Is an investigational formulation thatbines the atypical antipsychotic medication Zyprexa (olanzapine) with a pamoate salt, resulting in an extended delivery of up to four weeks.In its letter, the FDA said it needs more information to better understand the risk and underlying cause of excessive sedation events that have been observed in about 1 percent of patients in clinical trials.Were discussed during the FDA's Feb.Psychopharmacologic Drugs Advisorymittee hearing.The conclusion of that meeting, themittee voted that there were circumstances under which Zyprexa LAI would be acceptably safe and effective for the treatment of acutely exacerbated schizophrenia and maintenance treatment of schizophrenia in adults.In its letter, however, the FDA cited a new excessive sedation event that occurred shortly before the Feb.Hearing.Alerted the agency and the advisorymittee about the existence of a possible new case on Feb.Noting that Lilly was investigating the details of the event including conflicting information about the time of onset.Additional information, Lilly was able to confirm after the advisorymittee hearing that this was a case of excessive sedation and that it began between 3 to 5 hours after injection.Previous excessive sedation events had begun within three hours of injection.All previous patients with excessive sedation, this patient fully recovered."We are disappointed by the FDA's decision and we aremitted to ongoing discussions to better understand the agency's perspective regarding this recent case of excessive sedation and to define the path forward and the associated timeline," said Dr.Stotka, Vice President of U.Regulatory Affairs, Eli Lilly andpany.The chronic and severe nature of schizophrenia, persistent challenges with adherence, and the limited number of approved depot formulations, we continue to believe that, if approved, Zyprexa LAI would provide a valuable treatment option for patients suffering from schizophrenia.Independent regulatory reviews of Zyprexa LAI applications are ongoing in the European Union and other countries including Canada and Australia.About Long-acting Injectable Antipsychotic Medications Long-acting antipsychotics have been associated with improved treatment adherence and reduced treatment failures.Administering long-acting medications, healthcare professionals know when patients have received their medication and can immediately detect non-adherence when a patient fails to return for a scheduled injection.From both oral and injected short-acting formulations, long-acting antipsychotics allow for stable concentrations of the active drug to remain at a therapeutic range for an extended period of time.About Schizophrenia Schizophrenia is a severe and debilitating illness often characterized by acute psychotic episodes including delusions (false beliefs that cannot be corrected by reason), hallucinations (usually in the form of non-existent voices or visions) and long-term impairments such as diminished emotion, lack of interest and depressive symptoms, such as hopelessness and suicidal thoughts.Addition to these symptoms, patients with schizophrenia are at greater risk for medicalorbidities than the general population.Oral Zyprexa Zyprexa is indicated in the United States for the short- and long-term treatment of schizophrenia, acute mixed and manic episodes of bipolar disorder, and maintenance treatment of bipolar disorder.Was introduced in 1996, it has been prescribed to approximately 24 million people worldwide.Is not approved for patients under 18 years of age.Zyprexa is not approved for the treatment of patients with dementia-related psychosis.Patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of deathpared with those patients taking a placebo.In addition,pared to elderly patients with dementia-related psychosis taking a placebo, there was a significantly higher incidence of cerebrovascular adverse events in elderly patients with dementia-related psychosis treated with Zyprexa.Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolara or death, has been reported in patients treated with atypical antipsychotics, including Zyprexa.While relative risk estimates are inconsistent, the association between atypical antipsychotics and increases in glucose levels appears to fall on a continuum and olanzapine appears to have a greater association than some other atypical antipsychotics.Consider the risks and benefits when prescribing olanzapine to patients with an established diagnosis of diabetes mellitus, or who have borderline increased blood glucose level.Olanzapine should be monitored regularly for worsening of glucose control.With risk factors for diabetes who are starting on atypical antipsychotics should undergo baseline and periodic fasting blood glucose testing.Who develop symptoms of hyperglycemia during treatment should undergo fasting blood glucose testing.Undesirable alterations in lipids have been observed with olanzapine use.Monitoring, including baseline and follow-up lipid evaluations in patients using olanzapine, is advised.And sometimes very high, elevations in triglyceride levels have been observed with olanzapine use.Mean increases in total cholesterol have also been seen with olanzapine use.Potential consequences of weight gain should be considered prior to starting olanzapine.Receiving olanzapine should receive regular monitoring of weight.As with all antipsychotic medications, a rare and potentially fatal condition known as NMS has been reported with Zyprexa.Signs and symptoms appear, immediate discontinuation is rmended.Manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac dysrhythmia).May include elevated creatinine phosphokinase, myoglobinuria (rhabdomyolysis), and acute renal failure.Also, as with all antipsychotic treatment, prescribing should be consistent with the need to minimize Tardive Dyskinesia (TD).Of developing TD and the likelihood that it will be irreversible are believed to increase as the duration of treatment and the total cumulative dose of antipsychotic increase.Syndrome may remit, partially orpletely, if antipsychotic treatment is withdrawn.The mostmon treatment-emergent adverse event associated with Zyprexa in placebo-controlled, short-term schizophrenia and bipolar mania trials was somnolence.Events were dizziness, weight gain, personality disorder (COSTART term for nonaggressive objectionable behavior), constipation, akathisia, postural hypotension, dry mouth, asthenia, dyspepsia, increased appetite and tremor.Full prescribing information, including a boxed warning, is available at .Would you like to for our weekly ?The end of each week we'll send you an email containing links to the most popular articles (by page impression) from your 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