Can you drink coffee while taking olanzapine?

In this article:

• Olanzapine and coffee
• Olanzapine and taste
• Coffee and other antipsychotics
• Best practices for olanzapine
• The bottom line

In this article

• Olanzapine and coffee
• Olanzapine and taste
• Coffee and other antipsychotics
• Best practices for olanzapine
• The bottom line

Olanzapine, also known by the brand name Zyprexa, is a second-generation antipsychotic medication that works by balancing brain chemicals serotonin and dopamine. It is commonly used in psychiatry to treat schizophrenia, bipolar disorder, and other mental health conditions. If you’ve recently been prescribed olanzapine, you may be wondering whether you need to curb your caffeine habit or if you can safely enjoy your favorite morning brew.

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Can you drink coffee on olanzapine?

The good news for coffee connoisseurs is that you can likely still consume caffeine while taking olanzapine. There are just a few considerations before ordering your next espresso.

The most important thing to keep in mind is how much coffee you choose to drink. “Both caffeine and olanzapine are broken down by the same liver enzyme called CYP1A2. When you drink coffee, it can slow down how your body processes olanzapine, which means the medication levels in your blood can go up, sometimes by about 40%,” explains Nick Triviso, a psychiatric mental health nurse practitioner at Neuro Wellness Spa in Los Angeles, California.

While the potential interaction between olanzapine and caffeine isn’t as dangerous as other interactions, higher olanzapine levels caused by overindulging in caffeine have the potential to increase the occurrence or severity of side effects like drowsiness, weight gain, low blood pressure, or muscle stiffness.

Hamilton Gaiani, MD, psychiatrist and Chief Medical Officer at Firepit Health, explains that caffeine can also indirectly worsen adverse effects like sleep disruption, anxiety, or jitteriness. This is in line with more widely known side effects of caffeine itself, which include appetite suppression and anxiety. For example, case reports indicate that while heavy coffee drinkers gained less weight and had better cholesterol levels while on olanzapine, their psychiatric symptoms weren’t as well controlled.

In order to avoid increased side effects of either olanzapine or caffeine itself, most experts recommend limiting caffeine intake while taking olanzapine. Triviso suggests aiming for roughly the same amount every day and not overdoing it on the java. “Don’t suddenly go from no coffee to several cups. For most people on olanzapine, I suggest limiting caffeine to 100 mg to 300 mg daily, which is about 1-3 cups of coffee depending on how strong you make it,” he says.

Dr. Gaiani notes that patients on olanzapine who are especially sensitive to stimulation or sleep disruption may do better on the lower end of that range of caffeine amounts. If you’re not sure what levels work best for you, it’s okay to test different amounts within the range for approximately a week at a time and record any symptoms or side effects.

Can I take caffeine pills with olanzapine?

Because over-the-counter caffeine supplements deliver a concentrated dose of caffeine at one time, mixing them with olanzapine is not recommended. Caffeine pills have a higher risk of heightening olanzapine’s side effects, including drowsiness, which can lead to a negative feedback loop.

“Caffeine pills are more concentrated, so they have a stronger and faster effect than a cup of coffee,” explains Edmond Hakimi, DO, dual-board-certified internist and the medical director at Wellbridge. “If you are taking olanzapine and also taking caffeine pills to try to stay awake, that can cause a kind of tug-of-war—sedation from the olanzapine and stimulation from the caffeine.”

Triviso adds that the same is true of common energy drinks. “It’s easier to take too much too quickly,” he says, recommending that those taking olanzapine keep an eye on their total caffeine consumption and aim for less than 300 mg per day, regardless of the source.

Does coffee taste different while on olanzapine?

If you’re taking olanzapine, and your daily cup isn’t tasting quite right, it’s not just you. Some people report changes in how their coffee tastes while on olanzapine. This doesn’t just apply to java, though: Approximately half of those taking olanzapine experience dry mouth. Since saliva is a necessary component in taste perception, it’s possible that olanzapine can indirectly alter the taste of many foods and beverages.

“Some patients report that foods and drinks taste metallic or more bitter than usual,” shares Triviso. “While no one has specifically studied whether coffee tastes different on olanzapine, if bitter flavors are affected, your morning brew might not taste quite right. The good news is that taste usually returns to normal once you stop the medication.”

Adjusting your caffeine habits

If you’re concerned about drinking coffee while taking olanzapine—or it just doesn’t taste the same anymore—consider these strategies:

• Switch to decaffeinated coffee for at least some of your daily cups
• Try caffeine-free alternatives such as herbal teas
• Monitor your total daily caffeine intake from all sources
• Consider timing your caffeine consumption earlier in the day to avoid sleep disruption

Does coffee interact with other antipsychotics?

If you’re a regular coffee drinker who is concerned about interactions between caffeine and olanzapine, it may make sense to discuss alternative atypical antipsychotics with your healthcare provider. Other FDA-approved medications also treat psychosis and don’t carry the same risk of heightened side-effects when combined with caffeine, such as: 

• Geodon (ziprasidone)
• Abilify (aripiprazole)
• Risperidal (risperidone)
• Seroquel (quetiapine)
• Latuda (lurasidone)

RELATED: Latuda vs. Zyprexa

“If you’re someone who really enjoys coffee and doesn’t want to cut back, ziprasidone might be a good option; it doesn’t interact with caffeine and doesn’t cause weight gain,” suggests Triviso. “Aripiprazole and lurasidone are also fine with coffee.”

However, other antipsychotics have more serious interactions with caffeine. “Definitely avoid clozapine if you drink coffee,” warns Triviso. Like olanzapine, clozapine is also metabolized by the CYP1A2 enzyme and can be even more significantly affected by caffeine intake.

Best practices for taking olanzapine

While olanzapine is a generally safe medication, by following a few recommendations, you can ensure that you’re getting the most benefit from olanzapine while minimizing the risk of side effects or other serious drug interactions.

Because it tends to have a sedating effect, doctors often recommend that people schedule their dose of olanzapine in the evening. “Most people take olanzapine at night since it can make you sleepy,” advises Dr. Hakimi. “You do not have to take it with food, but some people find it easier on their stomach that way.”

When it comes to ensuring olanzapine’s effectiveness, the most important factor is committing to a consistent schedule, whether that’s in the evening or otherwise. “The big thing is consistency,” emphasizes Dr. Hakimi. “Take it at the same time each day, and do not stop suddenly without talking to your doctor.” 

Beyond consistency, there are a few more things you can do to ensure you’re getting the most from your olanzapine prescription, including following a balanced diet, ensuring you get enough sleep, engaging in regular physical activity, and ensuring you schedule regular follow-up appointments with your doctor.

What to avoid while taking olanzapine

While caffeine is largely acceptable to consume while taking olanzapine, there are a handful of foods and activities that should be avoided completely due to their potential to cause severe interactions. If these aren’t things that you’re able to remove from your routine, it’s important that you discuss a plan with your doctor.

• Alcohol: Because alcohol can significantly increase the sedative effects of olanzapine, so it’s best to completely avoid imbibing while taking olanzapine.
• Smoking: Because cigarette smoking induces liver enzymes, it also significantly impacts olanzapine’s effectiveness. 
• Grapefruit juice: Grapefruit interacts with many prescription drugs and, when taken with olanzapine, can increase the levels of medication in your system.
• Extreme heat: Because olanzapine affects the body’s ability to regulate temperature, it’s important to stay out of saunas and avoid exercising outside when the temperatures are extreme.
• Sudden medication changes: Because it’s necessary to taper off olanzapine gradually (like antidepressants) in order to avoid withdrawal effects, it’s extra important not to make any sudden changes to your medication. 

If you have concerns, seek professional medical advice.

The bottom line

While it’s possible to drink coffee while taking olanzapine, moderation and consistency are the keys to doing so safely. Medical professionals recommend keeping your caffeine intake between 100 mg and 300 mg daily (about 1-3 cups of coffee), consuming roughly the same amount each day, and avoiding sudden changes in your caffeine consumption habits. 

Because everyone responds differently to prescription antipsychotic drugs and caffeine, it’s important to work closely with your healthcare provider to build a treatment plan that aligns with your caffeine habits, lifestyle preferences, and treatment goals. Managing your caffeine intake can help you avoid complications and sleep disruption, and your healthcare provider can help you find the right balance between enjoying your daily coffee and optimizing your mental health treatment.