Family and Caregiver Schizophrenia Discussion Forum

Missed dose olanzapine and mood swings

Hi there! So my husband has Schizoaffective Disorder II (bipolar sub-type). It took over a year and several doctors to find the right diagnosis and medication regimen-that was a nightmare for a long time. He’s been in remission for about 8 months (of psychosis anyways) and has generally found about as happy an ending as you can get with this illness. Fingers crossed it stays this way. Only thing is since his diagnosis some things about his personality have of course changed. For reasons I’m not going into, I don’t take part in his medication regimen and I believe he does skip days from time to time. I know he used to during the nightmare months, but he hasn’t admitted to it since we found a regimen and doctor he likes. Nowadays he’s a lot quicker to lose his temper, some days way quicker than others, so I was wondering if anyone out there has experience with this disorder and Olanzapine and would know if skipping only a day can cause mood swings? For clarification, I don’t think he skips for more than a day and in the past when we had issues getting his rx filled on time, he was usually good for about 2- 2 1/2 days before he’d get mood swings, and they’d be much worse than what happens now. I’m just wondering if there can still be a delayed reaction even when he gets right back on it or for anyone else with experience, if missing only a day doesn’t cause any side effects with mood and this might just be his new norm. Thanks!

Hello @debb . Welcome to the site. I don’t have long term experience with olanzapine and mood swings as my daughter is on a totally different drug now (Haldol monthly injectible). When she was on Zyprexa, she was very irregular with taking the tablets when she got out of the hospital, and then she quit taking them totally. It DID improve her psychosis and mania (not her delusions though) in the hospital, but they crept back in rapidly when she stopped her pills at home. For months she thought she could take them “as needed”, so the psychosis and mood swings returned with a vengeance. From what I read about Zyprexa, its half life is 21-54 hours (so basically one to two days). I guess that means it could be a day or two before his mood swings turn on if a doses are missed. I am not medically trained, so that is just my opinion. I wish you well sorting this out.


As someone with SZA, my impression was the mood stabilization function of APs like Zyprexa was a secondary effect. They were prescribed off-label for years as they were primarily a SZ drug.

Caregivers need to realize that even with half-lives of a two days or more these drugs don’t work like switches. For me at least it’s not the sort of stereotypical Jekyll and Hyde behavior you see dramatized, it’s more subtle and gradual than that. Rapid-cycling bipolar disorder has a threshold of 4 cycles or more per 12 months, so if he’s just regular bipolar the mood swings should be much slower than you are seeing.

You may be confusing symptoms of depression with what you are calling mood swings. Depression in men can manifest differently than in women. Irritability and anger are common symptoms which most people miss, I know I was unaware I was in a depression when I was irritable, angry and sleepless. It’s counter-intuitive, think Sleepless in Seattle not the stereotypical symptoms you think equal depression.

All this said I’d say if you think dosages are being intentionally missed it’s probably twice or more than you think. I find a large part of recovery is learning how to mask symptoms from people because drugs don’t work perfectly and consistently for all symptoms. It’s a bit of acting and faking it to make it. Some of us are better at it than others, but we all have our tells.

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Have you checked the manufacture of the medicine?
If he’s sensitive to change and he gets another manufacture(still Zyprexa but different manufacture) he’ll go through medicine withdrawl like symptoms
That’s what happens to my son
Please check the manufacture
Thank you

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