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Olanzapine overdose presenting with acute muscle toxicity
Niraj Keyal1, Gentle Sunder Shrestha1, Saurabh Pradhan1
1Department of Anaesthesiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
Summary
Intentional overdose of olanzapine can cause rare muscle toxicity. Checking creatine phosphokinase (CPK) levels in patients prescribed olanzapine is recommended to detect this adverse effect.
Area of Science:
- Pharmacology
- Toxicology
- Neurology
Background:
- Olanzapine, an atypical antipsychotic, is increasingly used in intentional overdoses.
- Overdose typically causes altered consciousness and coma.
- Rarely, olanzapine can induce muscle toxicity via HT2A receptor binding.
Observation:
- A case of olanzapine overdose presented with acute muscle toxicity.
- The patient had elevated creatine phosphokinase (CPK) levels, indicating muscle damage.
- Initial presentation lacked obvious overt symptoms besides the overdose context.
Findings:
- The case highlights a rare but serious adverse effect of olanzapine overdose.
- Elevated CPK levels are a key indicator of olanzapine-induced muscle toxicity.
- Muscle toxicity mechanism involves HT2A receptor interaction in skeletal muscle.
Implications:
- Clinicians should consider checking CPK levels in patients with olanzapine overdose.
- Routine monitoring may be beneficial for patients prescribed olanzapine, especially those at risk.
- This finding emphasizes the importance of recognizing diverse olanzapine toxicity presentations.