Olanzapine overdose
- PDF / 171,099 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 90 Downloads / 189 Views
1 OS
Olanzapine overdose
Various toxicities secondary to olanzapine intoxication following an overdose of olanzapine in a suspected suicide attempt: case report A 51-year-old woman developed coma, bilateral basal ganglia haemorrhage, tetraparesis, oedema of the left hemisphere, lateonset neuroleptic malignant syndrome and persistent vegetative state secondary to olanzapine intoxication following an overdose of olanzapine in a suspected suicide attempt [route and durations of treatments to reactions onsets not stated]. The woman, who had a history of major depression, was brought to the hospital following a suspected suicide attempt with 1200mg of olanzapine (160 × 7.5mg of olanzapine). On arrival, she was in a comatose state. She was intubated and received charcoal [activated charcoal]; however, waking reaction did not occur. A left-hemispheric deep intracerebral haemorrhage was observed on a CT scan of the brain. Upon admission, her BP was in the normal range. She did not have history of alcohol or drug abuse or any preexisting diseases such as arterial hypertension or liver insufficiency. There were no signs of any preceding head trauma. It was found that prior to the presentation, she had been receiving olanzapine 5 mg/day, duloxetine and lorazepam for major depression. She was transferred to a tertiary care center 12h later for further therapy. A repeat CT scan of the brain showed significant secondary enlargement of the left-hemispheric haemorrhage, as well as a newly developed right-hemispheric intracerebral haemorrhage in the basal ganglia areas. An MRI of the brain at day 2 after admission confirmed bilateral intracerebral haemorrhage. Olanzapine serum levels measured approximately 24h after suspected intake were highly elevated (820 µg/L), confirming severe intoxication. Corrected QT interval was 450ms. Two days following the admission, her condition significantly improved. She regained consciousness, was able to speak, and did not show any severe focal deficits. However, within a few hours, she again lost her consciousness, a tetraparesis occurred, and reintubation was required. A repeat cerebral CT scan showed massive progression of the bilateral haemorrhage and enlargement of space-occupying oedema of the left hemisphere. There was no evidence of hypertensive crisis. Consequently, a left-hemispheric hemicraniectomy was performed. In the following days, hyperpyrexia, elevation of the creatine kinase (3885 U/L), moderate leukocytosis and muscle rigidity occurred suggesting late-onset neuroleptic malignant syndrome. The woman received treatment with dantrolene with an insufficient decrease in the fever. Her bilateral ICH was attributed to olanzapine intoxication. At a 2 month follow-up, she remained in a persistent vegetative state. Schweyer K, et al. Bilateral Basal Ganglion Hemorrhage after Severe Olanzapine Intoxication. Case Reports Psychiatry 2020: 2020. Available from: URL: http:// doi.org/10.1155/2020/2398721
0114-9954/20/1826-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights res
Data Loading...
