Two medicines, side by side
Olanzapine vs lithium
Olanzapine and lithium are both labeled for bipolar disorder. Drugs@FDA records approvals of olanzapine since 1996 and of lithium since 1970. Pharmacies paid $0.147 per olanzapine 20 mg tablet and $0.104 per lithium carbonate 300 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, olanzapine is an atypical antipsychotic and lithium a mood stabilizer.
Check it at the source: the olanzapine FDA label on DailyMed (effective March 5, 2026); the lithium FDA label on DailyMed (effective December 23, 2025).
Highlights of the olanzapine record
Olanzapine (Zyprexa) · label of March 5, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients.
Used for
From the label: indicationsOlanzapine is an atypical antipsychotic indicated: As oral formulation for the: · Treatment of schizophrenia. ( 1.1 ) · Adults: Efficacy was established in three clinical trials in patients with schizophrenia: two 6-week trials and one maintenance trial. ( 14.1 ) · Adolescents (ages 13-17): Efficacy was established in one 6-week trial in patients with schizophrenia ( 14.1 ). […]
On the market
- Earliest approval on file
- September 30, 1996
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.147 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 14
Highlights of the lithium record
Lithium (Lithobid) · label of December 23, 2025
LITHIUM TOXICITY Lithium toxicity is closely related to serum lithium concentrations, and can occur at doses close to therapeutic concentrations. Facilities for prompt and accurate serum lithium determinations should be available before initiating treatment [see Dosage and Administration ( 2.3 ), Warnings and Precautions ( 5.1 )]. WARNING: LITHIUM TOXICITY See full prescribing information for complete boxed warning.
Used for
From the label: indicationsLithium is a mood-stabilizing agent indicated as monotherapy for the treatment of bipolar I disorder: • Treatment of acute manic and mixed episodes in patients 7 years and older [see Clinical Studies ( 14 )] • Maintenance treatment in patients 7 years and older [see Clinical Studies (14)] Lithium is a mood-stabilizing agent indicated as monotherapy for the treatment of bipolar I disorder: • Treatment of acute manic and mixed episodes in patients 7 years and older ( 1 ) • Maintenance treatment in patients 7 years and older […]
On the market
- Earliest approval on file
- April 6, 1970
- Generic labelers
- 24 labelers
- Pharmacy cost
- $0.104 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 4
Source: FDA drug labels via openFDA (Olanzapine label of March 5, 2026, Lithium label of December 23, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do olanzapine and lithium differ on the record?
In FDA's classes, olanzapine is an atypical antipsychotic and lithium a mood stabilizer.
How each works, in its label's words: Olanzapine, “The mechanism of action of olanzapine, in the listed indications is unclear.”; Lithium, “The mechanism of action of lithium as a mood stabilizing agent is unknown.”
Half-life, in each label's words: Olanzapine, “Its half-life ranges from 21 to 54 hours (5th to 95th percentile; mean of 30 hr), and apparent plasma clearance ranges …”; Lithium, “The elimination half-life of lithium is approximately 18 to 36 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: olanzapine since 2011; lithium since 1986 (Drugs@FDA).
| Olanzapine | Lithium | |
|---|---|---|
| Labeled for | Schizophrenia, Bipolar disorder, Depression | Bipolar disorder |
| Pharmacologic class | Atypical Antipsychotic | Mood Stabilizer |
| How it works (label) | The mechanism of action of olanzapine, in the listed indications is unclear. However, the efficacy of olanzapine in schizophrenia could be mediated through a combination of dopamine and serotonin type 2 (5HT 2 ) antagonism. | The mechanism of action of lithium as a mood stabilizing agent is unknown. |
| Half-life (label) | Its half-life ranges from 21 to 54 hours (5th to 95th percentile; mean of 30 hr), and apparent plasma clearance ranges from 12 to 47 L/hr (5th to 95th percentile; mean of 25 L/hr). | The elimination half-life of lithium is approximately 18 to 36 hours. |
| Earliest approval on file (Drugs@FDA) | September 30, 1996 | April 6, 1970 |
| First generic approved | October 24, 2011 | May 21, 1986 |
| Generic labelers (NDC) | 43 labelers | 24 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.147 per tablet (Olanzapine 20 mg tablet) | $0.104 per capsule (Lithium carbonate 300 mg capsule) |
| 12-month price change | -5% | -6% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 14 | 4 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 107,881 | 41,678 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Olanzapine label, contraindicationsFor specific information about the contraindications of lithium or valproate, refer to the Contraindications section of the package inserts for these other products.
Olanzapine label, drug interactionsTherefore, concomitant olanzapine administration does not require dosage adjustment of lithium [see Warnings and Precautions ( 5.16 )].
Source: FDA drug labels via openFDA
What do the labels say about using others of their kind?
Lithium label, warnings and precautionsIf concomitant use of lithium with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms.
Source: FDA drug labels via openFDA
What next?
- Alternatives to olanzapine
- every medicine labeled for the same conditions