title: Olanzapine overdose presenting with acute muscle toxicity.
abstract: Olanzapine is an atypical antipsychotic drug that is being increasingly used as an intentional overdose. It usually presents with reduced and fluctuating level of consciousness and coma. It may rarely present with muscle toxicity by binding to HT2A receptor in skeletal muscle and increasing its permeability. We report a case of such poisoning which had no obvious symptoms but was brought to emergency due to overdose and was found to have acute muscle toxicity as evidenced by raised creatine phosphokinase (CPK) levels. From this, we also want to emphasize that CPK levels should be checked in all the patient's prescribed olanzapine to look for muscle toxicity.
authors.affiliation: Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
authors.forename: Niraj
authors.initials: N
authors.lastname: Keyal
authors.affiliation: Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
authors.forename: Gentle Sunder
authors.initials: GS
authors.lastname: Shrestha
authors.affiliation: Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Pradhan
authors.affiliation: Department of Emergency and General Practice, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Maharjan
authors.affiliation: Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
authors.forename: Subhash Prasad
authors.initials: SP
authors.lastname: Acharya
authors.affiliation: Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
authors.forename: Moda Nath
authors.initials: MN
authors.lastname: Marhatta
keywords: Creatine phosphokinase; olanzapine; overdose