May alter cardiac conduction (life-threatening arrhythmias occurred). May cause anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention). Antipsychotic use associated with esophageal dysmotility and aspiration (caution in risk of pneumonia). May cause extrapyramidal symptoms, including pseudoparkinsonism, acute dystonic reactions, akathisia, and tardive dyskinesia (risk of dystonia may be greater with increased doses, use of conventional antipsychotics, males, and younger patients). Atypical antipsychotics associated with development of hyperglycemia (greater association with hyperglycemia than other atypical antipsychotics; caution in diabetes or other disorders of glucose regulation). Use may be associated with neuroleptic malignant syndrome (risk may be increased in Parkinson’s disease or Lewy body dementia). May cause orthostatic hypotension. May be moderate to highly sedating. Possibility of suicide attempt inherent in psychotic illness or bipolar disorder (use with caution in high-risk patients during initiation of therapy). Impaired core body temperature regulation may occur. Significant weight gain (>7% of baseline weight) observed with antipsychotic therapy; incidence varies with product. Elderly patients with dementia-related psychosis treated with atypical antipsychotics are at increased risk of death compared to placebo (increased incidence of cerebrovascular adverse events reported in elderly patients with dementia-related psychosis; olanzapine not approved for this indication). Use with caution in narrow-angle glaucoma (condition may be exacerbated by cholinergic blockade), in hepatic disease or impairment, in myasthenia gravis (condition may be exacerbated by cholinergic blockade), in Parkinson’s disease (may be more sensitive to adverse effects), in breast cancer or other prolactin-dependent tumors (elevates prolactin levels), in renal disease, and in risk of seizures. Elderly patients may be at increased risk of seizures due to increased prevalence of predisposing factors. Olanzapine levels may be lower in patients who smoke.