The pathophysiology of rapid fluctuations in mental status associated with olanzapine: A case report.

Background: Olanzapine toxicity is reported to be a rare but specific phenomenon characterized by rapid fluctuations between somnolence and agitation, which has been referred to as "agitation despite sedation." A similar phenomenon is observed as an adverse reaction of the long-acting injectable olanzapine formulation, which has been referred to as "delirium/sedation syndrome."

Case Presentation: This case report describes a 48-year-old man diagnosed with schizophrenia who experienced rapid fluctuations between somnolence and agitation during a cross-titration of olanzapine to clozapine.