Rankings / Mood, Anxiety & Stress
Olanzapine + samidorphan (Lybalvi)
Mood, Anxiety & Stress · Antipsychotic + opioid antagonist
Tier B-
Bottom line
Read Off Label grades Olanzapine + samidorphan (Lybalvi) as B- (6.0/10) based on strong evidence, med-high benefit magnitude, and a med-high-risk safety profile.
Alkermes (Lybalvi).
Typical use: Oral once daily (olanzapine 5-20 mg + samidorphan 10 mg) — Rx.
What this is
Alkermes (Lybalvi). FDA-approved for schizophrenia and bipolar I. Samidorphan attenuated olanzapine-associated weight gain in registration trials (ENLIGHTEN-2); the open question is whether the metabolic-mitigation signal holds in real-world use. Industry-sponsored.
Mechanism
Fixed-dose olanzapine plus the opioid antagonist samidorphan, designed to retain olanzapine efficacy while blunting its characteristic weight gain via central opioid-receptor blockade.
Dose & route
Oral once daily (olanzapine 5-20 mg + samidorphan 10 mg)
Citations
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Olanzapine + samidorphan (Lybalvi) work?
- Read Off Label rates the evidence for Olanzapine + samidorphan (Lybalvi) as Strong and the benefit magnitude as med-high, producing an overall grade of B- (6.0/10). Alkermes (Lybalvi).
- Is Olanzapine + samidorphan (Lybalvi) safe?
- Olanzapine + samidorphan (Lybalvi) has a med-high risk profile in published human data. Legal status: Rx (FDA-approved: schizophrenia, bipolar I). This is not medical advice — see the disclaimer.
- What is the typical dose for Olanzapine + samidorphan (Lybalvi)?
- Oral once daily (olanzapine 5-20 mg + samidorphan 10 mg)
- How does Olanzapine + samidorphan (Lybalvi) work?
- Fixed-dose olanzapine plus the opioid antagonist samidorphan, designed to retain olanzapine efficacy while blunting its characteristic weight gain via central opioid-receptor blockade.
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.