Postinjection Delirium/Sedation Syndrome with Olanzapine Depot Injection

Sarangula, Sadhvi Mythili; Mythri, Starlin Vijay; Sanjay, Y; Reddy, M S

doi:10.4103/0253-7176.185946

Cited by 6 publications

(8 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…99 In terms of psychotropics, delirium has been reported with discontinuation of sertraline, 100 use of olanzapine, 101 valproate associated hyperammonemia, [102][103][104] restarting of clozapine, 105 mirtazapine associated hyponatremia, 106 use of a combination of clozapine and electroconvulsive therapy (ECT), 107,108 use of a combination of lithium and ECT, 109,110 and postinjection delirium/sedation syndrome associated with olanzapine depot injection. [111][112][113][114][115] Some of the case reports/case series focus on substance-related delirium, [116][117][118][119][120][121][122][123][124][125][126][127][128] either during the withdrawal phase or intoxication phase. The case reports also cover topics like refractory delirium tremens, delayed onset delirium tremens, delirium tremens with hollow viscus perforation, genital self-mutilation in alcohol withdrawal state complicated with delirium, delirium during opioid withdrawal, 122 naltrexone precipitating delirium, 121 delirium due to use of parental tramadol, 125 varenicline-induced delirium, 126 and delirium associated with zolpidem withdrawal 127 or intoxication.…”

Section: Case Reports Focusing On Deliriummentioning

confidence: 99%

Delirium Research in India: A Systematic Review

Grover

Kathiravan

Dua

2021

JNRP

View full text Add to dashboard Cite

Delirium is the most common psychiatric diagnoses encountered in patients with various medical-surgical illnesses, in all the treatment set-ups, with relatively higher incidence and prevalence in the intensive care units. As delirium is encountered in multiple specialties, it is important to understand the research on this diagnosis. This study aims to assess the research output involving patients of delirium from India. A comprehensive search was undertaken using Medline (PubMed) and other databases. Search words included were “delirium,” “delirious,” “delirium tremens” AND “India.” No filters were used. Internet and hand searches yielded 305 articles. Out of these articles, 151 had the terms “delirium,” “delirious,” “delirium tremens” in the title and these were included for the review. Additionally, 14 articles were included for the review, although these did not have these terms in the title, but delirium was one of the major outcome parameters in these studies. Majority of the papers were original articles (n = 81), and these were followed by, case reports (n = 58), review articles (n = 10), letter to the editor (not as case reports but as a communication; n = 13), editorials (n = 2) and one clinical practice guideline. Most of the original papers have either focused on epidemiology (incidence, prevalence, outcome, etc.), symptom profile, with occasional studies focusing on effectiveness of various pharmacological interventions. There is a dearth of research in the field of delirium from India. There is a lack of studies on biomarkers, evaluation of nonpharmacological interventions, and evaluation of prevention strategies. It is the need of the hour to carry out more studies to further our understanding of delirium in the Indian context.

show abstract

Section: Case Reports Focusing On Deliriummentioning

confidence: 99%

Delirium Research in India: A Systematic Review

Grover

Kathiravan

Dua

2021

JNRP

View full text Add to dashboard Cite

show abstract

“…The factors responsible for non-compliance are lack of insight in psychotic patients, drug side effects, lack of understanding about the illness, and treatment in families. 3 Depot antipsychotics have been developed for enhancing patient compliance and improving health outcomes, possibly reducing the risk of relapses. 4 Chances of hospitalizations in patients who are on long-acting injection (LAI) found to be lower compared to those who are on oral medication.…”

Section: Introductionmentioning

confidence: 99%

“…SGAs LAI such as paliperidone, aripiprazole, risperidone, and olanzapine LAI are now available. 3 In 1996 Olanzapine, an atypical antipsychotic was first introduced as an oral formulation, used in the treatment of schizophrenia and bipolar disorder. Pamoate salt of atypical antipsychotic Olanzapine in long-acting injection depot formulation (OLAI) often used in patients with schizophrenia having poor compliance, administered by deep intramuscular (IM) injection every 2-4 weekly, effective in both actively psychotic as well as stable cases.…”

Section: Introductionmentioning

confidence: 99%

“…5 It is the most affordable SGA LAI made available since September 2015 in the Indian Market, with its efficacy being comparable to the previously marketed LAIs. 3 This OLAI, however, has a cluster of adverse events characterized by post-injection delirium/sedation syndrome (PDSS). In this study, we have reported three patients attending psychiatry department in a tertiary care hospital who presented with similar cluster of symptoms following the introduction of above-mentioned OLAI and were subsequently managed.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Post-injection syndrome and olanzapine long-acting injection in patients with schizophrenia: A case series

Dey¹,

Khasnobis²

2022

Asian J Med Sci

View full text Add to dashboard Cite

Pamoate salt of atypical antipsychotic Olanzapine in long-acting injection depot formulation (OLAI) is often used in patients with schizophrenia having poor compliance. This depots formulation having a cluster of adverse events characterized by post-injection delirium/sedation syndrome (PDSS). Here, we present three cases of different age group, different gender suffering from Schizophrenia of varied duration of illness who developed PDSS after receiving OLAI, how they were identified and promptly managed with early intervention. PDSS noted in approximately 0.07% of the injections, in 1.3% of patients. Symptoms such as sedation, delirium, extrapyramidal symptoms, ataxia, autonomic dysfunction, aggression, and speech impairment were reported, onset was immediate to 3–5 h post-injection, patients recovered within 2–72 h. No such risk factors could be identified in any of the cases. PDSS following OLAI occurs when there is accidental intravascular release of high dose of olanzapine. The importance of post-injection syndrome in the above cases lies in the fact that following administration of OLAI a 3–4-h observation period in a health-care facility in the presence of an appropriate qualified personnel is of utmost importance. Furthermore, one should rule out other causes of acute sedation in such patients before establishing the diagnosis of PDSS. There is no specific antidote for olanzapine and almost all such patients improve with conservative and supportive treatment.

show abstract

“…There is a lack of data on the use of olanzapine LAI from India. So far, only three case reports have been published about PDSS from India, [30][31][32] and no data is available from India about the long-term experience and outcome with olanzapine LAI. In this background, the current study aimed to evaluate the clinical profile of patients suffering from schizophrenia who were prescribed olanzapine LAI and to evaluate the usefulness and acceptability of olanzapine LAI among these patients.…”

mentioning

confidence: 99%

Olanzapine Pamoate Use for Schizophrenia: Retrospective Records Based Study from a Tertiary Care Hospital

Grover¹,

Singla²,

Chakrabarti³

2020

Indian Journal of Psychological Medicine

View full text Add to dashboard Cite

Background: Little is known from India about the experience of using olanzapine long-acting antipsychotic injectables (LAI). In this background, this study aimed to evaluate the clinical profile of patients suffering from schizophrenia who were prescribed olanzapine LAI and to evaluate the usefulness and acceptability of olanzapine LAI among these patients. Methods: In this retrospective study, data of all the patients with schizophrenia receiving olanzapine pamoate, was extracted. Results: 40 patients (males-55%; mean [SD] age-36.2 (12) years; mean duration of illness (SD) prior to depot-143.3 (115.9) months) were included in the study. Olanzapine LAI was invariably prescribed in patients with a past history of non-compliance. Data was available for a mean (SD) follow-up duration of 17 (10.8) months. The most frequently used dose of olanzapine LAI used was 300 mg every two weeks (55%). This was followed by 405 mg every four weeks in (32.5%). Mean Clinical Global Impression (CGI) Severity score prior to starting of olanzapine LAI was 5.8 (0.7), which reduced to 2.7 (1.1) at the time of last follow-up or the last use of olanzapine LAI, and this was a statistically significant improvement (paired t-test value = 16.41; P < 0.001). Only one (2.5%) patient experienced Post injection Delirium/Sedation Syndrome during the study period. Only one patient was hospitalized after starting depot olanzapine. Conclusion: Olanzapine LAI is mostly used in patients with a history of non-compliance. Olanzapine LAI is associated with a significant reduction in the severity of illness.

show abstract

Postinjection Delirium/Sedation Syndrome with Olanzapine Depot Injection

Cited by 6 publications

References 17 publications

Delirium Research in India: A Systematic Review

Delirium Research in India: A Systematic Review

Post-injection syndrome and olanzapine long-acting injection in patients with schizophrenia: A case series

Olanzapine Pamoate Use for Schizophrenia: Retrospective Records Based Study from a Tertiary Care Hospital

Contact Info

Product

Resources

About