Indian Journal of Psychological Medicine
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Year : 2013  |  Volume : 35  |  Issue : 4  |  Page : 423-424

Olanzapine-induced tardive oculogyric crises

Department of Psychiatry, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India

Correspondence Address:
Amar D Bavle
187, 4th Cross, Central Excise Layout, RMV II Stage, Bangalore 560 094, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0253-7176.122249

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Tardive syndromes are much lower in prevalence in second generation antipsychotics (SGA) than in the typical antipsychotics. Although, olanzapine, which is an SGA, has a high risk of causing weight gain, metabolic syndrome, raised blood sugar, and dyslipidemias; it is widely used as the risk of developing extrapyramidal syndromes (EPS) is low. Among the various forms of EPS, tardive syndromes are the most feared, tardive dyskinesia, tardive akathisia, and tardive dystonia are the commonest tardive syndromes, the others being less common. Tardive oculogyric crises (TOC) are a rare form of tardive dystonia. This patient had TOC with prolonged unsupervised treatment with low-dose olanzapine. Added to that, she developed weight gain that was alarmingly high and such high gain in weight with olanzapine, to our knowledge, has not been reported. She responded to a low dose of trihexiphenydyl, and on stopping olanzapine and adding aripiprazole, has started losing weight.

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