O'Malley G F, Seifert S, Heard K, Daly F, Dart R C
Rocky Mountain Poison and Drug Center, Denver, CO, USA.
Ann Emerg Med. 1999 Aug;34(2):279-81. doi: 10.1016/s0196-0644(99)70249-0.
We report significant central nervous system depression and the previously unreported phenomenon of pupillary constriction after acute overdose of olanzapine (Zyprexa) in 4 patients. Phase 2 trials describe a typically benign course in overdose, and published abstracts note a wide spectrum of clinical effects with supratherapeutic ingestion of olanzapine. Our patients demonstrated profound central nervous system depression, and 2 required advanced airway support. All 4 patients recovered with supportive care. Olanzapine should be added to opioid and alpha(2)-adrenergic agonist intoxication in the differential diagnosis of the patient with depressed mental status and miosis.
我们报告了4例急性过量服用奥氮平（再普乐）后出现的显著中枢神经系统抑制以及此前未报告的瞳孔收缩现象。2期试验描述了过量服用后的典型良性病程，已发表的摘要指出，超治疗剂量摄入奥氮平会产生广泛的临床效应。我们的患者表现出严重的中枢神经系统抑制，2例需要高级气道支持。所有4例患者经支持治疗后均康复。在对精神状态 depressed和瞳孔缩小的患者进行鉴别诊断时，应将奥氮平中毒添加到阿片类药物和α2-肾上腺素能激动剂中毒的鉴别诊断中。
