title: Post-Injection Delirium/Sedation Syndrome after Olanzapine Long-Acting Intramuscular Injection - Who is at Risk?
abstract: The post-injection olanzapine delirium/sedation syndrome (PDSS) was observed in a 60-year-old Caucasian, schizophrenic, non-smoker and underweight [body mass index (BMI), 18.2 kg/m(2) ] women after the fourth intramuscular injection of 405 mg olanzapine pamoate. Clinical symptoms of PDSS were similar to those of acute oral olanzapine intoxication. The patient received supportive treatment and recovered fully. High olanzapine concentrations in serum, with maximum level of 698 ng/mL, were confirmed by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The authors wonder whether a low BMI and advanced age may predispose patients to PDSS occurrence.
authors.affiliation: Department of Emergency Medicine, Poznan University of Medical Sciences, Poland.|Department of Toxicology, Raszeja Hospital, Poznan, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Łukasik-Głębocka
authors.affiliation: Department of Toxicology, Poznan University of Medical Sciences, Poland.
authors.forename: Karina
authors.initials: K
authors.lastname: Sommerfeld
authors.affiliation: Department of Forensic Sciences, Poznan University of Medical Sciences, Poland.
authors.forename: Artur
authors.initials: A
authors.lastname: Teżyk
authors.affiliation: Department of Emergency Medicine, Poznan University of Medical Sciences, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Panieński
authors.affiliation: Department of Forensic Sciences, Poznan University of Medical Sciences, Poland.
authors.forename: Czesław
authors.initials: C
authors.lastname: Żaba
authors.affiliation: Department of Toxicology, Poznan University of Medical Sciences, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Zielińska-Psuja
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning* / Q000627:therapeutic use; D002853:Chromatography, Liquid; D003692:Delayed-Action Preparations; D003693:Delirium / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008875:Middle Aged; D000077152:Olanzapine; D012559:Schizophrenia / Q000188:drug therapy; D013577:Syndrome; D053719:Tandem Mass Spectrometry; D014474:Unconsciousness / Q000139:chemically induced*
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D001569:Benzodiazepines; D000077152:Olanzapine