Marked elevation of serum creatine kinase associated with olanzapine therapy.
OBJECTIVE
To report a case of marked elevation of serum creatine kinase (CK) associated with olanzapine therapy.


METHODS
A 39-year-old white Jewish schizophrenic man treated with olanzapine developed an elevated serum CK concentration with a peak concentration of 4000 IU/L (normal < 230). No other diagnostic criteria for neuroleptic malignant syndrome (NMS) were present. On discontinuation of the drug, serum CK concentrations returned to normal within eight days.


CONCLUSIONS
Olanzapine, like other atypical antipsychotic drugs, may cause muscle injury with concomitant elevations of serum CK of muscle origin. We suggest that in patients treated with olanzapine, CK concentrations should be checked on initiation of therapy, within the first 48 hours, and weekly thereafter for at least one month. In addition, patients with clinical signs suggestive of NMS should be monitored more carefully. For those patients with a history of NMS, or even of isolated serum CK elevation during antipsychotic therapy, follow-up should be stricter.


CONCLUSIONS
Marked elevation of serum CK may be a possible complication of olanzapine therapy.
Marcus
E L
EL
Acute Geriatric Department, Sarah Herzog Memorial Hospital, Jerusalem, Israel. elm@inter.net.il
Vass
A
A
Zislin
J
J
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines; D002908:Chronic Disease; D003402:Creatine Kinase / Q000097:blood*; D006801:Humans; D008297:Male; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000201:enzymology / Q000503:physiopathology; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D003402:Creatine Kinase; D000077152:Olanzapine