My son was always anxious socially way before he had his first psychotic break.
He was 18 when he started taking it. He finished his senior year in high school and actually had a couple teachers he liked that year. That was rare for him.
He also applied for quite a few jobs during that time. However, he was way too honest on his applications so never got a job offer. He’d put down that he thought it was fine to smoke pot, and that if other employees were stealing that he’d mind his own business and not tell. He thought it was an opinion poll or something.
If he had taken the Zyprexa consistently, I think he would have done much better, but he had lots of times where he would get stable, then not take it or take less than he should because he was sure he could manage his symptoms - recognize when he was getting sick and go back up to the recommended dosage. That’s when he had near-perfect insight.
It worked for him for a long time with him doing that, but it finally either got away from him or he got way sicker.
Bear in mind that he also came out of his first two psychotic breaks with absolutely no medicine because we just couldn’t get him in to see the right person while he was sick and we chose to not hospitalize him. In hindsight, that could have been a huge mistake.
He did not want to keep taking it because he said he felt dead inside when he was taking it, that he couldn’t enjoy anything, even music. A lot of people have that complaint and think it should be used to treat acute psychosis, then once someone is stable they should be transitioned to something else with less side effects. No one would argue that it’s a great emergency drug that can snap people out of psychosis quickly if it works for them.
He also slowly gained a lot of weight on it, more from inactivity than increased appetite. When he stopped taking it completely, he lost 60 pounds in 3 months and went from 200 to about 135/140, which is as thin as he should ever be. The first few years he was on it, he didn’t really gain more than 5 or 10 pounds, then it started creeping up.
EDIT: I should give you a more precise answer. On Zyprexa consistently, he did very well, a little bit better than his previous baseline, but he has other issues besides his psychosis that makes it hard for him to socialize and work.