{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:07:28Z","timestamp":1792112848146,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,20]],"date-time":"2022-11-20T00:00:00Z","timestamp":1668902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>Olanzapine pamoate is an intramuscular depot injection for the treatment of schizophrenia. Approximately 1.4% of patients develop a serious adverse event called post\u2010injection delirium\/sedation syndrome (PDSS), characterised by drowsiness, anticholinergic and extrapyramidal symptoms. The objective is to investigate olanzapine PDSS presentations including clinical features and treatment approach. This is a retrospective review of olanzapine PDSS patients from three toxicology units and the NSW Poisons Information Centre between 2017 and 2022. Adult patients were included if they had intramuscular olanzapine then developed PDSS criteria. Clinical symptoms, treatment, timing and length of symptoms were extracted into a preformatted Excel database. There were 18 patients included in the series, with a median age of 49\u2009years (interquartile range [IQR]: 38\u201358) and male predominance (89%). Median onset time post injection was 30\u2009min (IQR: 11\u201338). PDSS symptoms predominate with drowsiness, confusion and dysarthria. Median length of symptoms was 24\u2009h (IQR: 20\u201354). Most common treatment included supportive care without any pharmacological intervention (<jats:italic>n<\/jats:italic>\u2009=\u200910), benzodiazepine (<jats:italic>n<\/jats:italic>\u2009=\u20094) and benztropine (<jats:italic>n<\/jats:italic>\u2009=\u20093). In one case, bromocriptine and physostigmine followed by oral rivastigmine were given to manage antidopaminergic and anticholinergic symptoms respectively. This proposed treatment combination could potentially alleviate some of the symptoms but needs further studies to validate the findings. In conclusion, this case series supports the characterisation of PDSS symptomology predominantly being anticholinergic with similar onset (&lt;1\u00a0h) and duration (&lt;72\u2009h). Bromocriptine is proposed to manage PDSS if patients develop severe dopamine blockade and physostigmine followed by rivastigmine for anticholinergic delirium.<\/jats:p>","DOI":"10.1111\/bcp.15588","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T10:05:28Z","timestamp":1667988328000},"page":"903-907","source":"Crossref","is-referenced-by-count":11,"title":["Case series profile of olanzapine post\u2010injection delirium\/sedation syndrome"],"prefix":"10.1111","volume":"89","author":[{"given":"Jason","family":"Seebaluck","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine &amp; Clinical Toxicology Prince of Wales Hospital  Randwick NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Downes","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; Toxicology Unit Calvary Mater Newcastle Hospital  Waratah NSW Australia"},{"name":"New South Wales Poisons Information Centre Children's Hospital at Westmead  Westmead NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Brown","sequence":"additional","affiliation":[{"name":"New South Wales Poisons Information Centre Children's Hospital at Westmead  Westmead NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Harris","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Unit Princess Alexandra Hospital  Woolloongabba QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine Z.","family":"Isoardi","sequence":"additional","affiliation":[{"name":"New South Wales Poisons Information Centre Children's Hospital at Westmead  Westmead NSW Australia"},{"name":"Clinical Toxicology Unit Princess Alexandra Hospital  Woolloongabba QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0083-282X","authenticated-orcid":false,"given":"Betty S.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine &amp; 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