Abstract:

Objective To explore the clinical characteristics of olanzapine-induced peripheral edema. Methods Clinical data of a case of olanzapine-induced peripheral edema were reported, and a comprehensive analysis of similar cases was made by literature review. Results A 42-year-old female patient with anxiety disorder was treated with venlafaxine sustained-release tablets 75 mg and zopiclone tablets 7.5 mg once daily at night. She was additionally given to olanzapine tablets 5 mg once daily at night. On the 5th day, the patient developed swelling of eyelids, ankles and dorsum of feet. Edema subsided after 5 days of olanzapine tablet withdrawal, while other drugs remained unchanged. However, after four days of re-use of olanzapine tablets 5 mg once daily at night, the patient developed swelling of eyelids, ankles and dorsum of feet again, and subsided after 4 days of withdrawal. Literature review of 23 cases of olanzapine-induced peripheral edema showed that 17 (73.91%) cases developed edema within 30 days of olanzapine medication at any dosages, with an increased risk by taking a higher dose of olanzapine. Edema could affect the lower limbs, feet, periorbital, eyelids, globular conjunctiva, and tongue, and multi-site edema was seen in some cases. Withdrawal or reducing the dosage of olanzapine resulted in edema subside within 30 days, and within 14 days in 19 (82.61%) cases. Conclusion Olanzapine-induced peripheral edema often occurs early in the medication period, with a good prognosis after withdrawal or reducing the dosage.

Key words: edema, olanzapine, psychotic disorders