Lennestål Roland, Asplund Cay, Nilsson Mats, Lakso Hans-Ake, Mjörndal Tom, Hägg Staffan
Division of Clinical Pharmacology, Department of Pharmacology and Clinical Neuroscience Norrland University Hospital, Linköping University Hospital, Linköping, Sweden.
J Anal Toxicol. 2007 Mar;31(2):119-21. doi: 10.1093/jat/31.2.119.
Olanzapine is a widely used second generation antipsychotic drug. Case reports of intoxications have been published, but reports in the literature of non-fatal intoxications of olanzapine containing repeated measurements of serum levels are scarce. Therefore, this case of non-fatal olanzapine intoxication is presented, in which 19 blood samples were drawn during 2 weeks. The highest (initial) measured value was estimated at 800 pg/L. This patient ingested 550 mg of olanzapine resulting in clinical signs of intoxication, including seizures. Because the patient was found the day after the intoxication, the initial concentration had probably been higher. The pharmacokinetics of olanzapine has been described as linear and dose-proportional throughout the therapeutic dosing range. Large overdoses, however, have been described to show non-linear pharmacokinetics. In this study's series of serum concentrations, a two-phase elimination was seen, with an initial elimination half-life of about 24 h during the first 3 days, followed by a second phase with a half-life of about 2.5 days. The patient in this case recovered completely. Because the elimination time after intoxication can be considerably longer than expected, it is recommended that the patient's serum concentrations after intoxication be monitored.
奥氮平是一种广泛使用的第二代抗精神病药物。已经发表了中毒的病例报告，但文献中关于含奥氮平非致命中毒且有血清水平重复测量的报告很少。因此，本文报告了一例非致命性奥氮平中毒病例，在两周内采集了19份血样。测得的最高（初始）值估计为800 pg/L。该患者摄入了550 mg奥氮平，出现了中毒的临床症状，包括癫痫发作。由于该患者在中毒后第二天被发现，初始浓度可能更高。奥氮平的药代动力学在整个治疗剂量范围内被描述为线性且与剂量成正比。然而，大量过量用药已被描述为呈现非线性药代动力学。在本研究的一系列血清浓度中，观察到两相消除，在最初3天内初始消除半衰期约为24小时，随后是半衰期约为2.5天的第二阶段。该病例中的患者完全康复。由于中毒后的消除时间可能比预期长得多，建议对中毒患者的血清浓度进行监测。
