Olanzapine (Zyprexa) is frequently used in ICU
for delirium. One of the side effects to be aware of is hyperglycemia. Olanzapine
may induce hyperglycemia by altering insulin secretion from the pancreatic beta-cell through blockade of the muscarinic M3 receptor. It has been reported to
induce DKA (Ketoacidosis).
If Olanzapine-induced hyperglycemia is
suspected, it should be withdrawn or switched to some other medicines without
worsening the psychiatric condition of patient.
Further
reading
1. Weston-Green, Katrina;
Huang, Xu-Feng; Lian, Jiamei; Deng, Chao (2012). "Effects of olanzapine on
muscarinic M3 receptor binding density in the brain relates to weight gain,
plasma insulin and metabolic hormone levels". European Neuropsychopharmacology
22 (5): 364–73.
2. Lindenmayer JP, Patel R.
Olazapine-induced ketoacidosis with diabetes mellitus (letter) Am J Psychiatry.
1999;156:1471.
3. Roefaro J, Mukherjee SM. Olanzapine-lnduced hyperglycemic nonketonic
coma. Ann Pharmacother.2001;35:300–2.
4. Seaberg HL, McLendon BM, Doraiswamy PM. Olanzapine-Associated Severe
Hyperglycemia, Ketonuria, and Acidosis: Case Report and Review of Literature.
Pharmacotherapy. 2001;21:1448–54
5. Ober SK, Hudak R, Rusterholtz Hyperglycemia and olanzapine. Am J
Psychiatry. 1999;156:970.
6. Goldstein LE, Sporn J, Brown S, Kim H, Finkelstein J, Gaffey GK, et
al. New-onset diabetes mellitus and diabetes ketoacidosis associated with
olanzapine treatment. Psychosomatics. 1999;40:438–4
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