Pharmacopsychiatry 2006; 39(4): 157-158
DOI: 10.1055/s-2006-946708
Letter
© Georg Thieme Verlag KG Stuttgart · New York

Successful Switch to Olanzapine after Rhabdomyolysis Caused by Water Intoxication and Clozapine Use

A Case ReportT. Tényi1 , V. Vörös1
  • 1Department of Psychiatry and Psychotherapy, University of Pécs, Medical Faculty, Pécs, Hungary
Further Information

Publication History

Received: 19.12.2005 Revised: 10.4.2006

Accepted: 8.5.2006

Publication Date:
27 July 2006 (online)

Preview

We report on a case of rhabdomyolysis induced by the correction of hyponatremia after psychogenic polydipsia and clozapine use, where the switch to a high dose of olanzapine resulted in the non-recurrence of rhabdomyolysis. The 46-year-old patient with the diagnosis of schizophrenia paranoid type, who had been on clozapine treatment for the previous 4 years, was admitted with the symptoms of generalized seizure and vomiting, and as severe hyponatremia was proved, its correction with the parallel use of clozapine treatment was done. CK concentrations increased to 48 120 U/L without any symptom of neuroleptic malignant syndrome. To prevent acute renal insufficiency, high-volume alkaline diuresis was initiated and clozapine was tapered and stopped. On the day 12 of treatment, olanzapine was started and was elevated to 30 mg/day. CK concentration began to fall returning to the normal concentration on day 20. Six months after the switch to olanzapine no recurrence of rhabdomyolysis was detected; clinical and laboratory findings were normal. We suggest that after a benzodiazepine-type antipychotic-induced rhabdomyolysis, a switch to another atypical antipsychotic can be a cautious clinical strategy.

References

Tamás Tényi M.D. Ph. D.

Rét u.2

7623 Pécs

Hungary

Phone: +36 72 535900

Fax: +36 72 535951

Email: tamas.tenyi@aok.pte.hu