Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Olanzapine(click to collapse)
1/4 selected
Olanzapine
Zyprexa
Second-Generation Antipsychotic
FDA-approved indications
- Schizophrenia (adults; adolescents 13–17 years)
- Acute manic or mixed episodes in Bipolar I — mono or adjunct with lithium/valproate
- Bipolar I maintenance (adults)
- Treatment-resistant depression — combination with fluoxetine (adults)
Off-label uses
- Anorexia nervosa
- Chemotherapy-induced nausea
- Delirium
MechanismAtypical Antipsychotic
Half-life21 to 54 hours
Decision GuideWhen to pick each / when to consider an alternative
Olanzapine
Consider when
- Acute agitation requiring rapid control — IM olanzapine for acute agitation; fastest onset among SGA IM formulations
- EPS-free profile critical — near-placebo akathisia (RR 0.99) and antiparkinson use (RR 1.02); avoids motor side effects
- Treatment-resistant depression adjunct — FDA-approved as Symbyax (olanzapine/fluoxetine) for TRD and bipolar depression
- Bipolar mania or maintenance — strong efficacy signal in Huhn 2019 NMA; FDA-approved for acute mania and maintenance
- +1 more
Consider an alternative when
- Cardiometabolic risk — class-top weight gain among non-clozapine SGAs (+3.82 kg Burschinski 2023); diabetes risk OR 1.67
- First-episode psychosis where metabolic baseline is preservable — early metabolic damage is poorly reversible; aripiprazole preferred
- BMI ≥25 or rapid weight gain history — labeled 30%+ weight gain ≥7% of body weight; appetite stimulation is near-universal
- Daytime sedation poorly tolerated — high H1 antagonism; dose-dependent somnolence limits functional recovery
- +1 more
| Axis | Olanzapine SGA |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Agranulocytosis / severe neutropenia | |
Cerebrovascular events (elderly w/ dementia) | |
Neuroleptic malignant syndrome (NMS) | |
DRESS / multiorgan hypersensitivity | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Akathisia / EPS | |
Tardive dyskinesia | |
Seizure risk | |
| Metabolic | |
Weight gain | |
Metabolic (glucose / lipids) | |
| Endocrine | |
Prolactin elevation | |
| Autonomic | |
Anticholinergic burden | |
Orthostatic hypotension | |
| Cardiac | |
QTc prolongation | |
| GI | |
Nausea / GI (general) | |
| Hepatic | |
Liver enzymes / hepatotoxicity | |
| Sexual | |
Sexual dysfunction | |
| Interactions | |
CYP interactions / DDI profile | |
| Pregnancy | |
Lactation / breastfeeding safety | |