title: [Severe intoxication probably from olanzapine (Zyprexa). Beneficial effect of glucagon].
abstract: We report the case of a 43-year-old schizophrenic who sustained, after 12 days of treatment including olanzapine (20 mg.day-1), carbamazepine, levomepromazine and alprazolan, a severe shock with bradycardia (HR: 40 b.min-1), circulatory collapse (SAP: 60 mmHg), hypothermia (T: 27 degrees C), coma and disseminated intravascular coagulation. A significant improvement was obtained with high doses of intravenous glucagon, whereas the normalization of central temperature, atropine, adrenaline and volume loading had been inefficient. Olanzapine, alone of associated with other psychotropics, could cause severe circulatory collapse with hypothermia and coma responding to a treatment including glucagon.
authors.affiliation: Service de réanimation polyvalent, centre hospitalier général de Châteauroux, France.
authors.forename: F
authors.initials: F
authors.lastname: Joye
authors.forename: M
authors.initials: M
authors.lastname: Orrillard
authors.forename: F
authors.initials: F
authors.lastname: Marion
authors.forename: I
authors.initials: I
authors.lastname: Michoux
authors.forename: R
authors.initials: R
authors.lastname: Parisot
mesh_terms: D000328:Adult; D000525:Alprazolam / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines; D001919:Bradycardia / Q000139:chemically induced; D002220:Carbamazepine / Q000627:therapeutic use; D004211:Disseminated Intravascular Coagulation / Q000139:chemically induced* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005934:Glucagon / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007035:Hypothermia / Q000139:chemically induced; D007262:Infusions, Intravenous; D008297:Male; D008728:Methotrimeprazine / Q000627:therapeutic use; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives*; D012559:Schizophrenia / Q000188:drug therapy*; D012769:Shock / Q000139:chemically induced
chemical_list: D014150:Antipsychotic Agents; D005765:Gastrointestinal Agents; D001569:Benzodiazepines; D002220:Carbamazepine; D010890:Pirenzepine; D005934:Glucagon; D008728:Methotrimeprazine; D000077152:Olanzapine; D000525:Alprazolam