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Olanzapine-induced Tardive Oculogyric Crises.
Amar D Bavle1, Girish M N Kumar1
1Department of Psychiatry, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India.
Indian Journal of Psychological Medicine
|January 1, 2014
Summary
Second-generation antipsychotics (SGA) have a lower risk of tardive syndromes. This case highlights rare tardive oculogyric crises and extreme weight gain with low-dose olanzapine, a widely used SGA.
Area of Science:
- Neuroscience
- Psychopharmacology
Background:
- Second-generation antipsychotics (SGA) are associated with a lower prevalence of extrapyramidal syndromes (EPS) compared to typical antipsychotics.
- Olanzapine, an SGA, is frequently prescribed due to its low risk of EPS, despite potential for weight gain and metabolic issues.
Observation:
- A patient developed tardive oculogyric crises (TOC), a rare form of tardive dystonia, during prolonged, unsupervised, low-dose olanzapine treatment.
- The patient experienced alarmingly high weight gain, which is reportedly unprecedented for olanzapine treatment.
Findings:
- Tardive oculogyric crises (TOC) can occur even with low-dose olanzapine.
- Significant weight gain associated with olanzapine may be more severe than previously reported.
Implications:
- This case underscores the importance of monitoring for rare but severe adverse effects like TOC and extreme weight gain, even with low-dose SGAs.
- Management involved trihexyphenidyl, discontinuation of olanzapine, and substitution with aripiprazole, leading to weight loss, suggesting alternative treatment strategies.
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