Neuropharmacology of Olanzapine
Mental problems account for a significant percentage of diseases affecting societies all over the world. One of the biggest challenges associated with the control of the ailments is lack of access for medication by a majority of societies all over the world (WHO, 2003). The accessibility can be increased through the formulation and implementation of policies that will facilitate their supply. This process may involve the training of appropriate personnel and provision of adequate funds to finance the process. The World Health Organization has played a significant role in encouraging governments to prioritize the ailments during revenue allocation in a bid to create a healthy world (WHO, 2003). The organization also helps the countries in the implementation of the policies.
Olanzapine and its Use in Treating Schizophrenia and Bipolar Disease
Olanzapine belongs to the class of antipsychotics known as atypical or second-generation, a group of drugs that aided in the reduction of cases of diabetes that resulted from complications caused by schizophrenia (OTIS, 2016). Such patients also suffered from problems associated with glucose metabolism as well as resistance to insulin. The above effects cannot be explained fully on how schizophrenia causes the conditions to be the way they are. The brand name of Olanzapine drug is Zyprexa (PSYCH, 2010). Its mechanism of action has not been discovered yet, but researchers propose that it is likely to be mediated by serotonin type2 and dopamine (Lord et al., 2017). This psychotropic agent belongs to the class of thienobenzodiazepine (Dhar, Sidana, & Singh, 2010).
There are other groups of medications referred to as typical antipsychotics that can be used in place of Olanzapine in treating Schizophrenia and other mental ailments, but the latter is most preferred because it is characterized by less tardive dyskinesia and extra pyramidal side effects (Boyle et al., 2014). However, the drug is associated with increased chances of heart problems as a result of diabetes, glucose intolerance and dyslipidemia.
Bipolar disorder is also referred to as manic depression. The disease is characterized by abnormal mood changes (Boyle et al., 2014). They may seem depressed, but the state may change within a short time, and they become happy, the condition referred to the as manic episode when the mood is up and the depressive episode when low (NIH, 2015). The downs and lows experienced by people with the disorder are far much different from the normal. They tent to experience changes in energy level and sleep and may fail to think normally.
It has adverse effects which are a bit similar to those of schizophrenia such as the inability to keep a job and going to school (NIH, Schizophrenia, 2015). In extreme cases, the patients may develop suicidal thoughts or may attempt to hurt themselves such as through self-mutilation. This disease is can also be treated by use of appropriate drugs and patients who recover from it can still lead successful lives. The disorder affects people of almost all ages but more common with teens and early adults. Adverse effects associated with the disorder have been found to last throughout a person’s entire life.
Schizophrenia is a mental problem that causes serious changes in a person’s behavior, feelings, and thought. Patients suffering from this condition are characterized by hearing sounds that normal people cannot hear and are therefore seen to have lost touch with reality (NIH, Schizophrenia, 2015; Horacek et al., 2006). They may speak about things that don’t make sense to the normal people and always think that someone is just about to hurt them.
Its adverse effects are a bit similar to those of Bipolar Disorder and patients may find it difficult to go to school and keeping a job. Despite the level of disability the disease causes, it can still be treated by use of appropriate medications and patients live a normal life again (NIH, Bipolar Disorder, 2015; NIH, Schizophrenia, 2015). This condition affects both genders and all races and ethnic groups but is more common with men than women between 16 and 30.
The drug is well absorbed and is characterized by a half-life of 21-54 hour. This drug reaches maximum plasma concentration after six hours. The attainment of its steady concentration takes a period of abbot seven days (Boyle et al., 2014). Its metabolism is aided by cytochrome P450 enzymes 2D6 and 1A2 and direct glucuronidation. Certain medical conditions that alter the rate of its clearance from the blood plasma may or may not necessitate prescription adjustments. Smoking induces some cytochrome enzymes such as 1A2 and therefore leads to faster metabolism of the drug.
Conditions such as renal complications may seem to reduce its clearance, but the effect does not necessitate prescription adjustments (Boyle et al., 2014). This is because of the many other elimination pathways such as through feces which aid in the attainment of the normal rate of Olanzapine elimination.
The many side effects associated with Olanzapine compared to the other antipsychotics requires that medical practitioners weigh up first the individual patient characteristics and the potential efficacy to achieve its best effects (NIH, Bipolar Disorder, 2015). This approach helps to reduce chances of development of secondary medical complications and more specifically the cardiac problems. The use of this drug should always be followed by metabolic monitoring especially for patients with schizophrenia.
Detection of increased side effects should be followed by immediate administration of drugs with fewer side effects (NIH, Schizophrenia, 2015). Drugs that require less pharmacological management of cardiac problems and lifestyle modifications are a better alternative to Olanzapine.
Increase in the metabolic effects as a result of the use of Olanzapine has been attributed to increased levels of postprandial insulin and a reduction in the sensitivity of insulin. Some receptors are involved in the metabolic effects caused by Olanzapine. Acetylcholine muscarinic M3 receptor is the main example (Horacek et al., 2006). The affinity of Olanzapine for this receptor is a possible reason that increases its predisposing effects on its users to diabetes. The drug causes blockage of acetylcholine binding to the pancreatic islet M3R in vitro, a factor that inhibits the secretion of insulin by pancreatic beta cells.
People with special medical complications such as those with hepatic disorders have very slight changes in the rate of Olanzapine elimination. This might be as a result of the many other elimination pathways such as through the kidneys (Eli Lilly and Company, 2003). The small change, therefore, does not necessitate adjustments in drug prescriptions for patients with such cases. Patients in at 60-70 years of age and above have a higher rate of Olanzapine elimination than normal, and the use of Olanzapine medications on such patients should, therefore, be done with utmost care.
Males have a relatively higher Olanzapine elimination than women. This difference does not have many pharmacological implications because the effects of the drug on both genders have been found to be about the same (Eli Lilly and Company, 2003). This factor, therefore, does not also necessitate adjustments in drug prescription. The existence of more than one factor in a patient that may necessitate the adjustments should be dealt with even more care when prescribing Olanzapine for a patient. Old patients and who are smokers may require more care after treatment with Olanzapine. Such care may require a more frequent monitoring of the metabolic conditions of a patient.
conclusion
People who have schizophrenia and bipolar disease may suffer from other medical problems, and this factor may confuse in determining whether the patients have the above disorders. Bipolar disorder, for example, may take years to be diagnosed. Confusion between the symptoms of schizophrenia and Bipolar Disorder is also common for the medical practitioners. Some of the common problems that cause such confusion are thyroid disorders, drug abuse, and anxiety disorders. Obesity is also a common problem that leads to the same. Treatment for both the diseases is meant to mainly reduce their adverse effects and hardly cures the problems completely. Patients are advised to inform appropriate medical practitioners about any side effects associated with the use of Olanzapine.
Psychotherapy is another strategy that is commonly used in treating the disorders. This approach helps such patients in managing their own lives by enabling them to interact well with friends and family members. The approach is achieved best when family members are involved as the therapists. Some patients respond negatively to both of the above disorders, and they can be treated by the use of electroconvulsive therapy, also referred to as “shock” therapy (NIH, 2015). This method has been found to correct some of the common mental disorders.