Kerr Thomas A, Jonnalagadda Sreenivasa, Prakash Chandra, Azar Riad
Division of Gastroenterology, Washington University School of Medicine, St. Louis, Mo., USA.
Case Rep Gastroenterol. 2007 Jun 22;1(1):15-20. doi: 10.1159/000104222.
Atypical antipsychotic agents (clozapine, olanzapine) have been linked to metabolic effects and acute pancreatitis.
We reviewed the inpatient and outpatient records of three patients who developed acute pancreatitis while being treated with olanzapine. The mean age of the patients was 37.7 years (range 18-54 years, 2 female, 1 male). No alternative cause of acute pancreatitis was found in two of the three patients. In the remaining patient, olanzapine may have contributed to acute pancreatitis in the setting of hypertriglyceridemia. Olanzapine was discontinued in all instances. Over a mean follow-up of 14 months, one patient has had a relapsing course, but the remaining two patients have been symptom free without recurrence of acute pancreatitis.
Our case series adds further support to the potential link between olanzapine use and acute pancreatitis. Close monitoring of metabolic parameters is suggested in patients treated with olanzapine. Alternative antipsychotic agents should be considered in patients at high risk for pancreatitis.
非典型抗精神病药物（氯氮平、奥氮平）与代谢效应及急性胰腺炎有关。
我们回顾了3例在接受奥氮平治疗期间发生急性胰腺炎的患者的住院和门诊记录。患者的平均年龄为37.7岁（范围18 - 54岁，2名女性，1名男性）。3例患者中有2例未发现急性胰腺炎的其他病因。在其余1例患者中，奥氮平可能在高甘油三酯血症的情况下导致了急性胰腺炎。所有病例均停用了奥氮平。平均随访14个月，1例患者病情复发，但其余2例患者无症状，急性胰腺炎未复发。
我们的病例系列进一步支持了使用奥氮平与急性胰腺炎之间的潜在联系。建议对接受奥氮平治疗的患者密切监测代谢参数。对于胰腺炎高危患者，应考虑使用其他抗精神病药物。
