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Overdose and death with olanzapine: two case reports.

J E Gerber1, B Cawthon

  • 1Forensic Medical, Metropolitan Davidson County, Nashville, Tennessee, USA.

The American Journal of Forensic Medicine and Pathology
|September 16, 2000
PubMed
Summary

Olanzapine toxicity deaths are rare, but this study details two recent cases. Both were attributed to olanzapine toxicity, highlighting potential risks even in non-suicide scenarios.

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Area of Science:

  • Forensic Toxicology
  • Pharmacology

Background:

  • Olanzapine, an atypical antipsychotic, has been available since 1996.
  • Olanzapine-related fatalities are infrequently reported in medical literature.

Observation:

  • This paper reports two cases of olanzapine toxicity encountered by a single medical examiner's office over five months.
  • One case involved suicide, while the other did not.
  • Toxicologic analysis revealed significant blood olanzapine concentrations (0.237-0.675 microg/ml) and wide-ranging gastric concentrations (0.197-17.400 microg/ml).

Findings:

  • No consistent pathological findings were observed, except for moderate coronary atherosclerosis in the non-suicide case.
  • Brain, liver, and kidney tissue showed undetectable drug concentrations.
  • Both cases were ultimately attributed to olanzapine toxicity.

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Implications:

  • These findings suggest that olanzapine toxicity may be an underrecognized cause of death.
  • Further investigation into the toxicodynamics and pharmacokinetics of olanzapine in fatal cases is warranted.
  • Clinicians should remain vigilant regarding potential olanzapine toxicity in patients, irrespective of suicidal intent.