olanzapine and Pharyngitis

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

An orally disintegrating tablet formulation of olanzapine (ODT olanzapine) is designed to dissolve rapidly upon contact with saliva. We describe a manic patient who has an esophageal stricture and chronic pharyngitis, two conditions that impede the swallowing of medications. She was successfully treated for her mania with this orally disintegrating formulation. This case report shows that ODT olanzapine may be useful in the psychiatric management of manic and other patients for whom olanzapine is appropriate, and who have an underlying medical condition that impedes swallowing oral medications.

Topics: Administration, Oral; Adult; Antipsychotic Agents; Benzodiazepines; Bipolar Disorder; Chronic Disease; Esophageal Stenosis; Female; Humans; Olanzapine; Pharyngitis