Postinjection Delirium/Sedation Syndrome After 31st Long-Acting Olanzapine Depot Injection

Clin Neuropharmacol. 2019 Mar/Apr;42(2):64-65. doi: 10.1097/WNF.0000000000000329.

Abstract

Objective: Long-acting depot preparations of antipsychotics are the mainstay of treatment for patients with schizophrenia who show nonadherence to their medications. Olanzapine pamoate is one of the recently approved long-acting depot psychotropic preparations that have shown its efficacy both in clinical trials and in clinical uses against the illness. However, emerging literature indicates toward a cluster of adverse effects known as postinjection delirium/sedation syndrome (PDSS).

Methods: We here present a case of PDSS in a woman with paranoid schizophrenia. After maintaining well for almost 1½ years, she developed PDSS at her 31st scheduled long-acting olanzapine injection.

Results: Several features of PDSS including its mechanism and course have been discussed.

Conclusions: More research is necessary to understand the syndrome and the association between PDSS and long-acting olanzapine injection. Clinicians should keep in mind that PDSS may worsen compliance in an index patient and affect the course of the illness.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / adverse effects*
  • Delayed-Action Preparations / administration & dosage
  • Delayed-Action Preparations / adverse effects
  • Delirium / chemically induced*
  • Delirium / diagnosis
  • Delirium / psychology
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / psychology
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / adverse effects*
  • Olanzapine / administration & dosage
  • Olanzapine / adverse effects*
  • Schizophrenia, Paranoid / diagnosis
  • Schizophrenia, Paranoid / drug therapy*
  • Schizophrenia, Paranoid / psychology
  • Syndrome

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations
  • Hypnotics and Sedatives
  • Olanzapine