Acute Hepatocellular-Cholestatic Liver Injury after Olanzapine Therapy

Letters18 February 2003Acute Hepatocellular-Cholestatic Liver Injury after Olanzapine TherapyKhaled A. Jadallah, MD, David L. Limauro, MD, and Anthony M. Colatrella, MDKhaled A. Jadallah, MDMercy Hospital; Pittsburgh, PA 15219-5166 (Jadallah, Limauro, Colatrella), David L. Limauro, MDMercy Hospital; Pittsburgh, PA 15219-5166 (Jadallah, Limauro, Colatrella), and Anthony M. Colatrella, MDMercy Hospital; Pittsburgh, PA 15219-5166 (Jadallah, Limauro, Colatrella)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-4-200302180-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Olanzapine, a thienobenzodiazepine derivative, is an atypical antipsychotic agent indicated for the treatment of schizophrenia and related psychotic disorders (1, 2). Conventional, phenothiazine antipsychotics and older atypical antipsychotics have both been reported to cause acute hepatitis (3, 4). To date, no cases of olanzapine-induced acute hepatitis have been described in the literature. This case in this letter has been reported to the manufacturer and to the U.S. Food and Drug Administration.Case Report: A 78-year-old woman received a diagnosis of acute depression with psychotic features and was prescribed olanzapine, 10 mg/d. Thirteen days later, she developed ...References1. Beasley CM, Tollefson G, Tran P, Satterlee W, Sanger T, Hamilton S. Olanzapine versus placebo and haloperidol: acute phase results of the North American double-blind olanzapine trial. Neuropsychopharmacology. 1996;14:111-23. [PMID: 8822534] CrossrefMedlineGoogle Scholar2. Beasley CM, Sanger T, Satterlee W, Tollefson G, Tran P, Hamilton S. Olanzapine versus placebo: results of a double-blind, fixed-dose olanzapine trial. Psychopharmacology (Berl). 1996;124:159-67. [PMID: 8935812] CrossrefMedlineGoogle Scholar3. Kellner M, Wiedemann K, Krieg JC, Berg PA. Toxic hepatitis by clozapine treatment [Letter]. Am J Psychiatry. 1993;150:985-6. [PMID: 8494085] CrossrefMedlineGoogle Scholar4. Krebs S, Dormann H, Muth-Selbach U, Hahn EG, Brune K, Schneider HT. Risperidone-induced cholestatic hepatitis. Eur J Gastroenterol Hepatol. 2001;13:67-9. [PMID: 11204814] CrossrefMedlineGoogle Scholar5. Maria VA, Victorino RM. Development and validation of a clinical scale for the diagnosis of drug-induced hepatitis. Hepatology. 1997;26:664-9. [PMID: 9303497] CrossrefMedlineGoogle Scholar6. Gerber JE, Cawthon B. Overdose and death with olanzapine: two case reports. Am J Forensic Med Pathol. 2000;21:249-51. [PMID: 10990286] CrossrefMedlineGoogle Scholar7. Zyprexa [package insert]. Indianapolis, IN: Eli Lilly; 1997. Google Scholar8. Gmez JC, Sacristn JA, Hernndez J, Breier A, Ruiz Carrasco P, Antn Saiz C, . The safety of olanzapine compared with other antipsychotic drugs: results of an observational prospective study in patients with schizophrenia (EFESO Study). Pharmacoepidemiologic Study of Olanzapine in Schizophrenia. J Clin Psychiatry. 2000;61:335-43. [PMID: 10847307] CrossrefMedlineGoogle Scholar9. Tollefson GD, Beasley CM, Tran PV Street, JS Krueger, JA Tamura, RN , . Olanzapine versus haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorders: results of an international collaborative trial. Am J Psychiatry. 1997;154:457-65. [PMID: 9090331] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Khaled A. Jadallah, MD; David L. Limauro, MD; Anthony M. Colatrella, MDAffiliations: Mercy Hospital; Pittsburgh, PA 15219-5166 (Jadallah, Limauro, Colatrella) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDrug-Associated Liver Injury Related to AntipsychoticsOlanzapine-Induced Elevated Liver Function Tests in an Older Person Treated for Antidepressant-Induced ManiaThe first patient to receive olanzapine: A recollectionAntidepressants- and antipsychotics-induced hepatotoxicityDrug-Induced Oxidative Stress and Cellular ToxicityManagement of Hepatotoxicity Induced by the Use of OlanzapineInvolvement of oxidative stress and mitochondrial/lysosomal cross-talk in olanzapine cytotoxicity in freshly isolated rat hepatocytesOlanzapineOlanzapine-Induced Triglyceride and Aminotransferase Elevations Without Weight Gain or Hyperglycemia Normalized After Switching to AripiprazoleHepatotoxicity of Psychotropic Drugs and Drugs of AbuseAntipsychotics and Abnormal Liver Function TestsIn Vitro Approach to Assess the Potential for Risk of Idiosyncratic Adverse Reactions Caused by Candidate DrugsWhich psychotropic medications induce hepatotoxicity?Hepatic effectsLate-onset cholestatic hepatitis induced by olanzapine in a patient with schizophreniaNEUROLEPTIC DRUGSRisperidone- and Quetiapine-Induced CholestasisA review of liver function tests during treatment with atypical antipsychotic drugs: A chart review studySevere liver enzyme elevations after three years of olanzapine treatment: A case report and review of olanzapine associated hepatotoxicityUse of psychotropics in special patient groupsAntipsychotic drugs 18 February 2003Volume 138, Issue 4Page: 357-358KeywordsAntipsychoticsDrugsEnzymesHepatitisHepatitis ALiverLiver function testsPhosphatasesSerum glutamic oxaloacetic transaminaseSigns and symptoms ePublished: 18 February 2003 Issue Published: 18 February 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. 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