Delayed-Onset olanzapine-induced rhabdomyolysis.

Abstract

Olanzapine is a commonly used and effective second-generation antipsychotic agent used for the control of paranoia and agitation in schizophrenia and bipolar disorder as well as in the behavioural and psychological symptoms of dementia. Serious side effects of treatment are uncommon but spontaneous rhabdomyolysis represents a rare complication. We describe here a patient treated with a stable dose of olanzapine for more than 8 years who developed acute severe rhabdomyolysis without an identifiable trigger and without features suggestive of neuroleptic malignant syndrome. The rhabdomyolysis was atypical in its delayed onset and severity with a creatine kinase level of 345 125 U/L, the highest level reported in the available literature. We also describe the clinical manifestations of delayed-onset olanzapine-induced rhabdomyolysis and its differentiation from neuroleptic malignancy syndrome, and we highlight key aspects of management to prevent or minimise further complications such as acute kidney injury.

• Authors: Jun Hua Bowen Lim, Billy Robinson, Judith Savige
• Journal: BMJ case reports (BMJ Case Rep) Vol. 16 Issue 3 (Mar 10 2023) ISSN: 1757-790X [Electronic] England
• PMID: 36898712 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Olanzapine
• Benzodiazepines
• Antipsychotic Agents

Topics

• Humans
• Olanzapine (therapeutic use)
• Benzodiazepines (therapeutic use)
• Antipsychotic Agents (adverse effects)
• Schizophrenia (drug therapy)
• Neuroleptic Malignant Syndrome (drug therapy)
• Rhabdomyolysis (complications)