- 5mg and 10mg tablets (sublingual)
- 10mg lyophilized powder (IM)

Executive Summary

(February 2023)


Olanzapine is a second generation (atypical) antipsychotic with a potent antagonism of serotonin 5-HT2A, 5-HT2C, dopamine D1-4, histamine H1 and alpha1-adrenergic receptors. It also has a moderate antagonism of muscarinic M1-5 receptors, as well as a  weak agonism to GABA-A, BZD and beta-adrenergic receptors. 

Adult dose for severe agitation:
5 to 10mg IM, repeated every 20 min if necessary

Adult dose

Acute agitation associated with psychiatric disorders (2, 7):

Pediatric dose

Usual dosing: 

Usual dosing: 

1st versus 2nd generation antipsychotics for agitation

There are significant differences among first and second generation antipsychotics, and there is an abundant amount of  literature available that compare olanzapine with haloperidol as well as other therapies to treat agitation. Clinically relevant data is summarized below: 

Therefore, olanzapine is currently recommended as a first-line antipsychotic alternative for an agitated psychiatric adult patient (2, 11). In the pediatric  population it is considered to be safe and effective (8), but is not yet US-FDA nor EMA approved for agitation (7, 9).


Olanzapine is a second generation (atypical) antipsychotic. It has a wide range of different receptors activity: 



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