Olanzapine is a serotonin-dopamine antagonist. It works on positive and negative symptoms. I have bee on Olanzapine for over three years now and I am not entirely sure if it helps a bit or a lot as I have been taking two antipsychotics (Olanzapine and Haloperidol first, then Olanzapine and Aripiprazole, and ow Olanzapine and Amisulpride), but I would certainly be extremely ill without it.
It is rather sedating, but it depends on what dose you are on and how your body deals with the drug (as I say, one can't really predict their liver enzymes). It does induce hunger and subsequent weight gain, and I don't know anyone who hasn't gained any weight on Olanzapine.
But Olanzapine is less of a dopamine antagonist than it is a serotonin antagonist, which means that extra-pyramidal side-effects, hyperprolactinaemia etc are less frequent than, say, Risperidone and Haloperidol. I know people who have experienced those side-effects on Olanzapine however, so it's not definite.
Weight gain and sedation are usually the most problematic I believe.
However Olanzapine has good efficacy and is widely used.
The Electronic Medicines Compendium do a good description of side-effects, contraindications, cautions etc.
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