Status epilepticus in a patient treated with olanzapine and mirtazapine.
OBJECTIVE
Few cases of seizures associated with olanzapine therapy and even fewer with mirtazapine have been published, most of them in patients with confounding risk factors. Our objective was to report a case of Status epilepticus in a patient receiving olanzapine and mirtazapine, with no previous history of seizure and no confirmed underlying cause for seizure.


METHODS
A 48-year-old white, psychotic woman developed generalized tonic-clonic seizures that progressed to Status epilepticus during hospitalization. 4 days before the incident, mirtazapine (30 mg) was added to the treatment, while 2 days before the incident, the treatment switched from quetiapine to olanzapine, and mirtazapine was increased to 60 mg. No other toxic, metabolic, electrolyte or anatomic abnormality was identified. After discontinuation of olanzapine, the patient remained seizure-free.


CONCLUSIONS
To our knowledge, this is the second reported case of Status epilepticus that has been associated with the use of olanzapine, while only one report of seizures, but none of Status epilepticus connected to mirtazapine is found in the literature. Although olanzapine has infrequently been associated with epileptogenic risk, it should be used cautiously especially when concomitant medication or other predisposing factors exist.
Spyridi
S
S
C'Department of Psychiatry, Faculty of Medicine, Aristotle University of Thessaloniki, Greece. spyridesstella@yahoo.com
Sokolaki
S
S
Nimatoudis
J
J
Iacovides
A
A
Kaprinis
G
G
D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D000077152:Olanzapine; D011618:Psychotic Disorders / Q000188:drug therapy; D013226:Status Epilepticus / Q000139:chemically induced*
D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D008803:Mianserin; D000078785:Mirtazapine; D000077152:Olanzapine