PMID: 15385843Sep 24, 2004Paper

Heavy smoking, reduced olanzapine levels, and treatment effects: a case report

Therapeutic Drug Monitoring
Chih-Chiang ChiuKun-Po Chen

Abstract

A 30-year-old schizophrenic male patient, a heavy smoker, was successfully treated with olanzapine 15 mg/d during hospitalization. His cigarette consumption increased rapidly from 12 to 80 cigarettes per day following his discharge. Ten days later, his delusion of persecution, levels of hostility, and aggressive behavior worsened, while the plasma levels of olanzapine concurrently decreased. Based on our observations of this case, we suggest that the reduced levels of plasma olanzapine and exacerbated clinical symptoms are closely related to the increased consumption of cigarettes. A possible explanation would be that heavy smoking induced cytochrome P4501A2, the major enzyme involved in olanzapine metabolism. Therefore, patients who smoke should be closely monitored for their cigarette consumption when the dosage of olanzapine is adjusted.

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Citations

Jun 19, 2012·Current Psychiatry Reports·Brett A EnglishStanford Jhee
Aug 3, 2005·The American Journal of Nursing·Cora Muñoz, Cheryl Hilgenberg
Jun 10, 2011·Clinical Pharmacokinetics·Erin SchwengerMary H H Ensom
Feb 19, 2011·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Jennifer Arnoldi, Nicole Repking
Nov 15, 2012·Therapeutic Drug Monitoring·Lisbeth PatteetHugo Neels

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