原创力文档post-injection deliriumsedation syndrome in patients with schizophrenia treated with olanzapine long-acting injection, ii investigations of mechanismpost-injection deliriumsedation综合症与奥氮平治疗的精神分裂症患者长效针剂,二世的调查机制.pdfVIP
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post-injection deliriumsedation syndrome in patients with schizophrenia treated with olanzapine long-acting injection, ii investigations of mechanismpost-injection deliriumsedation综合症与奥氮平治疗的精神分裂症患者长效针剂,二世的调查机制
McDonnell et al. BMC Psychiatry 2010, 10:45
/1471-244X/10/45
R E S E A R C H A R T I C L E Open Access
Research article
Post-injection delirium/sedation syndrome in
patients with schizophrenia treated with
olanzapine long-acting injection, II: investigations
of mechanism
1 1 2 1 1 1
David P McDonnell* , Holland C Detke , Richard F Bergstrom , Prajakti Kothare , Jason Johnson , Mary Stickelmeyer ,
Manuel V Sanchez-Felix1 1 1
, Sebastian Sorsaburu and Malcolm I Mitchell
Abstract
Background: Olanzapine long-acting injection (LAI) is a salt-based depot antipsychotic combining olanzapine and
pamoic acid. The slow intramuscular dissolution of this practically insoluble salt produces an extended release of
olanzapine lasting up to 4 weeks. However, in a small number of injections ( 0.1%), patients experienced symptoms
suggestive of olanzapine overdose, a phenomenon that has been termed post-injection delirium/sedation syndrome
(PDSS). The authors conducted a series of parallel investigations into the possible reasons PDSS events occur.
Methods: Healthcare providers involved in the PDSS cases were queried for clinical information around the events.
Plasma samples from patients experiencing PDSS were collected when possible (12/30 cases) and olanzapine
concentrations compared with the known pharmacokinetic profile for olanzapine LAI. Product batches and used vials
from the PDSS cases were evaluated for compliance with established manufacturing standards and/or possible user
error. Because this depot formulation depends upon slow dissolution at the intramuscular injection site, in-vitro
experiments were conducted
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