Obsession to shout on olanzapine (Zyprexa)
Q: I am psychiatrist from India. I was treating a Bipolor affective disorder currently mania with psychotic feature. She was on Litium 900mg/day and olanzapine 5mg day since 2 month. Currently no manic or psychotic feature.but since one week she developed obsessive impulse to shout . once olanzapine was stoped, her OCD symptoms was remitted.
Dear Doctor S' --
Secondly, although OCD has been treated successfully by augmenting with olanzapine (Koran, Bogetto), there are reports of OCD symptoms emerging with olanzapine treatment (e.g. Lykouras, Mottard). I think I've seen the exacerbation of OCD by olanzapine myself, though not emergence de novo, as some of the patients described in these articles manifested.
On the whole, I still use olanzapine with much less hesitation than risperidone, as far as inducing symptoms goes (in bipolar disorder); however, the weight gain risk is so severe, I try to avoid it as a long term solution (though have had a few "saves" through topiramate as appetite suppressor!).