizziness, unsteadiness, difficulties maintaining balance, or walking
  • Feelings of weakness
  • Restlessness or inability to sit still
  • Pain in arms, legs, back, or any of the joints
  • Constipation
  • Dry mouth
  • Depression or feelings of sadness or emptiness
  • Breast enlargement in both boys and girls
  • Menstrual periods (delays or stoppage)
  • Unusual behaviors 
  • Pain in the bladder9 
  • Bloody or cloudy urine
  • Thick, white vaginal discharge with minimal to no odor
  • Slowed movements
  • Bruising
  • Memory problems

Important Information to Note:

If your teen encounters any of the following less common olanzapine side effects, it’s important to seek medical help immediately.

  • Seizures
  • Falls
  • Blurred vision or other vision changes
  • Irregular or fast heartbeats
  • Difficulties with breathing or swallowing
  • Excessive sweating
  • Hives
  • Swelling in the arms, hands, feet, ankles, or lower legs
  • Muscle stiffness
  • Rashes, which may occur with fever and swelling of the glands or face
  • Sore throat and/or other signs of infection, such as fever, runny nose, and chills
  • Uncontrollable facial or body movements, such as twisting or trembling
  • Redness of the skin, skin peeling, or bruising 

Stopping Zyprexa Safely for Teens

As antipsychotics are powerful medications, it’s important not to stop using them suddenly.10

Abrupt olanzapine withdrawal may cause side effects or a relapse of mental health symptoms. The best approach is to discuss tapering options with your provider. Stopping any type of antipsychotic should be a gradual process, so your psychiatrist will work with you to lower your teen’s dose over time. During this time, your provider will also continue to monitor any Zyprexa withdrawal symptoms in adolescents so these can be managed promptly. 

Zyprexa Vs. Other Antipsychotics for Teens

Providers usually recommend medication based on a teen’s unique medical profile. For instance, they typically look at a number of factors, such as a teen’s:

  • Current symptoms
  • Past medical history
  • Response to any previous treatments
  • The effectiveness of the medication, including side effects

Physical and emotional responses to medications can vary from medication to medication and person to person. In general, while olanzapine is shown to be effective, it is notable for causing the most weight gain and increase in BMI or Body Mass Index compared to other antipsychotics.11 If this proves to be an issue for your teen, your provider may discuss alternative options, such as quetiapine and lurasidone. 

Frequently Asked Questions About Olanzapine

While this article aimed to cover as much information about olanzapine and its effects as possible, you may still have some outstanding questions or concerns. The following FAQs and answers may be able to fill these gaps. 

What Is the Age Limit for Zyprexa?

Zyprexa is not FDA-approved for children under 13 years. An exception is when it’s combined with fluoxetine to treat children above 10 years old for depression. While no upper limit exists, antipsychotics are less frequently prescribed for people under 18 years of age and over 65 years of age.12 

Is Zyprexa a High-Risk Medication?

All medications, especially antipsychotics like Zyprexa, come with the potential for side effects and risks. The side effects can vary from person to person depending on their unique medical profile. However, your provider will start you off on the lowest dose possible and closely monitor you to promptly treat and manage any adverse effects.

As previously mentioned, Zyprexa’s biggest risk is the potential for weight gain. You can check out the previous section on this if you’d like to learn more about the benefits and risks linked to this medication.

What Is the Difference Between Olanzapine and Zyprexa?

Olanzapine is the name of the drug, while Zyprexa is the name of the brand. In other words, if you’re taking olanzapine or Zyprexa, they’re the same thing, so they come with the same potential benefits and side effects.

Is Olanzapine (Zyprexa) Safe for Teens? A Comprehensive Guide for Families

Get Help for Your Teen Today with Mission Prep Healthcare

At Mission Prep, we specialize in adolescent mental health treatment, offering a range of services tailored to meet the unique needs of teens and their families. Our programs include:

  • Residential Treatment: For intensive 24/7 support in a compassionate, caring, and supportive environment. 
  • Outpatient Mental Health Programs: Flexible treatment options to provide ongoing care for teens and their families based on your preferred schedule. 
  • Intensive Outpatient Program: Intensive outpatient programs provide a higher level of care compared to regular outpatient programs. For instance, teens can benefit from structured treatment while still being able to maintain their daily routines outside of the treatment center. These programs can also prove to be more affordable over the long term compared to residential treatment.

Our expert clinical care team will work with you one-on-one to develop personalized treatments for a wide range of mental health conditions, including schizophrenia, bipolar disorder, depression, anxiety, ADHD, psychosis, and anger issues. Our evidence-based approaches also approach mental health from a holistic viewpoint when necessary, incorporating medication management when needed. 

For more information or to schedule a consultation, fill out our contact form or contact us via phone call today. 

References

  1. Thomas, K., & Saadabadi, A. (2023, August 28). Olanzapine. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK532903/
  2. McGurk, S. R., Lee, M., Jayathilake, K., & Meltzer, H. Y. (2004, May 11). Cognitive effects of olanzapine treatment in schizophrenia. https://pmc.ncbi.nlm.nih.gov/articles/PMC1395781/
  3. Thomas, K., & Saadabadi, A. (2023, August 28). Olanzapine. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK532903/
  4. U.S. Food & Drug Administration. (1996). Highlights of prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020592s062021086s040021253s048lbl.pdf
  5. Fleischhaker, C., Heiser, P., Hennighausen, K., Herpertz-Dahlmann, B., Holtkamp, K., Mehler-Wex, C., Rauh, R., Remschmidt, H., Schulz, E., & Warnke, A. (2008). Weight gain in children and adolescents during 45 weeks treatment with clozapine, olanzapine and risperidone. Journal of Neural Transmission, 115(11), 1599–1608. https://doi.org/10.1007/s00702-008-0105-9
  6. National Institute of Mental Health. (2009, October 27). Significant weight gain, metabolic changes associated with antipsychotic use in children. https://www.nimh.nih.gov/news/science-updates/2009/significant-weight-gain-metabolic-changes-associated-with-antipsychotic-use-in-children
  7. Holt, R. I. G. (2019). Association between antipsychotic medication use and diabetes. Current Diabetes Reports, 19(10). https://doi.org/10.1007/s11892-019-1220-8
  8. MedlinePlus. (n.d.). Olanzapine: Drug information. https://medlineplus.gov/druginfo/meds/a601213.html
  9. Mayo Clinic. (2025, May 1). Olanzapine (oral route). https://www.mayoclinic.org/drugs-supplements/olanzapine-oral-route/description/drg-20071350
  10. Horowitz, M. A., Jauhar, S., Natesan, S., Murray, R. M., & Taylor, D. (2021). A method for tapering antipsychotic treatment that may minimize the risk of relapse. Schizophrenia Bulletin, 47(4), 1116–1129. https://doi.org/10.1093/schbul/sbab017
  11. Xia, L., Li, W., Liu, H., Hao, R., & Zhang, X. (2018). Olanzapine versus risperidone in children and adolescents with psychosis: A meta-analysis of randomized controlled trials. Journal of Child and Adolescent Psychopharmacology, 28(4), 244–251. https://doi.org/10.1089/cap.2017.0120
  12. Cascade, E. F., Kalali, A. H., & Citrome, L. (2007, July 1). Antipsychotic use varies by patient age. https://pmc.ncbi.nlm.nih.gov/articles/PMC2880928/



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