olanzapine and Brain-Injuries

Traumatic brain injury (TBI) can result in serious and disabling neuropsychiatric disorders.. The authors report a case of a 51-year old male, admitted to the psychiatric ward for acute psychosis and suicidal ideation, probably associated with TBI. After a temporal head trauma he initiated auditory/verbal hallucinations and subsequently developed paranoid delusions. The electroencephalography showed slow bilateral temporal activity and the neuropsychological testing showed several impairments. The patient improved with olanzapine at a dosage of 20 mg daily.. This case shows the difficulty of differential diagnosis between schizophrenia and psychotic disorder due to traumatic brain injury.. The authors conducted a revision of literature about the diagnosis, epidemiology, clinical aspects, laboratory and structural investigations and the treatment of this condition. Based on this revision work, the authors sketch some recommendations about the work-up that should be done when faced with this diagnostic hypothesis.

Topics: Antipsychotic Agents; Benzodiazepines; Brain Injuries; Diagnosis, Differential; Electroencephalography; Hallucinations; Humans; Male; Middle Aged; Neuropsychological Tests; Olanzapine; Paranoid Disorders; Portugal; Psychotic Disorders; Schizophrenia

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Brain Injuries; Humans; Male; Olanzapine; Radiography; Stress Disorders, Post-Traumatic; Tomography Scanners, X-Ray Computed

Topics: Adult; Benzodiazepines; Brain Injuries; Hiccup; Humans; Illusions; Male; Olanzapine; Selective Serotonin Reuptake Inhibitors

The use of typical neuroleptics has always been the mainstay of treatment for delirium following traumatic brain injury (TBI). Given the recent application of atypical neuroleptics to various psychiatric conditions formerly treated with typical neuroleptics, one questions whether this new class of drugs is superior to its predecessor in treating delirium post-TBI. We present a case of one patient with TBI-induced delirium where in fact the use of the typical mid-potency neuroleptic, loxapine, appeared to have a better clinical effect over the atypical neuroleptic, olanzapine.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Brain Injuries; Delirium; Humans; Loxapine; Male; Olanzapine; Pirenzepine

Traumatic brain injury can cause a variety of impairments, including persistent alterations in personality, mood, and cognition. Antipsychotic agents are frequently used to treat pathologic behaviors in traumatic brain injury patients, but the influence of prolonged administration of such drugs on cognition after injury is unknown. The effects of two antipsychotic drugs on cognitive recovery after traumatic brain injury were assessed using the fluid percussion model in rats.. The typical antipsychotic, haloperidol, and the third-generation antipsychotic, olanzapine, were administered via intraperitoneal injection beginning 24 hr after injury and continuing daily for the duration of the study. Morris water maze performance was assessed on days 11-15 postinjury.. Haloperidol, an antagonist acting on D2-like dopamine receptors, exacerbated the cognitive deficits induced by injury, as injured rats treated with 0.30 mg/kg haloperidol performed worse in the Morris water maze than injured rats treated with vehicle.. Our results demonstrate the importance of the D2 receptor in cognitive recovery after traumatic brain injury. Also, the data illustrate that some classes of antipsychotic drugs may influence cognitive recovery, and further research is needed to determine the optimal pharmacologic treatment of aggression, agitation, and other pathologic behaviors in patients with traumatic brain injury.

Topics: Analysis of Variance; Animals; Antipsychotic Agents; Benzodiazepines; Brain Injuries; Cognition Disorders; Dopamine Antagonists; Dose-Response Relationship, Drug; Haloperidol; Injections, Intraperitoneal; Male; Maze Learning; Olanzapine; Pirenzepine; Rats; Rats, Sprague-Dawley; Swimming

Weight gain in mentally ill patients is an evident problem, and obesity can be two- to three-fold more prevalent in psychiatric patients than in the general population. We report two patients who gained weight during previous antipsychotic treatment but who lost weight when shifted to quetiapine.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Brain Injuries; Chlorpromazine; Dibenzothiazepines; Humans; Male; Obesity; Olanzapine; Quetiapine Fumarate; Schizophrenia, Paranoid; Weight Gain; Weight Loss

The aim of this paper is to document regular nocturnal intensification of delusional nihilistic and persecutory ideas (Cotard delusion) linked with extreme depersonalisation and hypervivid dreaming.. A 17-year-old man presented with Cotard and Capgras delusions after sustaining multiple cognitive impairments secondary to traumatic brain injury.. Delusional ideation fully resolved within 14 days of commencement of olanzapine 5 mg daily.. This patient's experience of perceptual abnormalities and impairments in meta-abilities related to self-monitoring and critical inferencing lends support to multicomponent sensory processing accounts of brain injury related, content-specific delusional syndromes.

Topics: Adolescent; Antipsychotic Agents; Benzodiazepines; Brain Injuries; Capgras Syndrome; Circadian Rhythm; Delusions; Humans; Male; Olanzapine; Perceptual Disorders; Pirenzepine; Syndrome