Deprex

Deprex Tablet

Deprex is an antipsychotic agent and has affinities for serotonin 5HT2A/2C, 5HT3, 5HT6; dopamine D1, D2, D3, D4, D5; cholinergic muscarinic receptors M1-M5; α1 adrenergic; and histamine H1 receptors. The mechanism of action of Deprex, as with other drugs having efficacy in schizophrenia, is unknown. However, it has been proposed that this drug’s efficacy in schizophrenia is mediated through a combination of dopamine and serotonin type 2 (5HT2) antagonism. 

Deprex is well absorbed after oral administration, reaching peak plasma concentrations within 5 to 8 hours. The absorption is not affected by food. Deprex is not mutagenic or clastogenic as well as not carcinogenic.

Uses

Deprex is used for the acute and maintenance treatment of schizophrenia and related psychoses where positive symptoms (e.g. delusions, hallucinations, disordered thinking, hostility and suspiciousness) and/or negative symptoms (e.g. flattened affect, emotional and social withdrawal, poverty of speech) are prominent.

Deprex is used for the treatment of acute manic or mixed episodes in bipolar disorder, with or without psychotic features and with or without a rapid cycling course

Deprex is also used to associated treatment for these conditions: Acute Agitation, Acute Depressive Episode, Bipolar 1 Disorder, Bipolar Disorder With Manic or Mixed Episodes, Delirium, Delusional Parasitosis, Gilles de la Tourette's Syndrome, Major depressive disorder, recurrent episode, Mixed manic depressive episode, Post Traumatic Stress Disorder (PTSD), Psychosis, Schizophrenia, Acute Manic episode

Deprex

Trade Name Deprex
Generic Olanzapine
Olanzapine Other Names Olanzapin, Olanzapina, Olanzapine, Olanzapinum
Weight 5mg, 10mg,
Type Tablet
Formula C17H20N4S
Weight Average: 312.432
Monoisotopic: 312.14086735
Protein binding

Olanzapine is largely bound to plasma proteins and hence, about 93% of the administered dose is bound. The main proteins for binding are albumin and alpha-1 acid glycoprotein.

Therapeutic Class Atypical neuroleptic drugs
Manufacturer Square Pharmaceuticals Ltd
Available Country Bangladesh,
Last Updated: June 23, 2021 at 11:23 am

Structure

Deprex
Olanzapine Structure

Dosage

Deprex dosage

The recommended starting dose for Deprex is 10 mg/day, administered as a single daily dose without regard to meals. Daily dosage may subsequently be adjusted on the basis of individual clinical status within the range of 5-20 mg daily. An increase to a dose greater than the routine therapeutic dose of 10 mg/day i.e. to a dose of 15 mg/day or greater, is recommended only after appropriate clinical reassessment.

Children: Deprex has not been studied in subjects under 18 years of age.

Elderly patients (age 65 and over): starting dose 5 mg/day

Patients with hepatic and/or renal impairment: starting dose 5 mg/day 

When more than one factor is present which might result in slower metabolism (female gender, geriatric age, non-smoking status), consideration should be given to decreasing the starting dose. Dose escalation, when indicated, should be conservative in such patients.

Side Effects

Very common undesirable effects are somnolence and weight gain. Besides increased appetite, elevated glucose levels, elevated triglyceride levels, dizziness, akathisia, Parkinson's disease, dyskinesia, orthostatic hypotension, mild and transient anticholinergic effects including constipation and dry mouth, asthenia, edema and photosensitivity reaction etc. may be observed.

Precaution

Deprex should be used cautiously in patients who have a history of seizures or have conditions associated with seizures. Deprex should be used cautiously in patients with low leukocyte and/or neutrophil counts for any reason, drug induced bone marrow depression/toxicity caused by radiation therapy or chemotherapy, hypereosinophilic conditions, impaired hepatic function, and patients using hepatotoxic medicines, centrally acting drug and medicines know to increase QT interval, especially in the elderly. Patients should be cautioned about operating hazardous machinery, including motor vehicles.

Interaction

Drugs that induce CYP1A2 or glucoronyl transferase enzymes (omeprazole, rifampicin), inhibitor of CYP1A2 (fluvoxamine), centrally acting drugs, antihypertensive agents.

Food Interaction

  • Avoid alcohol. Alcohol may potentiate CNS adverse effects and orthostatic hypotension.
  • Take with or without food. The absorption of olanzapine is unaffected by food.

Volume of Distribution

The volume of distribution of olanzapine is reported to be of 1000 liters which indicate a large distribution throughout the body.

Half Life

Deprex presents a half-life ranging between 21 to 54 hours with an average half-life of 30 hours.

Clearance

The mean clearance rate of olanzapine is of 29.4 L/hour however, some studies have reported an apparent clearance of 25 L/h.

Pregnancy & Breastfeeding use

Deprex should be used in pregnancy only if the potential benefits justify the potential risk to the foetus. So, patients should be advised to notify their physician if they become pregnant or intend to become pregnant during treatment with Deprex. There is no report to show teratogenecity. Patients should not breast feed if they are taking Deprex.

Contraindication

This is contraindicated in those patients with a known hypersensitivity to Deprex as well as in patients with known risk for narrow-angle glaucoma.

Concomitant illness: Deprex in patients with concomitant illness is limited, caution is advised when prescribing for patients with prostatic hypertrophy, or paralytic ileus and related conditions.

Neuroleptic Malignant Syndrome (NMS): If a patient develops signs and symptoms indicative of NMS, or presents with unexplained high fever without additional clinical manifestations of NMS, all antipsychotic medicines, including olanzapine must be discontinued.

Acute Overdose

Symptoms: Tachycardia, agitation/aggressiveness, dysarthria, extrapyramidal symptoms, reduced level of consciousness ranging from sedation to coma. 

Management: Symptomatic and supportive treatment. Gastric lavage and admin of activated charcoal may be effective.

Storage Condition

Store below 30˚ C. Protect from light and moisture. Keep out of the reach of children.

Innovators Monograph

Deprex contains Olanzapine see full prescribing information from innovator Monograph

FAQ

What is Deprex used for?

Deprex is an atypical antipsychotic primarily used to treat schizophrenia and bipolar disorder. For schizophrenia, it can be used for both new-onset disease and long-term maintenance.

How safe is Deprex?

Deprex is safe and effective in nonselected schizophrenic outpatients and are consistent with the efficacy and safety profile that Deprex has shown in previous controlled clinical trials.

How does Deprex work?

Deprex works by affecting naturally occurring chemical messengers in your brain.

What are the common side effects of Deprex?

Common side effects of Deprex are include:

  • dizziness, feeling unsteady, or having trouble keeping your balance
  • restlessness
  • unusual behavior
  • depression
  • difficulty falling asleep or staying asleep
  • weakness
  • difficulty walking
  • constipation
  • weight gain
  • dry mouth
  • pain in arms, legs, back, or joints
  • breast enlargement or discharge
  • late or missed menstrual periods
  • decreased sexual ability

Is Deprex safe during pregnancy?

Deprex should be used in pregnancy only when potential benefit justifies potential risk to the fetus. Deprex should only be considered during breastfeeding when the potential benefit justifies the potential risk to the infant.

Is Deprex safe during breastfeeding?

A safety scoring system finds Deprex to be acceptable during breastfeeding.

Can I drink alcohol with Deprex?

Avoid drinking alcohol or using illegal drugs while you are taking Deprex.

Can I drive after taking Deprex ?

Do not drive a car or operate machinery until you know how this medication affects you.

When should be taken of Deprex?

It is usually recommended to take Deprex at bedtime because it can cause sleepiness as a side effect. However, it is important to choose a time of day to take it that you can easily remember, which could be bedtime, a mealtime, or when you brush your teeth.

Can I take Deprex on an empty stomach?

You can take Deprex once daily with food or on an empty stomach.

How long does Deprex take to work?

When you first start taking Deprex, it may make you feel more relaxed and calm. Within 2 to 3 weeks, your other symptoms may start to improve. You may find Deprex makes you: able to concentrate better, and think more clearly.

Can I take Deprex for a long time?

Yes, many people take Deprex for a long time, including for many months or years, without any problems. Deprex can increase the amount of sugar in your blood and this can sometimes lead to diabetes.

What happens when I stop taking Deprex?

Stopping Deprex suddenly can cause withdrawal effects and stopping it too early could cause your illness to come back. See your doctor if you want to stop taking Deprex because it is better to come off it gradually.

Does Deprex help me sleep?

Deprex seems to preserve the normal structure of sleep and increase the amount of slow-wave sleep, which might be of additional benefit in treatment of schizophrenia.

Who should not take Deprex?

Deprex is not approved for use in older adults with dementia-related psychosis.

What happens if I miss a dose?

Take Deprex as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention.Overdose symptoms may include drowsiness, agitation, aggression, slurred speech, confusion, increased heart rate, jerky or uncontrolled muscle movements, trouble breathing, or fainting.

What happen If I just stop taking Deprex?

Stopping Deprex suddenly can cause withdrawal effects and stopping it too early could cause your illness to come back. See your doctor if you want to stop taking Deprex because it is better to come off it gradually.

Does Deprex cause brain damage?

When taken together, both Deprex and illness relapse have an effect on brain structure.

Does Deprex help me sleep?

Deprex seems to preserve the normal structure of sleep and increase the amount of slow-wave sleep, which might be of additional benefit in treatment of schizophrenia. The effective clinical dose may be lower for females than males.

Does Deprex make me hungry?

Deprex is associated with elevated appetite and food intake and decreased activity or impairment of metabolic regulation.

Will Deprex affect my fertility?

Deprex may increase the level of a hormone called prolactin in the body for a short time when you start taking it, but not to a very high level. If prolactin levels do rise for a short time after starting Deprex, this may affect fertility, regardless of gender.

Can Deprex affect kidneys?

Several adverse outcomes attributed to atypical antipsychotic drugs, specifically Deprex are known to cause acute kidney injury.