Olanzapine Associated Acute Peripheral Edema and Pericardial Effusion: A Case Report

Abstract

Olanzapine is a potent atypical antipsychotic drug used for the treatment of schizophrenia and bipolar disorder with approved efficiency. Olanzapine is superior to the typical antipsychotic drugs with low incidence of extrapyramidal side effects, especially tardive dyskinesia. The most common side effects associated with olanzapine are constipation, dyspepsia, weight gain, somnolence, asthenia, dry mouth and dizziness. Peripheral edema associated with olanzapine is rarely reported and as far as we know there is no report in the literature about peripheral edema concomitant with pericardial effusion related to olanzapine. The mechanism of these side effects associated with olanzapine is still unclear and there are different hypotheses in the literature. Herein we report the first case that developed both peripheral edema and pericardial effusion after olanzapine administration. Although very rarely encountered, clinicians should be aware of these possible side-effects.

Whole-body edema with olanzapine: A case report and literature review

“…11,12,14,[20][21][22][23][24][25][26][27][28][29][30] In most cases, symptom resolution occurred after withdrawal, or dose reduction, of olanzapine. 11,12,14,[20][21][22][23][24][25][26][27][28][29][30] Based on these findings, it may be reasonable to rechallenge patients with a lower dose of olanzapine that was previously tolerated. It may also be reasonable to trial augmentation of antidepressants with an alternate SGA if olanzapine at any dose was not tolerated.…”

“…The degree of variability among case presentation and symptomatic management suggests that additional research on olanzapine-associated edema is warranted to determine when intervention beyond discontinuation of the drug alone is warranted. 11,12,14,[20][21][22][23][24][25][26][27][28][29][30]…”

Drug-induced pericarditis

“…63 Agents with a chemical structure similar to that of clozapine include quetiapine and olanzapine, with both implicated in the development of pericarditis, or even constrictive pericarditis in the case of quetiapine. 64,65 The effusion is presumably due to the immune response to the agents administered; the patients often present with eosinophilia and elevated levels of infl ammatory markers; the condition resolves upon therapy discontinuation.…”

Dose-Dependent Facial Edema Secondary to Olanzapine in a Medium-Long Stay Psychiatry Ward

“…1 Its most common adverse reactions are weight gain and sedation, 2 although edematous reactions can also occur, usually peripherally. 3 Occasionally, it may appear in other areas, such as the facial region, 4 but this is an uncommon side effect of unknown mechanism for which there are few documented cases in the literature. We present a clinical case of a middle-aged woman who developed facial edema secondary to olanzapine with dose-dependent features.…”

“…Olanzapine is an atypical antipsychotic used in some pathologies, such as schizophrenia, bipolar disorder, or schizoaffective disorder 1 . Its most common adverse reactions are weight gain and sedation, 2 although edematous reactions can also occur, usually peripherally 3 . Occasionally, it may appear in other areas, such as the facial region, 4 but this is an uncommon side effect of unknown mechanism for which there are few documented cases in the literature.…”