Two medicines, side by side
Olanzapine vs risperidone
Olanzapine and risperidone are both labeled for bipolar disorder and schizophrenia. Drugs@FDA records approvals of olanzapine since 1996 and of risperidone since 1993. Pharmacies paid $0.147 per olanzapine 20 mg tablet and $0.0368 per risperidone 0.25 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Olanzapine, “The mechanism of action of olanzapine, in the listed indications is unclear.”; Risperidone, “The drug's therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D 2 ) and serotonin Type 2 (5HT 2 ) receptor antagonism.”
Check it at the source: the olanzapine FDA label on DailyMed (effective March 5, 2026); the risperidone FDA label on DailyMed (effective May 28, 2026).
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 risperidone record
Risperidone (Risperdal) · label of May 28, 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. RISPERDAL is not approved for the treatment of patients with dementia-related psychosis. [see Warnings and Precautions (5.1) ] WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsRISPERDAL is an atypical antipsychotic indicated for: Treatment of schizophrenia ( 1.1 ) As monotherapy or adjunctive therapy with lithium or valproate, for the treatment of acute manic or mixed episodes associated with Bipolar I Disorder ( 1.2 ) Treatment of irritability associated with autistic disorder ( 1.3 ) 1.1 Schizophrenia RISPERDAL (risperidone) is indicated for the treatment of schizophrenia. […]
On the market
- Earliest approval on file
- December 29, 1993
- Generic labelers
- 37 labelers
- Pharmacy cost
- $0.0368 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Olanzapine label of March 5, 2026, Risperidone label of May 28, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do olanzapine and risperidone differ on the record?
How each works, in its label's words: Olanzapine, “The mechanism of action of olanzapine, in the listed indications is unclear.”; Risperidone, “The drug's therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D 2 ) and serotonin Type 2 (5HT 2 ) receptor antagonism.”
Both are in FDA's class atypical antipsychotics.
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 …”; Risperidone, “The apparent half-life of risperidone was 3 hours (CV=30%) in extensive metabolizers and 20 hours (CV=40%) in poor …”
Both labels carry a boxed warning; the records quote them.
Generics: olanzapine since 2011; risperidone since 2008 (Drugs@FDA).
| Olanzapine | Risperidone | |
|---|---|---|
| Labeled for | Schizophrenia, Bipolar disorder, Depression | Bipolar disorder, Schizophrenia |
| Pharmacologic class | Atypical Antipsychotic | Atypical Antipsychotic |
| 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 risperidone in schizophrenia is unclear. The drug's therapeutic activity in schizophrenia could be mediated through a combination of dopamine Type 2 (D 2 ) and serotonin Type 2 (5HT 2 ) receptor antagonism. |
| 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 apparent half-life of risperidone was 3 hours (CV=30%) in extensive metabolizers and 20 hours (CV=40%) in poor metabolizers. |
| Earliest approval on file (Drugs@FDA) | September 30, 1996 | December 29, 1993 |
| First generic approved | October 24, 2011 | June 30, 2008 |
| Generic labelers (NDC) | 43 labelers | 37 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.147 per tablet (Olanzapine 20 mg tablet) | $0.0368 per tablet (Risperidone 0.25 mg tablet) |
| 12-month price change | -5% | -13% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 14 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 107,881 | 131,095 |
| 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)
What next?
- Alternatives to olanzapine
- every medicine labeled for the same conditions