Olanzapine-induced black hairy tongue: a rare case

Abstract

Olanzapine is second generation antipsychotic drug. It alters affinities for serotonin and dopamine receptors and provides mild sedating and calming effect. It is indicated for the treatment of schizophrenia, acute mania and the prevention of relapse in bipolar disorder. We present a case report of a 65- year- old man with bipolar disorder I, who developed black hairy tongue following treatment with olanzapine and completely recovered after withdrawal of treatment. Awareness about this particular adverse drug reaction will ensure proper management and avoid unnecessary investigations.

Black Hairy Tongue Associated With Olanzapine Use in a Female Dementia Patient

“…In 1 case, BHT disappeared after stopping using olanzapine and reappeared when olanzapine was used again at 5 mg/d. In another case, BHT also disappeared when olanzapine was reduced from a high dose to a low dose of 5 mg/d 11,12 . Our patient used a very low dose (2.5 mg/day) and still suffered from BHT for nearly 3 months, which indicates that there may be no definite dose-response relationship between olanzapine and BHT.…”

Pathophysiology and Management of Tongue Involvement in COVID-19 Patients

“…It is a painless and benign disorder due to the lack of desquamation and increased proliferation and hypertrophy of the tongue’s filiform papillae, leading to a black, sometimes brown, yellow, or green discoloration of the tongue, halitosis, and a metallic taste [ 23 ]. Several underlying conditions have been suggested to lead to this disorder, which include antibiotics, such as bismuth [ 24 ], amoxicillin [ 25 ], tetracycline [ 26 ], linezolid [ 27 ], and psychotropic agents, including olanzapine, phenothiazines, and tricyclic antidepressants [ 28 ]. Dehydration decreased saliva production, trigeminal neuralgia, poor oral hygiene, smoking, alcoholism, and infections were also observed to trigger this condition [ 29 ].…”

Amitriptyline-Induced Multifocal Oral Mucosal Dyspigmentation—Bridging Pharmacopsychodermatology in Skin of Color

“…To date, over 13 cases of imipramineinduced and three cases of amitriptyline-induced cutaneous hyperpigmentation have been reported, 4,5,7 with the onset of dyspigmentation often occurring many years after initiation of the TCA. 7 Although amitriptyline 8 and olanzapine 9 have been reported in the literature to cause black hairy tongue, amitriptyline has not yet been reported to cause multifocal oral mucosal dyspigmentation.…”