Olanzapine-Related Fatality

Stephens, Boyd G.; Coleman, Dan; Baselt, Randall C.

doi:10.1520/jfs14397j

Cited by 38 publications

(8 citation statements)

References 4 publications

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“…3 Our case survived to a very high dose of olanzapine (1600 mg), much higher than deaths reported with doses as low as 450 mg 4 or 600 mg. 5,6 There has been 1 previous report of survival after ingestion of 1500 mg olanzapine. 4 In most of the survived cases of olanzapine overdose, immediate intervention in form of gastric lavage and activated charcoal was carried out; 7 this can limit the amount of drug absorbed and decrease its bioavailability by 50Y60%.…”

Section: Discussionmentioning

confidence: 99%

Nonfatal Suicidal Olanzapine Overdose

Arora

Praharaj

2006

Clinical Neuropharmacology

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There is an increase in the usage of olanzapine because of its relatively benign adverse effect profile. We report a case of suicidal overdose who survived after ingestion of 1600 mg of olanzapine requiring minimal intervention. Fluctuation in mental status suggestive of toxic delirium was noted during recovery from overdose. There was minimal alteration in the clinical and biochemical parameters. Olanzapine is safe in monointoxication as evident from this case study.

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Section: Discussionmentioning

confidence: 99%

Nonfatal Suicidal Olanzapine Overdose

Arora

Praharaj

2006

Clinical Neuropharmacology

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“…This study included all forensic autopsy cases in which antipsychotics (Anatomical Therapeutic Chemical (ATC) group N05A, except N05AN01 lithium) were detected in femoral blood during the study period (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) A c c e p t e d M a n u s c r i p t 10 …”

Section: Study Populationmentioning

confidence: 99%

Antipsychotics ⿿ Postmortem fatal and non-fatal reference concentrations

Söderberg

Wernvik

Tillmar

et al. 2016

Forensic Science International

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“…The lowest dose associated with mild toxicity was 30 mg; the lowest dose associated with moderate toxicity was 120 mg; and the lowest dose associated with severe toxicity was 560 mg (61). There were also 17 level 4 and 6 articles with individual case information on 25 acute olanzapine ingestions in patients 12 years of age and older (63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78). The package insert for Zyprexa indicates that 67 of 3100 patients involved in premarketing trial overdosed on olanzapine.…”

Section: (4)mentioning

confidence: 99%

Atypical antipsychotic medication poisoning: An evidence-based consensus guideline for out-of-hospital management

Cobaugh

Erdman

Booze

et al. 2007

Clinical Toxicology

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American Association of Poison Control Centers, Washington, District of Columbia, USAThe objective of this guideline is to assist poison center personnel in the appropriate out-of-hospital triage and out-of-hospital management of patients with suspected acute ingestions of atypical antipsychotic medications by 1) describing the process by which an ingestion of an atypical antipsychotic medication might be evaluated, 2) identifying the key decision elements in managing cases of atypical antipsychotic medication ingestion, 3) providing clear and practical recommendations that reflect the current state of knowledge, and 4) identifying needs for research. This guideline applies to ingestion of atypical antipsychotic medications alone. Co-ingestion of additional substances could require different referral and management recommendations depending on the combined toxicities of the substances. This guideline is based on an assessment of current scientific and clinical information. The expert consensus panel recognizes that specific patient care decisions might be at variance with this guideline and are the prerogative of the patient and the health professionals providing care, considering all of the circumstances involved. This guideline does not substitute for clinical judgment. The grade of recommendation is in parentheses. 1) Patients with stated or suspected self-harm or the recipient of a potentially malicious administration of an atypical antipsychotic medication should be referred to an emergency department immediately. This activity should be guided by local poison center procedures. In general, this should occur regardless of the dose reported (Grade D). 2) Patients without evidence of self-harm should have further evaluation, including determination of the precise dose ingested, presence of signs or symptoms of toxicity, history of other medical conditions, and the presence of co-ingestants (Grade C). 3) Asymptomatic patients without evidence of attempted self-harm are unlikely to develop symptoms if the interval between the ingestion and the call is greater than 6 hours. These patients do not need referral and should receive follow-up based on local poison center protocols (Grade C). 4) All patients less than 12 years of age who are naïve to atypical antipsychotic medications and are experiencing no more than mild drowsiness (lightly sedated and can be aroused with speaking voice or light touch) can be observed at home unless they have ingested more than four times the initial adult dose for the implicated antipsychotic medication or a dose that is equal to or more than the lowest reported acute dose that resulted in at least moderate toxicity, whichever dose is smaller (i.e., aripiprazole 15 mg, clozapine 50 mg, olanzapine 10 mg, quetiapine 100 mg, risperidone 1 mg, ziprasidone 80 mg) (Grade D). 5) All patients 12 years of age or older who are naïve to atypical antipsychotic medications and are experiencing no more than mild drowsiness can be observed at home unless they have ingested more than five times th...

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Olanzapine-Related Fatality

Cited by 38 publications

References 4 publications

Nonfatal Suicidal Olanzapine Overdose

Nonfatal Suicidal Olanzapine Overdose

Antipsychotics ⿿ Postmortem fatal and non-fatal reference concentrations

Atypical antipsychotic medication poisoning: An evidence-based consensus guideline for out-of-hospital management

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