Loxapine vs. Zyprexa for Schizophrenia: Important Differences and Potential Risks.

Key takeaways

Loxapine (generic, formerly sold as Loxitane) and Olanzapine (Zyprexa) are both antipsychotic medications, but they belong to different classes. Loxapine is a first-generation (typical) antipsychotic, while Olanzapine is a second-generation (atypical) antipsychotic. Loxapine is primarily used to treat schizophrenia and is available only in generic form. It can cause more movement-related side effects, such as tremors and stiffness, compared to Olanzapine. Olanzapine, on the other hand, treats schizophrenia, bipolar disorder, and certain types of depression when combined with fluoxetine (Prozac). It is available as both a generic and brand-name medication. Olanzapine is more likely to cause weight gain and metabolic issues like high blood sugar and cholesterol. Both medications can cause drowsiness and should not be mixed with alcohol. However, Olanzapine is also available as an injection, which is typically administered in a clinical setting.

Loxapine

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Olanzapine

(Zyprexa)

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Summary for Loxapine

Prescription only

Loxapine is a typical antipsychotic used to treat schizophrenia. Loxapine is taken by mouth, typically once or twice daily. It can cause more movement-related side effects compared with atypical antipsychotics, such as aripiprazole (Abilify). It used to be sold under the brand name Loxitane, which is no longer available. Oral loxapine is now only available as generic capsules.

Indications for Loxapine

Schizophrenia

Pros and Cons for Loxapine

Pros

A good option if other schizophrenia medications haven't worked or have caused bothersome side effects
Dose can be adjusted by your provider based on your response
Available as a lower-cost generic medication

Cons

More likely to cause trouble controlling movements compared to other treatment options
Can raise your heart rate and lower your blood pressure
Risk of developing abnormal muscle movements that might not go away after you stop taking loxapine

Common Side Effects for Loxapine

Drowsiness
Extrapyramidal symptoms (movement problems, such as shakiness, stiffness, excess saliva, and loss of facial expression)
Restless muscles (akathisia)

Warnings for Loxapine

Higher risk of death in older adults
Uncontrollable body movements (tardive dyskinesia)
Neuroleptic malignant syndrome
Falls
Low white blood cell count
Seizures
Vision changes
High prolactin levels

Summary for Zyprexa

Prescription only

Olanzapine (Zyprexa) is an atypical antipsychotic used treat schizophrenia or bipolar disorder. It can also treat depression, in combination with fluoxetine (Prozac), when other treatments haven't worked well. This medication is thought to work by balancing the levels of certain chemicals in the brain. Olanzapine (Zyprexa) is taken by mouth, typically once daily, by adults and children. Olanzapine (Zyprexa) is also available as an injection that's usually given in a hospital or clinic setting. Some of the more common side effects of olanzapine (Zyprexa) include sleep problems, dizziness, and weight gain.

Indications for Zyprexa

Schizophrenia in adults and children age 13 years and older
Bipolar I disorder in adults and children age 13 years and older

When taken with fluoxetine (Prozac):

Bipolar depression in adults and children age 10 years and older
Depression that hasn't responded well to other treatments

Pros and Cons for Zyprexa

Pros

Taken by mouth
Taken once daily
Might notice an improvement in your symptoms in as early as a week of starting olanzapine (Zyprexa)
Available as a lower-cost generic

Cons

Can cause anticholinergic side effects, such as constipation and dry mouth
Can affect your sleep
More likely to cause weight gain, high blood cholesterol, and high blood sugar levels compared to some other atypical antipsychotics