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.
References
Jan 1, 1991·Clinical Pharmacology and Therapeutics·W Kalow, B K Tang
Jan 1, 1985·European Journal of Clinical Pharmacology·D R Abernethy, E L Todd
Feb 1, 1997·Drugs·B Fulton, K L Goa
Apr 1, 1997·The American Journal of Psychiatry·G D TollefsonM E Thieme
Jun 9, 1999·The American Journal of Psychiatry·R H KellyV K Burt
Oct 16, 1999·Therapeutic Drug Monitoring·E SkoghC Nordin
Feb 24, 2001·Journal of Clinical Psychopharmacology·P J PerryC Beasley
Dec 12, 2001·British Journal of Clinical Pharmacology·T SimonP Jaillon
Jan 5, 2002·Journal of Clinical Psychopharmacology·J M Meyer
Feb 2, 2002·The American Journal of Psychiatry·Jan VolavkaJeffrey A Lieberman
May 1, 2002·International Clinical Psychopharmacology·D F ZullinoP Baumann
Jul 27, 2002·Therapeutic Drug Monitoring·Elisabeth SkoghFinn Bengtsson
Jan 28, 2003·Therapeutic Drug Monitoring·Marianne Gex-FabryLuc P Balant
Mar 18, 2003·Journal of Clinical Psychopharmacology·Juan Antonio CarrilloJulio Benítez
Citations
Jun 19, 2012·Current Psychiatry Reports·Brett A EnglishStanford Jhee
Aug 3, 2005·The American Journal of Nursing·Cora Muñoz, Cheryl Hilgenberg
Jun 8, 2006·The Australian and New Zealand Journal of Psychiatry·Mark BarnesRoss McD Young
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
Sep 16, 2006·Holistic Nursing Practice·Cora Muñoz, Cheryl Hilgenberg
Oct 24, 2018·Clinical Therapeutics·Lei SunLisa von Moltke