The Use of Olanzapine for Nonmedical Opioid Use in a Patient with Cancer Receiving Palliative Care

Julião, Miguel; Caldas, Mafalda Lemos; Ulrich, João; Ferreira, Tiago; Calaveiras, Patrícia; Costa, Elisabeth; Sobral, Maria Ana; Bruera, Éduardo

doi:10.1089/jpm.2021.0569

Cited by 3 publications

(2 citation statements)

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“…Due to her severe and disruptive opioid use disorder, she was treated with olanzapine 5 mg daily, resulting in marked reduction of anxiety and craving behaviors and improved well-being, motivation, and pleasure in daily activities. The improvement in her non-medical opioid use behavior treated with olanzapine has been reported elsewhere (Julião et al, 2021).…”

Section: Case Presentationsupporting

confidence: 72%

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Facial edema as an adverse drug reaction to olanzapine in a patient with cancer receiving palliative care

Julião¹,

Sobral²,

Ferreira

et al. 2022

Pall Supp Care

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Objective Atypical neuroleptics such as olanzapine are indicated for the treatment of various psychiatric disorders and have been used in the palliative care setting also for several clinical indications. Peripheral and facial edema are a rare side effect of the treatment with olanzapine. We report a case of an advanced cancer patient cared receiving palliative care who developed severe facial edema after initiating a low dose of olanzapine in monotherapy. Method A patient with advanced cancer who presented with severe facial edema after initiating olanzapine for the treatment of her opioid use disorder. Results After excluding other differential diagnosis for facial edema, olanzapine was discontinued with complete resolution of the edema. Significance of results To the best of our knowledge, this is the first case reporting facial edema due to olanzapine treatment in a patient with advanced cancer. Our report will help clinicians recognize the possible role of olanzapine in cases of rapid onset of facial edema, allowing its rapid resolution.

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Section: Case Presentationsupporting

confidence: 72%

“…Olanzapine is an atypical neuroleptic indicated for various psychiatric disorders. Additionally, olanzapine has found to be useful in opioid-dependent patients with cancer and it has been used in the palliative care setting, reducing craving and overall opioid misuse (Go et al, 2018; Julião et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Facial edema as an adverse drug reaction to olanzapine in a patient with cancer receiving palliative care

Julião¹,

Sobral²,

Ferreira

et al. 2022

Pall Supp Care

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View full text Add to dashboard Cite

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Morphine

2022

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Tongue edema as an adverse drug reaction to low-dose olanzapine in a cancer patient receiving palliative care

Moroni,

Bruera

2024

Pall Supp Care

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Objectives Olanzapine is an atypical neuroleptic indicated for treatment of various psychiatric disorders, but it has also several indications in palliative care (PC) patients: opioids misuse, nausea not related to chemotherapy, anorexia-cachexia syndrome, and sleep and mood disorders. Peripheral and facial edema are a rare side effect of the treatment with olanzapine. I report a case of an advanced cancer patient cared receiving PC who developed moderate tongue edema on day 1 of a low dose of olanzapine. Methods A patient with advance and metastatic colon cancer presented moderate tongue edema on day 1 of a low dose (2.5 mg) of olanzapine for the treatment of his nausea, anorexia-cachexia syndrome, and mood disorder (mainly anxiety). Results The patient discontinued the drug with resolution of the edema. The day after he called our outpatients’ service, a prompt physical examination, together with blood tests, excluded other differential diagnosis. Significance of results To the best of our knowledge, this is the second case reporting head and neck localized edema due to olanzapine treatment in a patient with advanced cancer receiving PC. Considering the increasing use of olanzapine as off-label treatment in these patients (often for cluster symptoms), our report could help clinicians in daily practice and researchers on put a deeper focus on indications for olanzapine in PC.

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The Use of Olanzapine for Nonmedical Opioid Use in a Patient with Cancer Receiving Palliative Care

Cited by 3 publications

References 5 publications

Facial edema as an adverse drug reaction to olanzapine in a patient with cancer receiving palliative care

Facial edema as an adverse drug reaction to olanzapine in a patient with cancer receiving palliative care

Morphine

Tongue edema as an adverse drug reaction to low-dose olanzapine in a cancer patient receiving palliative care

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