olanzapine and Dyspnea

In December 2019, the novel coronavirus (SARS-CoV-2) infection was first reported in Wuhan city, central China, which has spread rapidly. The common clinical features of patients with SARS-CoV-2 infection included fever, fatigue, and damage to the respiratory or digestive system. However, it is still unclear whether SARS-CoV-2 infection could cause damage to the central nervous system (CNS) inducing psychiatric symptoms.. Herein, we present the first case of SARS-CoV-2 infection with manic-like symptoms and describe the diagnosis, clinical course, and treatment of the case, focusing on the identifications of SARS-CoV-2 in the specimen of cerebrospinal fluid (CSF). The patient developed manic-like symptoms when his vital signs recovered on illness day 17. After manic-like attack, the detection of SARS-CoV-2 specific IgG antibody in CSF was positive, while the reverse transcriptase-polymerase chain reaction (RT-PCR) on CSF for the SARS-CoV-2 was negative. The patient received Olanzapine for treatment and his mood problems concurrently improved as indicated by scores of Young Manic Rating Scale (YMRS).. This is a single case report only, and the RT-PCR test for SARS-CoV-2 in CSF was not performed simultaneously when SARS-CoV-2 was positive in samples of sputum and stool.. This first case of COVID-19 patient with manic-like symptoms highlights the importance of evaluation of mental health status and may contribute to our understanding of potential risk of CNS impairments by SARS-CoV-2 infection.

Topics: Antibodies, Viral; Antipsychotic Agents; Antiviral Agents; Betacoronavirus; Bipolar Disorder; Brain; Chest Pain; China; Clinical Laboratory Techniques; Cobicistat; Coronavirus Infections; COVID-19; COVID-19 Testing; Darunavir; Dyspnea; Fever; Glucocorticoids; Humans; Indoles; Magnetic Resonance Imaging; Male; Methylprednisolone; Middle Aged; Moxifloxacin; Olanzapine; Pandemics; Pharyngitis; Pneumonia, Viral; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2

Topics: Adult; Advance Care Planning; Aged; Antiemetics; Baclofen; Benzodiazepines; Constipation; Depressive Disorder, Major; Dyspnea; Female; Hiccup; Humans; Male; Methylphenidate; Middle Aged; Morphinans; Morphine; Nausea; Olanzapine; Palliative Medicine; Polyethylene Glycols; Prochlorperazine; Pruritus; Sertraline; Terminal Care; Walkers

Hypersensitivity syndrome is defined as a drug-induced complex of symptoms consisting of fever, rash, and internal organ involvement. The hypersensitivity syndrome is well recognized as being caused by anticonvulsants. Olanzapine is an atypical antipsychotic agent whose side effects include sedation, weight gain, and increased creatinine kinase and transaminase levels. To date, there have been no reports of hypersensitivity syndrome related to this drug. A 34-year-old man developed a severe generalized pruritic skin eruption, fever, eosinophilia, and toxic hepatitis 60 days after ingestion of olanzapine. After termination of olanzapine treatment, the fever resolved, the skin rash was reduced, eosinophil count was reduced to normal, and the transaminase levels were markedly reduced. Clinical features and the results of skin and liver biopsies indicated that the patient developed hypersensitivity syndrome caused by olanzapine.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Chemical and Drug Induced Liver Injury; Diagnostic Errors; Drug Eruptions; Drug Hypersensitivity; Dyspnea; Eosinophilia; Fever; Humans; Male; Olanzapine; Pirenzepine; Pruritus; Respiratory Hypersensitivity; Respiratory Insufficiency; Schizophrenia, Paranoid; Syndrome