A study on blood pressure changes following Olanzapine Long Acting Injection (LAI) in schizophrenia

BACKGROUND: Olanzapine pamoate long acting injection (LAI) is used in patients having schizophrenia who have poor oral drug compliance or in case they express wish for it. Several studies have assessed incidence of Post Injection Delirium/Sedation Syndrome (PDSS) and acute hemodynamic changes following a LAI dosage, hence guidelines suggest that patient should be kept in observation for 3-4 hours. AIM: To study blood pressure changes during observation period following Olanzapine LAI dosage in patients with schizophrenia. METHOD: 30 inpatients and outpatients diagnosed as having schizophrenia were taken for the study. They were kept in observation for 4 hours following Olanzapine Long Acting Injection (LAI) 405 mg after they had given consent for the same. Blood pressure was measured before giving the drug and at 30 minutes intervals following the injection. RESULT: More than half of the patients had significant fall in the BP for initial 2 hours, followed by return to baseline. 2 patients developed orthostatic hypotension whereas 1 patient developed PDSS and was managed accordingly. CONCLUSION: Olanzapine LAI can induce hemodynamic changes and it becomes critical to monitor BP repeatedly during observation period.