PL EN


Preferences help
enabled [disable] Abstract
Number of results
2016 | 16 | 3 | 150–154
Article title

Hematological safety of olanzapine

Content
Title variants
PL
Bezpieczeństwo hematologiczne olanzapiny
Languages of publication
EN PL
Abstracts
EN
Olanzapine is an atypical antipsychotic medication, previously expected to be safe in terms of hematological side effects and considered an alternative choice to clozapine in patients who develop hematotoxicities. However, since olanzapine was introduced to the market many case reports have been published revealing that it could cause hematoxicity. Some of these reports also indicated that olanzapine induced agranulocytosis. Therefore, we conducted a systemic review to explore and address this issue. Electronic database searches from 1998 to 2015 yielded 35 case reports of olanzapine-induced leukopenia and three related systematic reviews. The onset of leukopenia for the majority of these case reports followed in the first month of administration of olanzapine. Moreover, more than two third of these cases never developed drug-related leukopenia before the use of olanzapine. The ages of affected individuals were 16 to 83 years old and their races were African, Caucasian, Asian, Jewish and Mediterranean. The doses of olanzapine ranged from 2.5 to 30 mg. Interestingly, olanzapine was associated with third highest incidence of neutropenia among antipsychotics. The mechanism of olanzapine-induced neutropenia is still unknown, but could be similar to clozapine because of similar chemical composition. Therefore we recommend that the guidelines regarding olanzapine need to be reconsidered and closely monitored with patients being treated with olanzapine for hematological side effects.
PL
Olanzapina to nietypowy lek przeciwpsychotyczny, dotychczas uznawany za bezpieczny pod względem hematologicznym i stosowany jako alternatywa dla klozapiny u pacjentów z objawami hemotoksyczności. Jednak od czasu wprowadzenia tego leku na rynek pojawiło się wiele doniesień dotyczących jego hematologicznych działań niepożądanych. Niektóre z tych prac wskazują także, że olanzapina może wywoływać agranulocytozę. Celem przeprowadzonego przeglądu systematycznego było zbadanie tego zagadnienia. W elektronicznych bazach danych z lat 1998–2015 odnaleziono 35 doniesień dotyczących leukopenii indukowanej olanzapiną oraz trzy podobne przeglądy systematyczne. W większości przypadków leukopenia rozwijała się po pierwszym miesiącu stosowania tego leku. Ponadto w ponad dwóch trzecich przypadków leukopenia nie występowała w przeszłości. Pacjenci byli w wieku 16–83 lat i należeli do ras afrykańskiej, kaukaskiej, azjatyckiej, żydowskiej i śródziemnomorskiej. Olanzapinę stosowano w dawkach od 2,5 do 30 mg. Co ciekawe, lek ten był na trzecim miejscu wśród leków przeciwpsychotycznych pod względem wywoływania neutropenii. Mechanizm neutropenii wywołanej olanzapiną pozostaje nieznany, ale może być zbliżony do klozapiny ze względu na podobny skład chemiczny. W związku z powyższym uważamy, że wytyczne dotyczące olanzapiny należy na nowo przemyśleć, a pacjentów stosujących ten lek trzeba obserwować pod kątem występowania hemotoksyczności.
Discipline
Publisher

Year
Volume
16
Issue
3
Pages
150–154
Physical description
Contributors
  • Psychiatry Department, College of Medicine, Imam Univeristy, Po Box 26181, Riyadh, Saudi Arabia 11486, tel.: +966544486955, +96612037100, fax: +96612037100, asemalageel@yahoo.com
  • Consultant Psychiatrist, Alamal Complex for Mental Health, Riyadh, Saudi Arabia
References
  • Abdullah N, Voronovitch L, Taylor S et al.: Olanzapine and haloperidol: potential for neutropenia? Psychosomatics 2003; 44: 83–84.
  • Benedetti F, Cavallaro R, Smeraldi E: Olanzapine-induced neutropenia after clozapine-induced neutropenia. Lancet 1999; 354: 567.
  • Buchman N, Strous RD, Ulman AM et al.: Olanzapine-induced leukopenia with human leukocyte antigen profiling. Int Clin Psychopharmacol 2001; 16: 55–57.
  • Cordes J, Streit M, Loeffler S et al.: Reversible neutropenia during treatment with olanzapine: three case reports. World J Biol Psychiatry 2004; 5: 230–234.
  • Delieu JM, Horobin RW, Duguid JK: Formation of immature neutrophil leucocytes in schizophrenic patients treated with various antipsychotic drugs: comparisons and predictions. J Psychopharmacol 2006; 20: 824–828.
  • Dettling M, Cascorbi I, Hellweg R et al.: Genetic determinants of drug-induced agranulocytosis: potential risk of olanzapine? Pharmacopsychiatry 1999; 32: 110–112.
  • Duggal HS, Gates C, Pathak PC: Olanzapine-induced neutropenia: mechanism and treatment. J Clin Psychopharmacol 2004; 24: 234–235.
  • Flanagan RJ, Dunk L: Haematological toxicity of drugs used in psychiatry. Hum Psychopharmacol 2008; 23 Suppl 1: 27–41.
  • Freedman JL, Ryan CA, Coffey BJ: Olanzapine-induced agranulocytosis in an adolescent male with psychosis. J Child Adolesc Psychopharmacol 2011; 21: 185–189.
  • Gajwani P, Tesar GE: Olanzapine-induced neutropenia. Psychosomatics 2000; 41: 150–151.
  • Grover S, Hegde A, Agarwal M et al.: Olanzapine-associated leukopenia and thrombocytopenia managed with lithium in a patient who developed leukopenia with clozapine in the past: a case report. Prim Care Companion CNS Disord 2012; 14.
  • Hong X, Wang X: Agranulocytosis and neutropenia with typical and atypical neuroleptics. Am J Psychiatry 2001; 158: 1736–1737.
  • Jagadheesan K, Mehrtens J: Prolongation of clozapine-induced neutropenia with olanzapine. Aust N Z J Psychiatry 2007; 41: 192.
  • Kodesh A, Finkel B, Lerner AG et al.: Dose-dependent olanzapineassociated leukopenia: three case reports. Int Clin Psychopharmacol 2001; 16: 117–119.
  • Konakanchi R, Grace JJ, Szarowicz R et al.: Olanzapine prolongation of granulocytopenia after clozapine discontinuation. J Clin Psychopharmacol 2000; 20: 703–704.
  • Lander M, Bastiampillai T: Neutropenia associated with quetiapine, olanzapine, and aripiprazole. Aust N Z J Psychiatry 2011; 45: 89.
  • Leucht S, Komossa K, Rummel-Kluge C et al.: A meta-analysis of headto-head comparisons of second-generation antipsychotics in the treatment of schizophrenia. Am J Psychiatry 2009; 166: 152–163.
  • Lieberman JA, Stroup TS, McEvoy JP et al.; Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators: Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 1209–1223.
  • Lin YH, Chien YL: Valproic acid-related anticonvulsant hypersensitivity syndrome and subsequent olanzapine-related neutropenia and thrombocytopenia: a case report. J Clin Psychopharmacol 2012; 32: 132–133.
  • Malhotra K, Vu P, Wang DH et al.: Olanzapine-induced neutropenia. Ment Illn 2015; 7: 5871.
  • Mehta A, Sanitato J: A case of neutropenia and thrombocytopenia shortly after initiating olanzapine. Psychiatry (Edgmont) 2005; 2: 18–19.
  • Meissner W, Schmidt T, Kupsch A et al.: Reversible leucopenia related to olanzapine. Mov Disord 1999; 14: 872–873.
  • Montgomery J: Ziprasidone-related agranulocytosis following olanzapine-induced neutropenia. Gen Hosp Psychiatry 2006; 28: 83–85.
  • Naumann R, Felber W, Heilemann H et al.: Olanzapine-induced agranulocytosis. Lancet 1999; 354: 566–567.
  • Oyewumi LK, Al-Semaan Y: Olanzapine: safe during clozapineinduced agranulocytosis. J Clin Psychopharmacol 2000; 20: 279–281.
  • Salviati M, Ortona E, Colasanti T et al.: Olanzapine-induced neutropenia in a patient with systemic lupus erythematosus: a role of FcγRIIIb polymorphism? Lupus 2012; 21: 97–99.
  • Sayin A, Cosar B: Prolongation of clozapine-induced leukopenia with olanzapine treatment. Prog Neuropsychopharmacol Biol Psychiatry 2006; 30: 958–959.
  • Schuld A, Kraus T, Hinze-Selch D et al.: Granulocyte colony-stimulating factor plasma levels during clozapine- and olanzapine-induced granulocytopenia. Acta Psychiatr Scand 2000; 102: 153–155.
  • Steinwachs A, Grohmann R, Pedrosa F et al.: Two cases of olanzapineinduced reversible neutropenia. Pharmacopsychiatry 1999; 32: 154–156.
  • Stergiou V, Bozikas VP, Garyfallos G et al.: Olanzapine-induced leucopenia and neutropenia. Prog Neuropsychopharmacol Biol Psychiatry 2005; 29: 992–994.
  • Stip E, Langlois R, Thuot C et al.: Fatal agranulocytosis: the use of olanzapine in a patient with schizophrenia and myelodysplasia. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31: 297–300.
  • Stübner S, Grohmann R, Engel R et al.: Blood dyscrasias induced by psychotropic drugs. Pharmacopsychiatry 2004; 37 Suppl 1: S70–S78.
  • Su JA, Wu CH, Tsang HY: Olanzapine-induced agranulocytosis in systemic lupus erythematosus: a case report. Gen Hosp Psychiatry 2007; 29: 75–77.
  • Taylor D, Paton C, Kapur S (eds.): The Maudsley Prescribing Guidelines in Psychiatry. 11th ed., Wiley-Blackwell, Chichester 2012.
  • Teter CJ, Early JJ, Frachtling RJ: Olanzapine-induced neutropenia in patients with history of clozapine treatment: two case reports from a state psychiatric institution. J Clin Psychiatry 2000; 61: 872–873.
  • Thangadurai P, Jyothi KS, Gopalakrishnan R et al.: Reversible neutropenia with olanzapine following clozapine-induced neutropenia. Am J Psychiatry 2006; 163: 1298.
  • Thinn SS, Liew E, May AL et al.: Reversible delayed onset olanzapineassociated leukopenia and neutropenia in a clozapine-naive patient on concomitant depot antipsychotic. J Clin Psychopharmacol 2007; 27: 394–395.
  • Tolosa-Vilella C, Ruiz-Ripoll A, Mari-Alfonso B et al.: Olanzapineinduced agranulocytosis: a case report and review of the literature. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26: 411–414.
  • Wray CM, Sztuke-Fournier A: Olanzapine: hematological reactions. CMAJ 1998; 159: 81–82.
  • Wu SY, Liu CC, Hsieh MH: Successful re-exposure to clozapine following uneventful rechallenge with olanzapine in a patient with neutropenia related to both agents. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32: 1089–1090.
Document Type
review
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.psjd-297e8129-1143-4ef3-90cf-840086456c7b
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.