olanzapine and Opioid-Related-Disorders

Topics: Administration, Oral; Adult; Aged; Clonidine; Female; Humans; Injections, Intramuscular; Male; Middle Aged; Olanzapine; Opioid-Related Disorders; Prospective Studies; Severity of Illness Index; Substance Withdrawal Syndrome; Treatment Outcome; Young Adult

Topics: Analgesics, Opioid; Humans; Neoplasms; Olanzapine; Opioid-Related Disorders; Palliative Care

Topics: Administration, Oral; Adult; Antipsychotic Agents; Drug Interactions; Humans; Male; Olanzapine; Opioid-Induced Constipation; Opioid-Related Disorders; Psychotic Disorders; Psyllium; Treatment Failure

Opioid addiction, although uncommon in cancer patients, can be a significant challenge for optimal pain management in certain patients. We present a case of a 59-year-old man with advanced colon cancer whose compulsive craving for the buccal tablet of fentanyl citrate (BTFC) was improved with the use of olanzapine. He was hospitalized for abdominal pain caused by disease progression. He had visited several times at outpatient follow-up to obtain a prescription for BTFC because he took all medications before the appointed times. After admission, intravenous infusion of oxycodone and opioid rotation were applied to the patient to control his pain. However, he complained that the pain was not relieved at all and persistently asked for only BTFC 7 to 15 times per day. With the diagnosis of opioid addiction, the transdermal buprenorphine patch was applied, but was ineffective for controlling the addictive behaviors. Finally, olanzapine (10 mg/day per os), a dopamine receptor antagonist, was given to control the craving behavior because psychological dependence is mediated by the dopaminergic system. Three days later, opioid craving was reduced from five to one on a 5-point Likert scale. The pain was well controlled to numeric rating scale 1 or 2 without cravings for BTFC. Craving behavior as a result of opioid addiction may be controlled with olanzapine. Further prospective studies on this issue are warranted.

Topics: Cancer Pain; Craving; Humans; Male; Middle Aged; Olanzapine; Opioid-Related Disorders; Pain Management; Pain Measurement; Selective Serotonin Reuptake Inhibitors

Atypical antipsychotic medications are effective for treating both the positive and negative symptoms of schizophrenia. Olanzapine is an atypical antipsychotic that blocks dopaminergic, serotonergic, adrenergic, histaminergic, and muscarinic receptors. In this study, we used rodents to investigate whether olanzapine could suppress the hyperlocomotion, rewarding effect, and discriminative stimulus effect induced by the prototypic μ-opioid morphine, which are all considered to reflect the abuse potential or psychoactive effects of μ-opioids. Olanzapine at doses that failed to induce motor coordination produced a dose-dependent reduction in hyperlocomotion induced by morphine in mice. Olanzapine at a dose that did not produce motor dysfunction also inhibited the significant place preference induced by morphine in mice. Furthermore, the discriminative stimulus effect induced by morphine in rats was dose-dependently and significantly attenuated by olanzapine at the dose that did not induce the motor dysfunction. These results suggest that treatment with both μ-opioids and olanzapine at a dose lower than that at which it induces motor dysfunction could be very useful for preventing the abuse potential and/or psychoactive effects of μ-opioids.

Topics: Analgesics, Opioid; Animals; Antipsychotic Agents; Benzodiazepines; Disease Models, Animal; Male; Mice; Mice, Inbred ICR; Morphine; Olanzapine; Opioid-Related Disorders; Rats; Rats, Inbred F344; Reward

Topics: Anti-Inflammatory Agents; Antidepressive Agents, Tricyclic; Antipsychotic Agents; Ataxia; Benzodiazepines; Depressive Disorder, Major; Doxepin; Female; Humans; Middle Aged; Olanzapine; Opioid-Related Disorders; Prednisone; Psychotic Disorders; Treatment Outcome; Vasculitis, Central Nervous System