AI Article Synopsis
- A young man experienced acute akathisia and dystonia after accidentally overdosing on olanzapine (Zyprexa) following the recent discontinuation of fluoxetine.
- An overview of the relevant receptor chemistry and mechanisms was provided, along with a literature review showing varying reports on the incidence of extrapyramidal effects from these medications.
- The article recommends a careful diagnostic and treatment strategy for patients showing extrapyramidal symptoms, highlighting the importance of considering serious conditions like neuroleptic malignant syndrome and serotonin syndrome while stressing the need for clear discharge instructions to prevent complications.
Article Abstract
The patient with acute extrapyramidal signs and symptoms presents a significant clinical challenge. We present the case of a young man who developed an acute akathisia and dystonia after inadvertent overdose of olanzapine (Zyprexa) in the setting of a recent discontinuation of fluoxetine. The receptor chemistry and mechanisms pertinent to his presentation are reviewed. An analysis of the literature indicates that a broad incidence range is cited for the extrapyramidal effects of these medications. We suggest a diagnostic and therapeutic approach to the undifferentiated patient presenting with extrapyramidal signs and symptoms. The possibility of neuroleptic malignant syndrome (NMS), serotonin syndrome (SS), tricyclic overdose, and cocaine abuse should be considered in a patient with extrapyramidal signs and symptoms, given the potential for complications. An emphasis is placed on the need for carefully verbalized discharge instructions to avoid a potential untoward outcome.
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| http://dx.doi.org/10.1016/j.jemermed.2005.03.019 | DOI Listing |
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