{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T04:41:01Z","timestamp":1714365661602},"reference-count":29,"publisher":"American Society of Consultant Pharmacists","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:p>Drug-induced dystonias are rare but can occur with second-generation antipsychotics. They are usually dose-related and occur soon after dose initiation. This case describes the development of dystonia after two years of olanzapine 5 mg daily in an older person with Alzheimer\u2019s\n dementia. The dystonia resolved after diphenhydramine treatment on day two of hospitalization, but then the patient became delirious, which was treated with lorazepam on day three. Six days after admission, she developed tremors and rigidity that self-resolved. Her dystonia resolved after\n 11 days. The recurrence of symptoms during the hospitalization may have been a result of the progression of her dementia. This is the first known case of a patient developing dystonia after chronic use of low-dose olanzapine. This was not characterized as tardive dystonia because the dystonia\n was resolved with anticholinergic medication. This case illustrates the difficulty of using anticholinergics to treat dystonias in older people, which can precipitate delirium. Choosing an alternative antipsychotic with less extrapyramidal symptom risk is challenging as she had previous trials\n with quetiapine and risperidone. Clozapine was deemed an unfavorable alternative, as laboratory monitoring would be burdensome. Olanzapine-induced dystonias can develop anytime during therapy. Families must balance the desire for mood stabilization with antipsychotics side effects.<\/jats:p>","DOI":"10.4140\/tcp.n.2021.493","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T04:59:33Z","timestamp":1633064373000},"page":"493-500","source":"Crossref","is-referenced-by-count":3,"title":["Late-Onset Dystonia With Low-Dose Olanzapine in an Older Person: A Case Report"],"prefix":"10.4140","volume":"36","author":[{"given":"Sharon","family":"See","sequence":"first","affiliation":[{"name":"1St. John\u2019s University, College of Pharmacy and Health Sciences, Queens, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Daniel","sequence":"additional","affiliation":[{"name":"2Montefiore Nyack Hospital, Nyack, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martine","family":"Sanon","sequence":"additional","affiliation":[{"name":"3Director of Inpatient Geriatric Medicine Clinical Services, Brookdale Dept. of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"key":"ref1","first-page":"415","article-title":"Drug-induced movement disorders.","volume":"6","year":"2007","journal-title":"J Pharm Pract."},{"issue":"21","key":"ref2","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1093\/ajhp\/54.21.2461","article-title":"Management of acute extrapyramidal effects induced by antipsychotic drugs.","volume":"54","year":"1997","journal-title":"Am J Health Syst Pharm."},{"issue":"3","key":"ref3","first-page":"240","article-title":"Tardive dystonia and its treatment.","volume":"28","year":"2003","journal-title":"Rev Psychiatr Neurosci."},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1212\/WNL.32.12.1335","article-title":"Tardive dystonia: late-onset and persistent dystonia caused by antipsychotic drugs.","volume":"32","year":"1982","journal-title":"Neurology."},{"issue":"9","key":"ref5","doi-asserted-by":"crossref","first-page":"609","DOI":"10.2165\/00044011-200222090-00006","article-title":"Frequency of extrapyramidal adverse reactions in schizophrenic outpatients treated with risperidone, olanzapine, quetiapine or haloperidol: results of the Eire study.","volume":"22","year":"2002","journal-title":"Clin Drug Invest."},{"issue":"11","key":"ref6","first-page":"706743718777392","article-title":"Movement disorders associated with antipsychotic medication in people with schizophrenia: an overview of Cochrane reviews and meta-analysis","volume":"63","year":"2018","journal-title":"Can J Psychiatry."},{"issue":"27","key":"ref7","first-page":"160","article-title":"A case of aripiprazole-related acute dystonia in an adolescent patient.","volume":"2","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry."},{"issue":"2","key":"ref8","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1176\/jnp.15.2.241","article-title":"Acute dystonia caused by low dosage of olanzapine.","volume":"15","year":"2003","journal-title":"J Neuropsychiatry Clin Neurosci."},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"E24","DOI":"10.1176\/appi.neuropsych.13040077","article-title":"Olanzapine-induced tardive dystonia: a case report.","volume":"26","year":"2014","journal-title":"J Neuropsychiatry Clin Neurosci."},{"issue":"5","key":"ref10","doi-asserted-by":"crossref","first-page":"237","DOI":"10.4103\/0253-7613.44158","article-title":"Olanzapine induced tardive dystonia.","volume":"40","year":"2008","journal-title":"Indian J Pharmacol."},{"issue":"10","key":"ref11","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1176\/ajp.156.10.1662","volume":"156","year":"1999","journal-title":"Am J Psychiatry."},{"issue":"6","key":"ref12","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/S0006-3223(98)00242-X","article-title":"The current status of tardive dystonia.","volume":"45","year":"1999","journal-title":"Biol Psychiatry."},{"issue":"Pt 11","key":"ref13","first-page":"2053","article-title":"The natural history of tardive dystonia. 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