Drawbacks of Olanzapine Therapy: An Emphasis on Its Metabolic Effects and Discontinuation

Radical drug therapy for schizophrenia is usually hard to achieve with one currently available antipsychotic agent. Indeed, it is the negative symptoms of this morbidity that are a dilemma to neutralize. Most of the first-generation agents can deal with the positive symptoms of the disease to a convincing degree, but not with its negative symptoms. The creation of so-called second-generation agents aimed to treat the negative symptoms, as these invisible barriers are the real reasons that isolate psychotic individuals and hinder their integration into society. Unfortunately, these newly designed drugs turned out to induce different categories of undesired effects; the most embarrassing of which is the metabolic drawbacks, such as insulin resistance, weight gain, and other subcategories of metabolic consequences. In this work, we discuss the reasons behind these undesired metabolic effects, how to deal with these, and how to choose the proper agent for each psychotic case separately. The choice of antipsychotics should be tailored separately for each case, as each patient responds variably to each neuroleptic.