Olanzapine Poisoning in a Teenager
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Abstract
Background: Atypical antipsychotics have replaced traditional agents due to their lower rate of extrapyramidal effects. Poisonings and overdoses associated with these drugs are a major problem in both industrialized and non-industrialized countries.
Case summary: The patient is a 15-year-old teenager who was admitted to hospital with altered state of consciousness and abnormal movements, without initial antecedents of drug intake. Initial laboratory evidence showed mild hypokalemia and metabolic alkalosis, with a toxic urine screen initially testing positive for phenobarbital and later testing negative in a subsequent control. The patient was transferred to the intermediate care unit where she persisted with an altered state of consciousness, constant fever, and tachycardia. Due to the lack of clarity regarding the clinical picture, a lumbar puncture was performed with normal results. After a second interrogation of the family, an intake of 52 tablets of olanzapine before admission was documented. Neuroleptic malignant syndrome was suspected, additional studies were normal. The patient developed favorably. After a psychiatric assessment, an outpatient follow-up was determined.
Conclusion: In the presence of altered consciousness, it is important to keep in mind the possibility of poisoning in the differential diagnosis.
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