Olanzapine overdose mimicking opioid intoxication.
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.
O'Malley
G F
GF
Rocky Mountain Poison and Drug Center, Denver, CO, USA. geraldo@pol.net
Seifert
S
S
Heard
K
K
Daly
F
F
Dart
R C
RC
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
D014150:Antipsychotic Agents; D002492:Central Nervous System Depressants; D009294:Narcotics; D001569:Benzodiazepines; D010890:Pirenzepine; D000077152:Olanzapine