Lithium and Olanzapine interaction

For specific information about the contraindications of lithium or valproate, refer to the Contraindications section of the package inserts for these other products.

When using ZYPREXA in combination with lithium or valproate, refer to the Contraindications section of the package inserts for those products.

Use in Combination with Fluoxetine, Lithium, or Valproate When using ZYPREXA and fluoxetine in combination, the prescriber should also refer to the Warnings and Precautions section of the package insert for Symbyax.

When using ZYPREXA in combination with lithium or valproate, the prescriber should refer to the Warnings and Precautions sections of the package inserts for lithium or valproate [see Drug Interactions ( 7 )] .

Lithium — Multiple doses of olanzapine (10 mg for 8 days) did not influence the kinetics of lithium.

• Encephalopathic Syndrome: Increased risk in patients treated with lithium and an antipsychotic.

Because of a possible causal relationship between these events and the concomitant administration of lithium and antipsychotics, patients receiving such combined treatment should be monitored closely for early evidence of neurological toxicity and treatment discontinued promptly if such signs appear.

Atypical and Typical Antipsychotic Drugs Clinical Impact: Reports of neurotoxic reactions in patients treated with both lithium and an antipsychotic, ranging from extrapyramidal symptoms to neuroleptic malignant syndrome, as well as reports of an encephalopathic syndrome in few patients treated with concomitant therapy [see Warnings and Precautions ( 5.5 )] .

Encephalopathic Syndrome An encephalopathic syndrome, characterized by weakness, lethargy, fever, tremulousness and confusion, extrapyramidal symptoms, leukocytosis, elevated serum enzymes, BUN and fasting blood glucose, has occurred in patients treated with lithium and an antipsychotic.

This encephalopathic syndrome may be similar to or the same as neuroleptic malignant syndrome (NMS).