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Practice review
Olanzapine postinjection delirium/sedation syndrome after long-acting olanzapine depot injection presenting to the emergency department: practical guidelines for diagnosis and management
  1. Sietske A Kochen1,
  2. Charlotte S Hakkers2,
  3. Freek van Gorp3,
  4. Dylan W de Lange4,
  5. Lenneke E M Haas1
  1. 1Department of Intensive Care Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  2. 2Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
  3. 3Department of Pharmacy, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  4. 4Dutch Poison Information Center, University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Correspondence to Sietske A Kochen; s.ietske{at}hotmail.com

Abstract

Olanzapine long-acting injection is a commonly used antipsychotic drug formulation in the treatment of schizophrenia. Postinjection delirium/sedation syndrome (PDSS) is a potential side effect of this intramuscular depot, for which patients are often presented at the ED. In this article, we give an overview of the current literature outlining the key aspects of managing this syndrome in a critical care setting, illustrated by a typical fictional clinical case. We discuss several useful and practical aspects of PDSS for emergency physicians and critical care physicians, including pharmacological background, common symptoms, diagnostic criteria and therapeutic options.

  • toxicology
  • acute medicine
  • delirium
  • accidental
  • psychiatry

https://doi.org/10.1136/emermed-2024-213972

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    Footnotes

    • Handling editor Gene Yong-Kwang Ong

    • Contributors SAK initiated the collaborative project, led the project, collected and analysed the articles, and drafted and revised the document. SAK is the guarantor of the study. CSH initiated the collaborative project, assisted in analysing the articles, and drafted and revised the document. LEMH, FvG and DWdL drafted and revised the document.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.