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Fatal status epilepticus associated with olanzapine therapy
R J Wyderski1, W G Starrett, A Abou-Saif
1Department of Internal Medicine, School of Medicine, Wright State University, Dayton, OH 45409, USA. rjwyderski@mvh.org
The Annals of Pharmacotherapy
|August 31, 1999
Summary
This case report details a fatal instance of status epilepticus in a patient taking olanzapine. The event, likely an adverse drug reaction, highlights olanzapine
Area of Science:
- Neuroscience
- Pharmacology
- Clinical Toxicology
Background:
- Olanzapine is an atypical antipsychotic used for treating schizophrenia and bipolar disorder.
- Seizures are a known, albeit rare, adverse effect of some antipsychotic medications.
- Previous studies indicated a low incidence of seizures with olanzapine in premarketing trials.
Observation:
- A 41-year-old woman developed status epilepticus while on olanzapine for five months.
- No other contributing factors (toxic, metabolic, anatomic) were identified.
- The patient died from complications including rhabdomyolysis and disseminated intravascular coagulation.
Findings:
- The seizures were classified as a probable adverse drug reaction to olanzapine using the Naranjo scale.
- This represents the first reported case of fatal status epilepticus linked to olanzapine use.
- Pharmacodynamic similarities to clozapine, another antipsychotic known to induce seizures, suggest a potential shared mechanism.
Implications:
- The findings suggest that olanzapine, despite infrequent association, carries a risk of inducing seizures, potentially fatal.
- Further postmarketing surveillance is crucial to ascertain the true incidence and clinical significance of olanzapine-induced seizures.
- Clinicians should remain vigilant for seizure activity in patients prescribed olanzapine, considering it as a possible adverse effect.