Drug safety evaluation of olanzapine pamoate

INTRODUCTION: Olanzapine pamoate is one of three second-generation antipsychotics available as depot medication. While non-adherence is a major problem in the treatment of schizophrenia, olanzapine pamoate can improve adherence, though its use is limited by its safety profile.

AREAS COVERED: The review covers data on efficacy with a focus on tolerability and safety of olanzapine pamoate using the known databases including PubMed, Psychinfo and Embase using keywords. Relevant websites were also reviewed.

EXPERT OPINION: Olanzapine is an efficacious antipsychotic that can be used in its oral and depot formula (olanzapine pamoate) for the treatment of patients with schizophrenia. It has demonstrated superiority over conventional and some other atypical antipsychotics, with both formulas having comparable low rates of motor side effects. The side effects on body weight and glucose homeostasis are also similar in both formulas and limit its use. The only clear difference regarding side effects is 'the risk that 0.07% of injections in preclinical trials have led to a post-injection delirium/sedation syndrome event which requires a risk management plan'. Especially in outpatients this could cause inconveniences that should be overcome by offering, for example, psychological therapies or psychoeducation to effectively use the time when patients have to remain in the healthcare facilities.