title: Olanzapine overdose mimicking opioid intoxication.
abstract: We report significant central nervous system depression and the previously unreported phenomenon of pupillary constriction after acute overdose of olanzapine (Zyprexa) in 4 patients. Phase 2 trials describe a typically benign course in overdose, and published abstracts note a wide spectrum of clinical effects with supratherapeutic ingestion of olanzapine. Our patients demonstrated profound central nervous system depression, and 2 required advanced airway support. All 4 patients recovered with supportive care. Olanzapine should be added to opioid and alpha(2)-adrenergic agonist intoxication in the differential diagnosis of the patient with depressed mental status and miosis.
authors.affiliation: Rocky Mountain Poison and Drug Center, Denver, CO, USA. geraldo@pol.net
authors.forename: G F
authors.initials: GF
authors.lastname: O'Malley
authors.forename: S
authors.initials: S
authors.lastname: Seifert
authors.forename: K
authors.initials: K
authors.lastname: Heard
authors.forename: F
authors.initials: F
authors.lastname: Daly
authors.forename: R C
authors.initials: RC
authors.lastname: Dart
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000506:poisoning*; D001569:Benzodiazepines; D002490:Central Nervous System / Q000187:drug effects*; D002492:Central Nervous System Depressants / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015877:Miosis; D009294:Narcotics / Q000506:poisoning*; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000506:poisoning; D011680:Pupil / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D002492:Central Nervous System Depressants; D009294:Narcotics; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine