Zyprexa is my "go-to" drug for acute mania or acute agitated mixed states in people with bipolar disorder. It is highly sedating, and therefore can be used to get the manic patient sleeping. This usually breaks the mania quickly. In my experience, it has a low incidence of extrapyramidal side effects (EPS) or akathisia. However, it has a strong propensity toward promoting weight gain. Not all patients gain weight on it, but those who are likely to experience this side effect usually declare themselves in the early weeks of treatment by showing an astonishing rate of weight gain.
While it does not have the Food and Drug Administration (FDA) approval for the depressed phase of bipolar disorder, my experience is that it often treats the symptoms of depression or of mixed states quite effectively. The dosage of Zyprexa in adults can vary from as little as 5 mg at bedtime to 10 mg twice a day, or even higher.
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