{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:50:31Z","timestamp":1781189431253,"version":"3.54.1"},"reference-count":11,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"5","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n          <jats:title>Introduction<\/jats:title>\n          <jats:p>Acute agitation is a common presenting symptom in medical and mental health emergencies that may require pharmacologic intervention. There is a manufacturer recommendation against intramuscular coadministration of olanzapine with parenteral (intramuscular or intravenous) benzodiazepines despite a deficiency of high-quality evidence. The purpose of this study was to contribute to available literature regarding intramuscular olanzapine and parenteral benzodiazepine use in acutely agitated patients in the emergency department (ED).<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Methods<\/jats:title>\n          <jats:p>This was a single-center retrospective chart review of adult ED patients who received intramuscular olanzapine and a parenteral benzodiazepine within 2 hours. The composite primary endpoint evaluated the occurrence of cardiac or respiratory compromise within 2 hours of medication administration. Secondary endpoints mirrored the primary endpoint within 30 minutes and evaluated the occurrence of cardiac arrest or desaturation in the ED outside the 2-hour window.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results<\/jats:title>\n          <jats:p>One hundred eleven patients were included in the analysis, 64 (57.7%) of whom had documented vitals or oxygen status within 2 hours of medication administration. The composite primary endpoint occurred in 8 patients (12.5%), with only 1 patient requiring intervention with intravenous fluids. The secondary composite endpoint occurred in 2 (9.5%) of 21 patients with documented vitals or oxygen status within 30 minutes of treatment, neither of which required intervention. There were no identified events of intubation or significant cardiac events.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Discussion<\/jats:title>\n          <jats:p>Until better evidence is available, this combination therapy should, at minimum, include appropriate patient monitoring. Future studies should investigate risk factors for serious adverse effects.<\/jats:p>\n        <\/jats:sec>","DOI":"10.9740\/mhc.2024.10.280","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:01:02Z","timestamp":1727740862000},"page":"280-285","source":"Crossref","is-referenced-by-count":1,"title":["A retrospective review of intramuscular olanzapine and parenteral benzodiazepine coadministration in the emergency department"],"prefix":"10.9740","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8407-8726","authenticated-orcid":true,"given":"Jessica","family":"Laub","sequence":"first","affiliation":[{"name":"Clinical Pharmacist, Department of Pharmacy, Ralph H. Johnson VA Medical Center, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-5499","authenticated-orcid":true,"given":"Cierra N.","family":"Treu","sequence":"additional","affiliation":[{"name":"Director of Clinical Informatics, Department of Data Management, NYC Health + Hospitals\/South Brooklyn Health, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3084-3706","authenticated-orcid":true,"given":"Kei","family":"Takamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5991-1795","authenticated-orcid":true,"given":"Christopher","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Vice Chief of Clinical Services, Department of Emergency Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4719","reference":[{"key":"i2168-9709-14-5-280-b01","article-title":"Schaumburg (IL): Emergency Nurses Association (US); c2024","author":"Emergency Nurses Association Institute for Emergency Nursing Research [Internet].","unstructured":"Emergency Nurses Association Institute for Emergency Nursing Research [Internet].\n          \n          Schaumburg (IL): Emergency Nurses Association (US); c2024 [updated 2010; cited 2024 Jan 27]. Available from: https:\/\/enau.ena.org\/Public\/Catalog\/Main.aspx"},{"issue":"1","key":"i2168-9709-14-5-280-b02","series-title":"West J Emerg Med","first-page":"26","article-title":"The psychopharmacology of agitation: consensus statement of the American Association for Emergency Psychiatry Project Beta Psychopharmacology Workgroup","volume":"13","author":"Wilson","year":"2012","unstructured":"Wilson\n              MP,\n            \n            \n              Pepper\n              D,\n            \n            \n              Currier\n              GW,\n            \n            \n              Holloman\n              GH\n              Jr,\n            \n            \n              Feifel\n              D.\n            \n          \n          The psychopharmacology of agitation: consensus statement of the American Association for Emergency Psychiatry Project Beta Psychopharmacology Workgroup. West J Emerg Med. 2012;13(1):26-34. DOI: 10.5811\/westjem.2011.9.6866"},{"issue":"4","key":"i2168-9709-14-5-280-b03","series-title":"Ann Emerg Med","first-page":"374","article-title":"Intramuscular midazolam, olanzapine, ziprasidone, or haloperidol for treating acute agitation in the emergency department","volume":"72","author":"Klein","year":"2018","unstructured":"Klein\n              LR,\n            \n            \n              Driver\n              BE,\n            \n            \n              Miner\n              JR,\n            \n            \n              Martel\n              ML,\n            \n            \n              Hessel\n              M,\n            \n            \n              Collins\n              JD,\n            \n            et al.\n          \n          Intramuscular midazolam, olanzapine, ziprasidone, or haloperidol for treating acute agitation in the emergency department. Ann Emerg Med. 2018;72(4):374-85. DOI: 10.1016\/j.annemergmed.2018.04.027"},{"issue":"4","key":"i2168-9709-14-5-280-b04","series-title":"J Clin Psychiatry","first-page":"433","article-title":"Case reports of postmarketing adverse event experiences with olanzapine intramuscular treatment in patients with agitation","volume":"71","author":"Marder","year":"2010","unstructured":"Marder\n              SR,\n            \n            \n              Sorsaburu\n              S,\n            \n            \n              Dunayevich\n              E,\n            \n            \n              Karagianis\n              JL,\n            \n            \n              Dawe\n              IC,\n            \n            \n              Falk\n              DM,\n            \n            et al.\n          \n          Case reports of postmarketing adverse event experiences with olanzapine intramuscular treatment in patients with agitation. J Clin Psychiatry. 2010;71(4):433-41. DOI: 10.4088\/JCP.08m04411gry"},{"key":"i2168-9709-14-5-280-b05","series-title":"Package insert","author":"Zyprexa (olanzapine) injection.","year":"2017","unstructured":"Zyprexa (olanzapine) injection.\n          \n          \n            Package insert\n          . Lilly Research Laboratories; 2017."},{"issue":"5","key":"i2168-9709-14-5-280-b06","series-title":"J Emerg Med","first-page":"790","article-title":"A comparison of the safety of olanzapine and haloperidol in combination with benzodiazepines in emergency department patients with acute agitation","volume":"43","author":"Wilson","year":"2012","unstructured":"Wilson\n              MP,\n            \n            \n              MacDonald\n              K,\n            \n            \n              Vilke\n              GM,\n            \n            \n              Feifel\n              D.\n            \n          \n          A comparison of the safety of olanzapine and haloperidol in combination with benzodiazepines in emergency department patients with acute agitation. J Emerg Med. 2012;43(5):790-7. DOI: 10.1016\/j.jemermed.2011.01.024"},{"issue":"5","key":"i2168-9709-14-5-280-b07","series-title":"J Emerg Med","first-page":"889","article-title":"Potential complications of combining intramuscular olanzapine with benzodiazepines in emergency department patients","volume":"43","author":"Wilson","year":"2012","unstructured":"Wilson\n              MP,\n            \n            \n              MacDonald\n              K,\n            \n            \n              Vilke\n              GM,\n            \n            \n              Feifel\n              D.\n            \n          \n          Potential complications of combining intramuscular olanzapine with benzodiazepines in emergency department patients. J Emerg Med. 2012;43(5):889-96. DOI: 10.1016\/j.jemermed.2010.04.012"},{"issue":"5","key":"i2168-9709-14-5-280-b08","series-title":"Ment Health Clin","first-page":"208","article-title":"Coadministration of intramuscular olanzapine and benzodiazepines in agitated patients with mental illness","volume":"8","author":"Williams","year":"2018","unstructured":"Williams\n              AM.\n            \n          \n          Coadministration of intramuscular olanzapine and benzodiazepines in agitated patients with mental illness. Ment Health Clin. 2018;8(5):208-13. DOI: 10.9740\/mhc.2018.09.208"},{"key":"i2168-9709-14-5-280-b09","series-title":"Package insert","author":"Ativan (lorazepam) injection.","year":"2021","unstructured":"Ativan (lorazepam) injection.\n          \n          \n            Package insert\n          . Hikma Pharmaceuticals USA Inc.; 2021."},{"issue":"1","key":"i2168-9709-14-5-280-b10","series-title":"Acad Emerg Med","first-page":"29","article-title":"A large retrospective cohort of patients receiving intravenous olanzapine in the emergency department","volume":"23","author":"Martel","year":"2016","unstructured":"Martel\n              ML,\n            \n            \n              Klein\n              LR,\n            \n            \n              Rivard\n              RL,\n            \n            \n              Cole\n              JB.\n            \n          \n          A large retrospective cohort of patients receiving intravenous olanzapine in the emergency department. Acad Emerg Med. 2016;23(1):29-35. DOI: 10.1111\/acem.12842"},{"issue":"1","key":"i2168-9709-14-5-280-b11","series-title":"Ann Emerg Med","first-page":"72","article-title":"Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, randomized, double-blind, placebo-controlled clinical trial","volume":"61","author":"Chan","year":"2013","unstructured":"Chan\n              EW,\n            \n            \n              Taylor\n              DM,\n            \n            \n              Knott\n              JC,\n            \n            \n              Phillips\n              GA,\n            \n            \n              Castle\n              DJ,\n            \n            \n              Kong\n              DC.\n            \n          \n          Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, randomized, double-blind, placebo-controlled clinical trial. Ann Emerg Med. 2013;61(1):72-81. DOI: 10.1016\/j.annemergmed.2012.07.118"}],"container-title":["Mental Health Clinician"],"original-title":[],"link":[{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/14\/5\/article-p280.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/mhc\/article-pdf\/14\/5\/280\/3432042\/i2168-9709-14-5-280.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/mhc.kglmeridian.com\/downloadpdf\/journals\/mhcl\/14\/5\/article-p280.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/mhc.kglmeridian.com\/downloadpdf\/journals\/mhcl\/14\/5\/article-p280.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,23]],"date-time":"2025-02-23T00:02:46Z","timestamp":1740268966000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/14\/5\/article-p280.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":11,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.9740\/mhc.2024.10.280","relation":{},"ISSN":["2168-9709"],"issn-type":[{"value":"2168-9709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]}}}