Management overview for olanzapine poisoning

Olanzapine is an antipsychotic drug that in poisoning can cause fluctuating conscious state and prolonged anticholinergic delirium. Even with small olanzapine ingestions, the patient’s altered conscious state and profound delirium can be difficult to manage. Larger ingestions cause more severe poisoning with coma, tachycardia and hypotension.

Management of olanzapine poisoning is primarily supportive care. Most symptoms resolve within 48 hours, but intubation and ventilation may be required if the patient has coma with respiratory depression.

The long-acting injectable formulation of olanzapine rarely causes a postinjection syndrome with signs and symptoms consistent with olanzapine poisoning. Patients administered a long-acting injectable formulation of olanzapine require monitoring for signs of sedation every 30 minutes for at least 2 hours after the injection, or until the patient is alert and oriented and free from signs or symptoms of poisoning.