Delayed olanzapine induced myocarditis and rhabdomyolysis

Perera, Dhanuka

doi:10.1136/postgradmedj-2021-141118

Cited by 4 publications

(11 citation statements)

References 3 publications

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“…The current report presented a case of olanzapine-induced rhabdomyolysis; our case was unique both due to its delayed onset, as well as the severity of rhabdomyolysis with a creatine kinase significantly higher compared with similar case reports 5–15. Of the case reports in the current literature, most involved either commencement of new therapy5 6 12 14 or an intentional overdose 7 8 11.…”

Section: Discussionmentioning

confidence: 78%

“…Though olanzapine-induced rhabdomyolysis is a rare adverse reaction occurring in fewer than 1 in 10 000 of those taking this medication, this report describes the very real possibility of this side effect and the serious sequelae that can occur, and demonstrates the highest creatine kinase level reported with this medication thus far 5–15…”

Section: Treatmentmentioning

confidence: 72%

“…Less common and more serious complications include extrapyramidal movements, occurring in 0.1% of patients, and rhabdomyolysis, occurring in 0.1%–1.2% of patients 3 4. Previous reports of olanzapine-induced rhabdomyolysis typically describe this occurring soon after the initiation of treatment or in an overdose setting 5–15. Here we describe an unusual case of a person with olanzapine-induced rhabdomyolysis after decades of olanzapine use.…”

Section: Introductionmentioning

confidence: 72%

“…Of the case reports in the current literature, most involved either commencement of new therapy5 6 12 14 or an intentional overdose 7 8 11. Examples of delayed-onset olanzapine-induced rhabdomyolysis have been reported in the literature15 16 but are uncommon. Moreover, cases of olanzapine-induced rhabdomyolysis with creatine kinase peaks above 100 000 U/L are also uncommon even in cases of overdose 7 8 11.…”

Section: Discussionmentioning

confidence: 99%

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Delayed-Onset olanzapine-induced rhabdomyolysis

2023

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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.

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Section: Discussionmentioning

confidence: 78%

Section: Treatmentmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Delayed-Onset olanzapine-induced rhabdomyolysis

2023

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“… 1 Cardiomyopathy is a rare but reported complication of antipsychotic medications, with a few cases documented in the literature. 2 , 3 Although clozapine‐induced cardiomyopathy has been more frequently reported, there is a risk of myocarditis associated with first‐generation antipsychotics such as haloperidol and fluphenazine. 2 , 4 Olanzapine, an atypical antipsychotic belonging to the thienobenzodiazepine class, has gained widespread use owing to its perceived safety compared to its predecessor, clozapine.…”

Section: Introductionmentioning

confidence: 99%

Olanzapine‐induced cardiomyopathy: A mimicker of obesity cardiomyopathy?

Tolu‐Akinnawo,

Awoyemi,

Guzman

et al. 2024

Clinical Cardiology

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Olanzapine, an atypical antipsychotic medication, has gained prominence in the treatment of schizophrenia and related psychotic disorders due to its effectiveness and perceived safety profile. However, emerging evidence suggests a potential link between olanzapine use and adverse cardiovascular effects, including cardiomyopathy. This narrative review explores the mechanisms, clinical implications, and management strategies associated with olanzapine‐induced cardiomyopathy. A comprehensive review of the literature was conducted to investigate the relationship between olanzapine and cardiomyopathy. The search included epidemiological studies, clinical case reports, and mechanistic research focusing on the pathophysiology of olanzapine‐induced cardiomyopathy. The review also examined treatment strategies for managing this potential complication. Olanzapine‐induced cardiomyopathy is hypothesized to be associated with metabolic disturbances and receptor antagonism. The metabolic effects of olanzapine, such as weight gain, insulin resistance, and dyslipidemia, share similarities with obesity‐related cardiomyopathy. Additionally, olanzapine's antagonism of certain receptors may contribute to cardiovascular stress. The review highlighted that patients with new‐onset heart failure and significant weight gain while on olanzapine should be closely monitored for signs of cardiomyopathy. Early detection and prompt withdrawal of olanzapine, along with initiation of goal‐directed medical therapy, are crucial for mitigating this potentially life‐threatening condition. The relationship between olanzapine and cardiomyopathy is complex and not yet fully understood. However, the potential for significant cardiovascular risk necessitates vigilance among healthcare providers. Early identification and management of olanzapine‐induced cardiomyopathy can improve patient outcomes. Further research is needed to elucidate the precise mechanisms behind this adverse effect and to develop optimized treatment strategies for patients requiring antipsychotic therapy.

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Olanzapine

2021

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Delayed olanzapine induced myocarditis and rhabdomyolysis

Cited by 4 publications

References 3 publications

Delayed-Onset olanzapine-induced rhabdomyolysis

Delayed-Onset olanzapine-induced rhabdomyolysis

Olanzapine‐induced cardiomyopathy: A mimicker of obesity cardiomyopathy?

Olanzapine

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