Side Effects of Olanzapine

Mr. A, a 27-year-old African American, had been diagnosed with schizophrenia for the last 7 years. He had been compliant in taking his medications, haloperidol and benztropine. He had been complaining of muscle stiffness and other extrapyramidal side effects. Therefore, haloperidol and benztropine were tapered off, and he was started on a regimen of olanzapine, 10 mg p.o. daily at bedtime. On the fourth day, Mr. A returned to the clinic and reported that he had stopped taking olanzapine because it was causing excessive, chalky white, frothy, sticky salivation. Olanzapine was discontinued; this side effect disappeared over the next 2 days.

Mr. B, a 37-year-old African American, had been diagnosed with schizophrenia for the last 9 years. He had been compliant about taking his medications, trifluoperazine and benztropine, and had been working part-time. He was started on a regimen of olanzapine, 10 mg p.o. daily at bedtime, at his request to minimize chances of developing tardive dyskinesia. One week after starting olanzapine, Mr. B returned to the clinic and reported that he had experienced excessive whitish discharge from his eyes that was so sticky that when he woke up in the morning, his eyelids were stuck together. Olanzapine was discontinued, and subsequently, this discharge from his eyes disappeared.