Marcus E L, Vass A, Zislin J
Acute Geriatric Department, Sarah Herzog Memorial Hospital, Jerusalem, Israel.
Ann Pharmacother. 1999 Jun;33(6):697-700. doi: 10.1345/aph.18282.
To report a case of marked elevation of serum creatine kinase (CK) associated with olanzapine therapy.
A 39-year-old white Jewish schizophrenic man treated with olanzapine developed an elevated serum CK concentration with a peak concentration of 4000 IU/L (normal < 230). No other diagnostic criteria for neuroleptic malignant syndrome (NMS) were present. On discontinuation of the drug, serum CK concentrations returned to normal within eight days.
Olanzapine, like other atypical antipsychotic drugs, may cause muscle injury with concomitant elevations of serum CK of muscle origin. We suggest that in patients treated with olanzapine, CK concentrations should be checked on initiation of therapy, within the first 48 hours, and weekly thereafter for at least one month. In addition, patients with clinical signs suggestive of NMS should be monitored more carefully. For those patients with a history of NMS, or even of isolated serum CK elevation during antipsychotic therapy, follow-up should be stricter.
Marked elevation of serum CK may be a possible complication of olanzapine therapy.
报告一例与奥氮平治疗相关的血清肌酸激酶（CK）显著升高的病例。
一名39岁的患有精神分裂症的犹太裔白人男性，在接受奥氮平治疗时血清CK浓度升高，峰值浓度达4000 IU/L（正常<230）。不存在其他抗精神病药恶性综合征（NMS）的诊断标准。停药后，血清CK浓度在八天内恢复正常。
奥氮平与其他非典型抗精神病药物一样，可能导致肌肉损伤并伴随源自肌肉的血清CK升高。我们建议，对于接受奥氮平治疗的患者，在治疗开始时、最初48小时内以及此后至少一个月每周都应检查CK浓度。此外，对于有提示NMS临床体征的患者应进行更密切的监测。对于有NMS病史，甚至在抗精神病治疗期间有孤立性血清CK升高病史的患者，随访应更严格。
血清CK显著升高可能是奥氮平治疗的一种潜在并发症。
