Year 2016 / Volume 108 / Number 8
Case Report
Olanzapine-induced ischemic colitis

507-509

DOI: 10.17235/reed.2015.3856/2015

Esteban Sáez González, Francia Carolina Díaz Jaime, María Teresa Blázquez Martínez, Adolfo del Val Antoñana, Juan Antonio Ortuño Cortés,

Abstract
Ischemic colitis (IC) is an uncommon adverse event associated with antipsychotic agents, more commonly found with phenothiazine drugs and atypical neuroleptics such as clozapine. The risk of developing ischemic colitis increases when anticholinergic drugs are associated. We report the case of a 38-year-old woman with a history of schizoaffective disorder who had been on chronic quetiapine for 3 years, and presented to the ER because of diarrhea for 5 days. Four months previously, olanzapine had been added to her psychiatric drug regimen. Physical examination revealed abdominal distension with abdominal tympanic sounds and tenderness. Emergency laboratory tests were notable for increased acute phase reagents. Tomography revealed a concentric thickening of the colonic wall in the transverse, descending and sigmoid segments, with no signs of intestinal perforation. Colonoscopy demonstrated severe mucosal involvement from the sigmoid to the hepatic flexure, with ulcerations and fibrinoid exudate. Biopsies confirmed the diagnosis of ischemic colitis. The only relevant finding in her history was the newly added drug to her baseline regimen. An adverse effect was suspected because of its anticholinergic action at the intestinal level, and the drug was withdrawn. After 6 months of follow-up clinical, laboratory and endoscopic recovery was achieved. Therefore, antipsychotic medication should be considered as a potential cause of ischemic colitis, particularly atypical antipsychotics such as clozapine and olanzapine; despite being uncommon, this adverse event may result in high morbidity and mortality.
Share Button
New comment
Comments
No comments for this article
References
1. Higgins PD, Davis KJ, Line L. Systematic review: the epidemiology of ischaemic colitis. Aliment Pharmacol Ther 2004; 19: 729-38.
2. Brandt LJ, Feuerstadt P, Longstreth GF, et al. ACG Clinical guideline: epidemiology, risk factors, patterns of presentation, diagnosis, and management of colon ischemia (CI). Am J Gastroenterol 2015; 110: 18-44.
3. Yadav S, Dave M, Edakkanambeth Varayil J, et al. A Population-based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis. Clin Gastroenterol Hepatol 2015; 13: 731-38.
4. Longstreth GF, Yao JF. Diseases and drugs that increase risk of acute large bowel ischemia. Clin Gastroenterol Hepatol. 2010; 8: 49-54.
5. Peyrière H, Roux C, Ferard C, et al. Antypsichotics-induced ischaemic colitis and gastrointestinal necrosis: a review of the French pharmacovigilance database. Pharmaco epidemiol Drug Saf 2009; 18: 948-55.
6. Palmer SE, McLean RM, Ellis PM, et al. Life-threating clozapine-induced gastrointestinal hipomotility: an analysis of 102 cases. J Clin Psychiatry 2008; 69: 759-68.
7. Quetiapine ischaemic colitis. Prescrire Int 2014;23: 101.
8. Chengappa KN, Pollock BG, Parepally H, et al. Anticholinergic differences among patients receiving standard clinical doses of olanzapine or clozapine. J Clin Psychopharmacol 2000; 20: 311-6.
9. Park SJ, Gunn N, Harrison SA. Olanzapine and Benztropine as a Cause of ischemic Colitis in a 27-year-old Man. J Clin Gastroenterol 2012; 46: 515-7.
10. Chwieduk CM, Keating GM. Paliperidone extended release: a review of its use in the management of schizophrenia. Drugs 2010; 70: 1295-317
11. De Hert M , Dockx L, Bernagie C, et al. Prevalence and severity of antypsichotic related constipation in patients with schizoprenia: a retrospective descriptive study. BMC Gastroenterol 2011;11:17.
Citation tools
Sáez González E, Díaz Jaime F, Blázquez Martínez M, del Val Antoñana A, Ortuño Cortés J. Olanzapine-induced ischemic colitis. 3856/2015


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1088 visits.
This article has been downloaded 124 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 19/05/2015

Accepted: 26/05/2015

Online First: 10/12/2015

Published: 29/07/2016

Article revision time: 6 days

Article Online First time: 205 days

Article editing time: 437 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology