Olanzapine-induced atypical neuroleptic malignant syndrome in an adolescent man with anorexia nervosa

Ayyıldız, Hasret; Turan, Şenol; Gülcü, Didem; Poyraz, Cana Aksoy; Pehlivanoğlu, Esra; Çullu, Fügen; Arıkan, Mehmet Kemal

doi:10.1007/s40519-015-0247-3

Cited by 14 publications

(7 citation statements)

References 3 publications

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“…Biochemical side effects were closely monitored and were felt to be more related to refeeding processes than to medication [141]. Thirteen case reports (Table 24) have also been published [42,[143][144][145][146][147][148][149][150][151][152][153][154]. Pisano and colleagues [143] reported on five cases of adolescents with AN treated with 2.5 to 7.5 mg of olanzapine.…”

Section: Olanzapinementioning

confidence: 99%

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

et al. 2020

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Objectives: Eating disorders are common and serious conditions affecting up to 4% of the population. The mortality rate is high. Despite the seriousness and prevalence of eating disorders in children and adolescents, no Canadian practice guidelines exist to facilitate treatment decisions. This leaves clinicians without any guidance as to which treatment they should use. Our objective was to produce such a guideline. Methods: Using systematic review, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, and the assembly of a panel of diverse stakeholders from across the country, we developed high quality treatment guidelines that are focused on interventions for children and adolescents with eating disorders. Results: Strong recommendations were supported specifically in favour of Family-Based Treatment, and more generally in terms of least intensive treatment environment. Weak recommendations in favour of Multi-Family Therapy, Cognitive Behavioural Therapy, Adolescent Focused Psychotherapy, adjunctive Yoga and atypical antipsychotics were confirmed. Conclusions: Several gaps for future work were identified including enhanced research efforts on new primary and adjunctive treatments in order to address severe eating disorders and complex co-morbidities.

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Section: Olanzapinementioning

confidence: 99%

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

et al. 2020

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“…The symptoms consisted of high fever (max 40 °C), leukocytosis, elevated levels of creatine kinase (CPK), and fluctuation in his mental state. Although the drug was discontinued, NMS developed again after 30 days [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…No clear-cut, olanzapine-related adverse effects were reported by five papers [ 25 , 26 , 27 , 28 , 30 ]. A severe side effect was reported in a sole case report where the onset of Neuroleptic neuroleptic malignant syndrome after two days of treatment is described [ 31 ]. Liver enzymes [ 21 , 22 ] and lipid profile/cholesterol elevation [ 21 , 24 ], itching [ 23 ], headache [ 20 ] and sedation/somnolence [ 20 , 21 , 23 , 24 , 29 ] were reported, with only one case of QTc elongation [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Antipsychotics in the Treatment of Children and Adolescents with Anorexia Nervosa: A Systematic Review

et al. 2022

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Evidence about the use of pharmacologic agents in the treatment of Anorexia Nervosa (AN) is lacking, especially in childhood and adolescence. A systematic scoping review was conducted to outline current literature evidence about the use of antipsychotics in this population. A total of 499 studies were identified with the initial search, and 28 of these studies were selected regarding the use of olanzapine (n = 13), risperidone (n = 4), aripiprazole (n = 3), chlorpromazine (n = 3), pimozide (n = 1) clotiapine (n = 1) and multiple antipsychotics (n = 3) in these patients. Overall, major side effects were reported infrequently; improvements in psychopathology and weight measures have been suggested in the majority of the considered studies. Nonetheless, the lack of RCT or good-quality studies strongly limits the generalizability of results in clinical practice.

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“…Safety profile of olanzapine treatment in AN has also been a point of interest in our study. There are few case reports showing adverse effects including neuroleptic malignant syndrome, hypoglycemia, hyperglycemia, morning sedation, and heart block [34,36,37,42]. However, most studies report no significant adverse reactions.…”

Section: Qualitative Evaluationmentioning

confidence: 99%

Olanzapine in the treatment of anorexia nervosa: a systematic review

Çöpür

2020

Egypt J Neurol Psychiatry Neurosurg

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Anorexia nervosa, with the highest mortality rate among psychiatric diseases, is characterized by low body mass index, fear of weight gain, and disturbed body image. Even though multiple drugs have been proposed for the treatment of anorexia nervosa, current treatment modalities include nutritional support and psychotherapy. In this study, our aim is to analyze the efficiency and possible adverse effects of olanzapine, an atypical anti-psychotic drug, in the treatment of anorexia nervosa. The studies investigating the efficiency and possible adverse effects of olanzapine in anorexia nervosa have been searched by using 3 databases (Embase, PubMed, and Cochrane Library). DerSimonian-Laird random effects meta-analyses have been used in the statistical analysis. Effect of olanzapine treatment in accordance with the duration and dosage of drug have been analyzed by the determination of 95% confidence intervals (p value < 0.05 is considered as statistically significant). Despite the presence of some contradictory studies, olanzapine treatment has been found beneficial in anorexia nervosa. In addition, analysis reveals that statistically significant beneficial effect of olanzapine treatment is used at high doses and for short duration. Possible side effects include neuroleptic malignant syndrome, hypoglycemia, and heart block in patients suffering from anorexia nervosa. Even though there is obvious need for more comprehensive further studies, current literature favors olanzapine treatment. The efficiency of olanzapine is considered to be related to changes in dopaminergic and serotonergic system in anorexic patients both in terms of neurotransmitter levels and receptor activity.

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Olanzapine-induced atypical neuroleptic malignant syndrome in an adolescent man with anorexia nervosa

Cited by 14 publications

References 3 publications

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Antipsychotics in the Treatment of Children and Adolescents with Anorexia Nervosa: A Systematic Review

Olanzapine in the treatment of anorexia nervosa: a systematic review

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