Is Olanzapine like Xanax? (3+ differences)
In this article, we will compare the effects of two medications – Olanzapine (Zyprexa) and Alprazolam (Xanax). We will discuss their FDA-approved clinical uses, mechanisms of action, potential side effects, and many other differences.
Is Olanzapine like Xanax?
No, Olanzapine is not like Xanax. Olanzapine (also known as Zyprexa) and Alprazolam (also known as Xanax) are two different medications, which work with different mechanisms to treat mood conditions, depression and related disorders.
Both Olanzapine and Xanax are prescription medications and should only be used at the recommendation of a healthcare professional. Make sure not to take these medications without a prescription and also not to combine both medications without any guidance from your healthcare provider.
What are the key differences between Olanzapine and Xanax?
Olanzapine and Alprazolam have the following key differences:
FDA-approved clinical uses
Olanzapine is a second-generation, atypical antipsychotic agent, approved by the FDA for the treatment of schizophrenia above the age of 13, and acute treatment of manic or mixed episodes in bipolar disorder (1,2).
Xanax is a benzodiazepine, approved by the FDA for the acute treatment of generalised anxiety disorder (GAD), and panic disorder associated with or without agoraphobia in adults (3).
Mechanisms of action
Olanzapine is shown to act on dopamine and serotonin receptors, working as an antagonist on the dopamine D2 receptors, blocking the actions of dopamine. This effect decreases delusions, hallucinations and disorganized speech or thoughts. Olanzapine works in almost the same way on serotonin 5HT2A receptors as an antagonist, decreasing symptoms such as poor attention and lack of motivation (2).
Xanax is shown to act on the gamma-aminobutyric acid (GABA-A) receptors in the brain, acting in favour of the neurotransmitter gamma amino-butyric acid (GABA) in enhancing its effects of reducing anxiety, and calming the patient (4).
Olanzapine causes side effects like (2):
- Weight gain, due to an increase in appetite
- Impaired glucose tolerance
- Extrapyramidal symptoms like tardive dyskinesia and akathisia etc.
Xanax produces an array of side effects like (4):
- Poor balance or coordination
- Increased sweating
- Appetite or weight changes
- Blurred vision
- Dry mouth
- Decreased mental alertness
- Loss of interest in sex
It is important to keep in mind that not all individuals experience these side effects. Make sure to inform your healthcare provider of any side effects which may be linked to Olanzapine or Xanax.
Olanzapine is not addictive, so it can be used in the long-term management of schizophrenia, bipolar disorder or related conditions. Individuals taking olanzapine generally do not have to worry about the addiction potential (1,2).
Xanax has a high addiction potential, especially with prolonged use. Benzodiazepines, including Xanax, are found to cause physical dependence in individuals taking them. The risk for dependence increases with chronic treatment with high doses. The risk of physical dependency makes it hard for healthcare providers to prescribe Xanax for long-term use (3,4).
There is a risk of withdrawal symptoms while discontinuing olanzapine therapy, hence olanzapine should be tapered gradually and individuals should be carefully monitored. Some individuals can experience increased emotional instability and mood swings while withdrawing from olanzapine (2).
With Xanax, the withdrawal symptoms are more profound like rebound anxiety, blurred vision, abnormal involuntary movements, memory impairment, panic attacks, muscle twitching, and insomnia and can even be life-threatening like seizures, hallucinations, mania and suicidality. Rapid dosage reduction or abrupt discontinuation of therapy can increase withdrawal symptoms (3,4,5).
Please keep in mind that no medication should be stopped abruptly. You must work with your healthcare provider on decreasing the dose of Olanzapine or Xanax so that withdrawal symptoms do not occur.
How to choose between Olanzapine and Xanax?
The decision between Olanzapine and Xanax should always be made by your healthcare provider. You should never start any medication without a prescription from your doctor. The right choice of medication will depend on many factors, as each medicine affects each person differently. A few factors that may affect the choice of medication are:
Your healthcare provider will assess the nature of your symptoms and make a diagnosis. The choice of medication will be made on the diagnosis. Olanzapine is primarily approved for schizophrenia, and bipolar disorder, which will be the drug of choice if you have these conditions. Xanax, on the other hand, is prescribed for anxiety and panic disorders, so it may be a better option if anxiety is the primary concern (1,3).
Use for long-term or short-term
After diagnosis, your healthcare provider will assess whether you will need the medication for long-term or short-term use. After that, your doctor will assess which medicine will be suitable. Long-term or short-term use of Olanzapine or Xanax depends on the severity of the symptoms and the risk of dependency and withdrawal.
If both medications are not suitable, there are many other alternatives to both Olanzapine and Xanax which your healthcare provider may prescribe to you to treat your symptoms.
Can you take Olanzapine and Xanax together?
Concomitant use of Olanzapine and Xanax is not normally recommended as both medications can cause many disturbing symptoms. Some symptoms associated with concomitant use are:
- Low heart rate
- Blood pressure
- Excessive sedation
- Respiratory depression
These symptoms can sometimes even lead to death. Please note that you should use the medication prescribed by your doctor, in the dosages prescribed, and not make any amendments to your prescription on your own.
In this article, we have addressed the basic differences between Olanzapine and Xanax. We have also discussed which factors should be kept in mind while deciding which medication to use, and how any decision regarding medication use should be taken by a healthcare professional.
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The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZYPREXA (olanzapine) tablets for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/020592s062021086s040021253s048lbl.pdf
Thomas K, Saadabadi A. Olanzapine. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2022. PMID: 30422498. https://europepmc.org/article/NBK/nbk532903
The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. XANAX (alprazolam) tablets for oral use, CIV . Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/018276s055lbl.pdf
George TT, Tripp J. Alprazolam. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538165/
*Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med. 2018 Jan/Feb;12(1):4-10. doi: 10.1097/ADM.0000000000000350. PMID: 28777203; PMCID: PMC5846112. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/