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On Olimelt for schizophernia, suffer laziness, cholestrol, weight gain. Should the dosage be reduced ?

I am taking 5 mg olimelt from last 10 years for treating my disorders related to schizopherania and bipolar disorder.Due to the slightly negative symptoms of this medicine such as social withdrawl (which now reduced to some extent), lazyness,weight & calestorl gain, and less initiative for mental work can I reduced the dose of medicine to 2.5 mg. Please suggest.
Asked On : Wed, 10 Apr 2013
Answers:  7 Views:  1196
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Psychiatrist 's  Response
Hi Akhilsood198 ,

Welcome to HCM Forum ,

Continuing Olimelt for last 10 years inspite of side effect u suffering and seeking help before decision is appreciable.

Though among mentioned problem by you weight gain and cholesterol rise can be attributable to same medicine.But social withdrawal and laziness ,mental slowness can not be attributable to drug -There are chances that this is because of your residual illness (So called Negative symptoms of schizophrenia.) - which requires change in medicine or addition of medicine and not lowering of current medicine.

There are now lot of option available with minimal to no side effect in treatment comparatively 10 year back.There are drugs which are weight neutral, even drug option also available which able to decrease your weight.So consult to your psychiatrist who seen you since years , discuss your problem with him,Definitely he will make change in your treatment.

Hope this helps.

Best regards.
Answered: Thu, 25 Apr 2013
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Psychiatrist Dr. Sundar Gnanavel's  Response
Thanks for your query. Olimelt is olanzapine, a second generation antipsychotic used for treatment of schizophrenia. The minimum effective dosage is 5 mg. I suggest you do not decrease the dosage without your psychiatrist's opinion.
You can consider dietary modifications and daily exercises that would tackle both your weight gain and negative symptoms. Wish you good health.
Dr Sundar
Answered: Sat, 13 Apr 2013
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Psychiatrist Dr. Ashish Mittal's  Response
welcome to Healthcare Magic.

Olimelt contain olanzapine, which is an atypical/newer antipsychotic. It has good effect on psychotic illness like schizophrenia and bipolar disorder.

Long term use is associated with metabolic syndrome, which present as increase weight, blood sugar level, BP, obesity and derange lipid profile. In such cases monitoring of bsl/lipid profile/BP/Weight, life style modification measures and change of medicine may be required.

5mg dose is lowest effective dose of olanzapine. Reduction of doses or change of medicine should be done under your psychiatrist supervision only. As any change in medicine may lead exacerbation of symptoms.

Wish you all the best.

Dr Ashish Kumar Mittal
Answered: Thu, 11 Apr 2013
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Psychiatrist Dr. Srinivasa S.R.R.Y.'s  Response
Thanks for writing to Health Care Magic
As you have been under treatment since the past 10 years dosage reduction may be considered after consultation with your psychiatrist. Olanzapine is known to cause weight gain, increased appetite and high cholesterol as side-effects. There are antipsychotics which donot cause these side-effects like Aripiprazole, Asenapine, Amisulpride etc. So the medication may be changed to these drugs. But all this has to be done under supervision of a psychiatrist. Don't try to experiment with the dosage yourself.
Hope this helps you
Thanks and regards
Answered: Fri, 10 May 2013
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Psychiatrist Dr. Seikhoo Bishnoi's  Response
Dec 2014
Welcome to HCM

Olimelt consists of olanzapine and it is an atypical antipsychotic drug. You are taking it since last 10 years in 5 mg doses. At this dose side effects are there but less in severity. You mentioned that you are having sedation, weight gain, hypercholesterolemia etc so dose reduction may be an option if your other psychotic symptomatology is under control. You can take other medicines which have comparatively less metabolic effects as Aripiprazole. For reduction of doses of olanzapine or addiction of some other drug please consult your psychiatrist. Don't reduce the dose by own as it may worsen the symptoms.

Dr. Seikhoo Bishnoi, MD
Answered: Wed, 10 Apr 2013
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Psychiatrist Dr. Nehal Shah's  Response
thanks for using health care magic.
Olimelt containing olanzapine is good anti psychotic drug.
Olanzapine is many times associated with metabolic side effects like increase weight gain and lazziness.
rather than reducing dose on self, you should consult Psychiatrist for it. Doctor will compare the side effect ratio with chances of recurrence. He may advise the change of drug like aripiprazole or asenepine having lower metabolic side effects.
for negative , residual symptoms, Alon with drug, you should go for counselling and positive reinforcement for taking initiative.
Answered: Thu, 18 Apr 2013
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

You have not stated your age, gender, personal habits, family history or co-morbidities
As a principle, no drug should be reduced or stopped by the patient himself.
You are already on a low dose and your problem may rebound.
See your Psychiatrist

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Thu, 18 Apr 2013
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