PMID- 20156413
OWN - NLM
STAT- MEDLINE
DCOM- 20100430
LR  - 20220408
IS  - 1555-2101 (Electronic)
IS  - 0160-6689 (Linking)
VI  - 71
IP  - 4
DP  - 2010 Apr
TI  - Case reports of postmarketing adverse event experiences with olanzapine 
      intramuscular treatment in patients with agitation.
PG  - 433-41
LID - 10.4088/JCP.08m04411gry [doi]
AB  - OBJECTIVE: Agitation is a medical emergency with increased risk for poor outcome. 
      Successful treatment often requires intramuscular (IM) psychotropics. Safety data 
      from the first 21 months of olanzapine IM, approved in the United States for the 
      treatment of agitation associated with schizophrenia and bipolar disorder, are 
      presented. METHOD: A Lilly-maintained safety database was searched for all 
      spontaneous adverse events (AEs) reported in temporal association with olanzapine 
      IM treatment. RESULTS: The estimated worldwide patient exposure to olanzapine IM 
      from January 1, 2004, through September 30, 2005, was 539,000; 160 cases 
      containing AEs were reported from patients with schizophrenia (30%), bipolar 
      disorder (21%), unspecified psychosis (10%), dementia (8%), and depression (5%). 
      Many reported concomitant treatment with benzodiazepines (39%) or other 
      antipsychotics (54%). The most frequently reported events involved the following 
      organ systems: central nervous (21%), cardiac (12%), respiratory (6%), vascular 
      (6%), and psychiatric (5%). Eighty-three cases were considered serious, including 
      29 fatalities. In these fatalities, concomitant benzodiazepines or other 
      antipsychotics were reported in 66% and 76% of cases, respectively. The most 
      frequently reported events in the fatal cases involved the following organ 
      systems: cardiovascular (41%), respiratory (21%), general (17%), and central 
      nervous (10%). The majority of fatal cases (76%) included comorbid conditions and 
      potentially clinically significant risk factors for AEs. CONCLUSIONS: Clinicians 
      should use care when treating agitated patients, especially when they present 
      with concurrent medical conditions and are treated with multiple medications, 
      which may increase the risk of poor or even fatal outcomes. Clinicians should use 
      caution when using olanzapine IM and parenteral benzodiazepines simultaneously.
CI  - Copyright 2010 Physicians Postgraduate Press, Inc.
FAU - Marder, Stephen R
AU  - Marder SR
AD  - Building 210, Room 130, West Los Angeles VA Healthcare Center, 11301 Wilshire 
      Blvd, Los Angeles, CA 90073, USA. marder@UCLA.edu
FAU - Sorsaburu, Sebastian
AU  - Sorsaburu S
FAU - Dunayevich, Eduardo
AU  - Dunayevich E
FAU - Karagianis, Jamie L
AU  - Karagianis JL
FAU - Dawe, Ian C
AU  - Dawe IC
FAU - Falk, Deborah M
AU  - Falk DM
FAU - Dellva, Mary Anne
AU  - Dellva MA
FAU - Carlson, Janice L
AU  - Carlson JL
FAU - Cavazzoni, Patrizia A
AU  - Cavazzoni PA
FAU - Baker, Robert W
AU  - Baker RW
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100209
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
RN  - 0 (Antipsychotic Agents)
RN  - 12794-10-4 (Benzodiazepines)
RN  - N7U69T4SZR (Olanzapine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Adverse Drug Reaction Reporting Systems/*statistics & numerical data
MH  - Aged
MH  - Aged, 80 and over
MH  - Antipsychotic Agents/administration & dosage/*adverse effects/therapeutic use
MH  - Benzodiazepines/administration & dosage/*adverse effects/therapeutic use
MH  - Bipolar Disorder/drug therapy/mortality/psychology
MH  - Child
MH  - Databases as Topic/statistics & numerical data
MH  - Fatal Outcome
MH  - Female
MH  - Humans
MH  - Injections, Intramuscular
MH  - Male
MH  - Middle Aged
MH  - Olanzapine
MH  - Psychomotor Agitation/*drug therapy
MH  - Risk Factors
MH  - Schizophrenia/drug therapy/mortality
MH  - Schizophrenic Psychology
MH  - Treatment Outcome
EDAT- 2010/02/17 06:00
MHDA- 2010/05/01 06:00
CRDT- 2010/02/17 06:00
PHST- 2008/05/23 00:00 [received]
PHST- 2009/01/02 00:00 [accepted]
PHST- 2010/02/17 06:00 [entrez]
PHST- 2010/02/17 06:00 [pubmed]
PHST- 2010/05/01 06:00 [medline]
AID - 10.4088/JCP.08m04411gry [doi]
PST - ppublish
SO  - J Clin Psychiatry. 2010 Apr;71(4):433-41. doi: 10.4088/JCP.08m04411gry. Epub 2010 
      Feb 9.