Severe intoxication likely from olanzapine (Zyprexa (R)). Beneficial effect of glucagon.

We report the case of a 43-year-old schizophrenic who sustained, after 12 d ays of treatment including olanzapine (20 mg.day(-1)), carbamazepine, levom epromazine and alprazolan, a severe shock with bradycardia (HR: 40 b.min(-1 )), circulatory collapse (SAP: 60 mmHg), hypothermia (T: 27 degrees C), com a and disseminated intravascular coagulation. A significant improvement was obtained with high doses of intravenous glucagon, whereas the normalizatio n of central temperature, atropine, adrenaline and volume loading had been inefficient. Olanzapine, alone or associated with other psychotropics, coul d cause severe circulatory collapse with hypothermia and coma responding to a treatment including glucagon. (C) 1999 Elsevier, Paris.