Olanzapine abuse: A case report

Introduction: Olanzapine is a thienobenzodiazepine which specifically blocks 5-HT2A and D2 receptors and additionally blocks muscarinic (M1), H1, 5-HT2C, 5-HT3.5-HT6, a l, and D4 receptors. It has greater affinity for 5-HT2 receptors than for D2 receptors (Kelly, Conley & Carpenter 2005). Olanzapine has consistently been found to be significantly superior to placebo and comparable with, or superior to, haloperidol for the treatment of overall, positive, and negative symptoms of schizophrenia. In this case, we want to report a case of olanzapine abuse.

Case Report: A 48-year old, primary school graduate, married, female patient was admitted to our psychiatry clinic with tachycardia, insomnia, and anxiety. In psychiatric assessment, she mentioned that her symptoms have been similar for 15 years and in the last 3 years she has used citalopram 40 mg/d and olanzapine 10 mg/d and after this treatment her symptoms decreased. During psychiatric treatment when her consequent doctor wanted to stop the olanzapine treatment, she did not succeed and the patient had anxiety, insomnia, and anger and reported decreased symptoms after using the drug again

Discussion: Besides medications with obvious abuse potential such as benzodiazepines and methyphenidate and other stimulants, abuse of a number of commonly prescribed psychiatric medications has been reported. The abuse of anticholinergic drugs was first reported in 1960 with the description of a patient, who increased her trihexyphenidyl to achieve antidepressant and euphoriant effects. Recently, abuse of quetiapine for its sedative and anxiolytic effects has been reported. The abuse risk of quetiapine has been also reported in our country and Kaya et al. studied the abuse risk of quetiapine with prisoners. In the literature there are only two cases of olanzapine abuse.