Olanzapine: operation and effects of this psychopharmaceutical

This drug is very popular in the treatment of disorders such as schizophrenia or bipolar disorder.

Schizophrenia and other similar psychotic disorders are old acquaintances for psychology and medicine. Different researchers have proposed different ways of understanding this type of disorders, which generate profound suffering in the person who suffers from it and in his or her environment, as well as looking for different ways of treating them.

From psychopharmacology, different types of substances have been used in order to deal with this problem and the symptoms that sufferers show: antipsychotics or neuroleptics. One of these psychotropic drugs is olanzapine..

Psychotic disorders and dopamine

The so-called psychotic disorders are a group of mental disorders in which strange and implausible perceptions and ideas appear and usually a certain loss of contact with reality.

Within this type of disorders, among which schizophrenia stands out.Within this type of disorder, among which schizophrenia stands out, there are both symptoms that add elements to the individual's behavior or positive symptoms (hallucinations being the characteristic example) and those that cause a decrease in the individual's capacities (such as alogia or cognitive impairment) or negative symptoms.

At the neuropsychological level it is observed that the presence of symptoms of this type are usually linked to problems in the synthesis and uptake of the neurotransmitter known as dopamine. Positive symptoms are associated with an excess of dopaminergic activity in the mesolimbic pathway, whereas negative symptoms tend to be linked to the presence of deficit or absence of dopamine in the mesocortical pathway..

In this sense, we have tried to search for substances and active ingredients that can produce a change in the synthesis and reuptake of dopamine in these areas.

Brief history of neuroleptics

Throughout history, numerous substances and compounds have been found and investigated whose active ingredients allow a reduction of the psychotic symptoms present in schizophrenia and other similar disorders.

The first substances of this type were found by chance, but they were a great advantage for patients with this disorder by allowing their treatment. These are the classical or typical neuroleptics. Their main mechanism of action is on the dopamine D2 receptor, which they block indiscriminately throughout the brain.

This causes a decrease in the level of dopamine in the mesolimbic pathway, positive symptoms such as hallucinations are greatly diminished. to a great extent. However, as they act throughout the brain and not only in this pathway, they easily generate different side effects, and do not have a therapeutic effect on negative symptoms. In fact, by further decreasing the level of dopamine in the mesocortical pathway, they may even worsen them.

The low effectiveness on negative symptoms and the presence of potentially severe side effects The ineffectiveness on negative symptoms and the presence of potentially severe side effects led to further research for safer and more effective substances. This research resulted in the creation of atypical antipsychotics or neuroleptics. And within this group, we can find olanzapine.

Olanzapine as an atypical neuroleptic

Olanzapine is one of the main atypical neuroleptics, substances used to reduce the symptoms of schizophrenia and other psychotic disorders. It is a substance derived from dibenzothiazepines, which is marketed in tablet and tablet form.

As an atypical neuroleptic, the main mechanism of action of olanzapine is based on blocking the is based on the blockade of dopamine D2 receptors, but this time there is also an anti-serotonergic effect.

As serotonin has an inhibitory effect on dopamine synthesis and release, the introduction of a component that limits the release of the former causes overall dopamine levels to remain stable in most nerve pathways. Thus, although it continues to have a great effect on the mesolimbic pathway, which helps to combat the positive symptoms of schizophrenia, it does not destabilize other pathways.

In addition, the fact that there are a large number of serotonergic receptors in the cortex large number of serotoninergic receptors in the cortex receptors in the cortex causes that, by limiting their action, the level of dopamine in the mesocortical pathway increases, which also makes it possible to combat some of the negative symptoms.

In this way, olanzapine and other similar substances make it possible to combat both positive and negative symptoms of schizophrenia in an efficient and safer way than classic antipsychotics, generating fewer and less severe secondary symptoms.

In which disorders is it used?

The main use of Olanzapine is in the treatment of psychotic-type disorders and especially schizophrenia. However, the properties of this substance have made it valid for the treatment of other psychic problems.

Specifically, it is used to combat manic episodes in bipolar disorder. It has also been used occasionally in some cases of borderline personality disorder.

Olanzapine side effects and contraindications.

Like all drugs, olanzapine can generate various side effects of varying intensity. side effects of varying intensity and may be contraindicated in some cases. This occurs because olanzapine affects some parts of the body in a way that is outside the therapeutic mechanisms by which it is intended to mitigate the symptoms of the disorder to be treated; something inevitable considering that the active ingredient is not "remote-controlled", but is still a molecule that interacts with everything it encounters. These unforeseen ways of influencing the human body lead to the emergence of side effects.

One of the most frequent side symptoms caused by this substance are increased appetite and weight gain. It can also lead to hyperglycemia, increased triglyceride levels and even diabetes, or be very detrimental to sufferers if dosages are not controlled and monitored.

It is also very common for olanzapine to generate a certain level of drowsiness or sedation, as well as excessive salivation, tachycardia (which is why it is not recommended in patients with Heart problems), hypotension, muscle weakness and dizziness.. Nausea and vomiting are also a possible side effect, as well as constipation. Finally, it can also cause a decrease in libido and erectile capacity.

Other less common symptoms are the presence of tardive dyskinesia presence of tardive dyskinesia (uncontrolled movements of the mouth and tongue. Fever, allergy, epileptic seizures, changes in visual perception or inflammation of body parts may also appear.

It is also contraindicated in those patients who have suffered cerebral infarcts or are in the process of dementia. Diabetic patients, with liver, pancreas or heart problems should not take this antipsychotic. In the case of pregnant women, olanzapine may cause problems in the fetus.In the case of pregnant women, olanzapine may cause problems in the fetus, so the doctor should be consulted about possible alternatives or ways to proceed.

Price

The price of olanzapine, for a box of 28 tablets of 5 milligrams, is about 26 euros, and about 575 Mexican pesos in Mexico.

Bibliographic references:

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