Olanzapine May Cause Delirium in Geriatric Patients

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Sir: Olanzapine, a second-generation antipsychotic, is indicated by the U.S. Food and Drug Administration (FDA) for schizophrenia and bipolar I acute mania but has limited evidence for use in elderly patients with these conditions.¹ Olanzapine was FDA-approved in December 2003 for maintenance monotherapy for bipolar disorder. Olanzapine at doses up to 20 mg is recommended to treat schizophrenia and acute mania.² The package insert, however, recommends a lower dosage in geriatric patients, based upon studies of elderly with schizophrenia or dementia with psychotic symptoms, not those with acute mania.