KeywordsLithium Drug Interaction Haloperidol Anxiety Disorder Olanzapine
requires intervention to prevent permanent impairment or damage
A 22-year-old woman receiving lithium for generalised anxiety disorders twice developed oculogyric crisis: once after receiving olanzapine for an anxiety attack, and once following administration of haloperidol [therapeutic indication not stated].
The woman, who had been receiving lithium 900mg [frequency not stated] and paroxetine for approximately 4 years, received olanzapine 2.5mg. A short time later, she was admitted to the ED with dystonic upward deviation of her eyes. She was very anxious, but her mental status remained otherwise unchanged.
The woman received IV biperiden and, within 30 minutes, she experienced remission of her extrapyramidal symptoms, whereas self-administration of biperiden retard had not led to considerable improvement before. She reported that she had developed oculogyric crisis for the first time 12 months previously, shortly after receiving haloperidol 5mg. She had received IV biperiden and her extrapyramidal disorders had resolved.Author Comment “[T]here is a possibility of a rare but serious interaction between lithium and atypical antipsychotic drugs.”
Drug-interactions - Lithium - Basal-ganglia-disorders - drug interactions - Haloperidol - drug-induced - Olanzapine - Ocular-motility-disorders
- 1.Rosenhagen MC, Schmidt U, Winkelmann J, Ebinger M, Knetsch I, Weber F.Olanzapine-induced oculogyric crisis. Journal of Clinical Psychopharmacology 26: 431, No. 4, Aug 2006 - GermanyGoogle Scholar