Olanzapine-induced acute pancreatitis

Baysal, Birol; Kayar, Yusuf; Özmen, Aykut; ElShobaky, Maged; Mahdi, Nabila; İnce, Ali Tüzün; Danalıoğlu, Ahmet; Şentürk, Hakan

doi:10.5152/tjg.2015.0216

Cited by 12 publications

(4 citation statements)

References 8 publications

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“…Clinicians in all cases were confident in ruling out any confounders of acute pancreatitis, in particular alcohol, gallstones and other drugs. The majority of the cases made use of radiological investigation to rule out cholelithiasis [1][2][3][4][5][6][7][8] (one exception was a patient with a previous history of cholecystectomy within the decade prior to presentation 9 ). In addition, a concurrent accidental verapamil overdose may have confounded one case, but the authors proposed that olanzapine was the causative agent.…”

Section: Discussionmentioning

confidence: 99%

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Olanzapine-induced acute necrotising pancreatitis leading to recurrent multiple organ dysfunction syndrome

2022

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A married mother in her 50s acutely developed vomiting, diarrhoea and severe epigastric pain 2 weeks following discharge from an acute psychiatric inpatient unit. She presented to the emergency department complaining of a 2-day history of the above symptoms. Blood tests revealed neutrophilia, grossly raised inflammatory markers and amylase levels triple the normal range. Based on radiological investigations, she was treated for necrotising pancreatitis that quickly escalated to multi-system organ failure and a lengthy intensive care unit admission. Common causes of pancreatitis, including cholelithiasis, alcohol and other drugs, were ruled out. Despite this, she suffered recurrent episodes of pancreatitis with significant morbidity. Olanzapine, started during her psychiatric admission, was determined to be the offending agent. Two years following the discontinuation of olanzapine, the patient has had no further episodes of acute pancreatitis.

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Section: Discussionmentioning

confidence: 99%

“…Olanzapine has been observed and documented to be associated with acute pancreatitis. [1][2][3][4][5][6][7][8][9][10] The likelihood of adverse events due to olanzapine is possible on average according to the Naranjo Scale (a validated adverse drug event rating scale). 11 The likely mechanism of action is acute hypertriglyceridaemia.…”

Section: Introductionmentioning

confidence: 99%

Olanzapine-induced acute necrotising pancreatitis leading to recurrent multiple organ dysfunction syndrome

2022

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“…The case presented here illustrates a rare but life-threatening reaction to antipsychotic medications. Previously reported cases of olanzapine-related DIP occurred soon after the initiation of treatment and in the setting of significantly elevated triglycerides [ 8 – 11 ]. This case illustrates that acute pancreatitis can occur long after the initiation of olanzapine and may be mediated by mechanisms other than hypertriglyceridemia.…”

Section: Discussionmentioning

confidence: 99%

Acute Necrotizing Pancreatitis following Long-Term Antipsychotic Use

Liebers

Ofomata

Badolato

et al. 2021

Case Reports in Psychiatry

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Introduction. Psychiatrists commonly use antipsychotic medications in the treatment of psychotic and mood disorders. A rare but known side effect of atypical antipsychotics is acute pancreatitis. Most cases of antipsychotic-induced pancreatitis occur within six months of initiation. The mechanism believed to cause this reaction is hypertriglyceridemia. Here, we present a unique case of antipsychotic-induced pancreatitis that deviates from previous cases in the time to onset of the pancreatitis and the mechanism of presentation. Case Presentation. We present a case of a patient with treatment-resistant schizophrenia managed for over a decade on olanzapine and haloperidol. Twelve years after stabilization on this medication regimen, the patient developed acute pancreatitis, which after extensive medical workup was attributed to his psychotropic medications. We review his medical and psychiatric history, his medical course and workup during the episode of pancreatitis, and review recommendations for patients at risk for antipsychotic-induced pancreatitis based on this case and the current literature. Discussion. This case illustrates that acute pancreatitis can occur long after the initiation of antipsychotic medications and may be mediated by mechanisms other than hypertriglyceridemia. While there are reports of antipsychotic-induced psychosis occurring within months, and in a limited set of cases, years, after medication initiation, the twelve-year time interval in the present case is by far the longest duration of an antipsychotic precipitating this adverse event recorded in the literature. This case highlights that although exceedingly rare, prescribers should be aware of the risk for drug-induced pancreatitis in patients stable on antipsychotic medications.

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“…This may occur 1) when triglycerides found in chylomicrons are hydrolyzed by pancreatic lipase, leading to the production of free fatty acids and induction of free radical damage (Tsuang et al, 2009) or 2) through an indirect mechanism related to atypical antipsychotics, obesity, and insulin resistance (Yan et al, 2013). Some cases of Olanzapine and Quetiapine-associated AP have been reported (Liou et al, 2014;Baysal et al, 2015). Most antipsychotic-related AP occurs within 3 months (Silva et al, 2016).…”

Section: Figurementioning

confidence: 99%

Risk factors for drug-related acute pancreatitis: an analysis of the FDA adverse event reporting system (FAERS)

Zhang,

Mao,

Liu

et al. 2023

Front. Pharmacol.

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Objective: While several drugs have been linked to acute pancreatitis (AP), the AP-related risk of most drugs remains unclear. This study investigated the risk factors for drug-induced AP by analyzing a large dataset from the FDA Adverse Event Reporting System (FAERS).Methods: The reporting odds ratios (ROR) were used to assess the reports of drug-induced AP from the first quarter of 2004 to the second quarter of 2022. Single-factor, LASSO, and multi-factor regression analysis were performed to explore drug-related AP-related risk factors. Bonferroni correction was applied for the multiple comparisons performed.Results: A total of 264 drugs associated with AP, including antineoplastic drugs (35/264), antidiabetic drugs (28/264), antibacterial drugs (24/264), immunomodulatory drugs (11/264), antipsychotic drugs (6/264), and other drugs (160/264) were retrieved. Multi-factor analysis showed that males, age 41–54 years old, and 36 drugs, including Tigecycline, were risk factors for drug-related AP. The median time to drug-related AP onset was 31 days (interquartile range [IQR] 7–102 days) and about 75% of adverse events occurred within 100 days.Conclusion: These findings may help clinicians to identify drug-related AP at the early stage and can be used to inform future studies of drug-related AP pathogenesis.

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Olanzapine-induced acute pancreatitis

Abstract: Baysal et al. Olanzapine-induced acute pancreatitisTurk J Gastroenterol 2015; 26: 289-90

Cited by 12 publications

References 8 publications

Olanzapine-induced acute necrotising pancreatitis leading to recurrent multiple organ dysfunction syndrome

Olanzapine-induced acute necrotising pancreatitis leading to recurrent multiple organ dysfunction syndrome

Acute Necrotizing Pancreatitis following Long-Term Antipsychotic Use

Risk factors for drug-related acute pancreatitis: an analysis of the FDA adverse event reporting system (FAERS)

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