Olanzapine zuclopenthixol

A 73-year-old woman with diabetes mellitus and schizophrenia was given haloperidol 8 mg/day instead of zuclopenthixol she also took levomepromazine 75 mg at night 10 days later she was found unconscious with a rectal temperature of 31.5° C (546). A few weeks later, she had two further episodes, first with olanzapine 10 mg/day (rectal temperature 31.7° C) and then with thioridazine 40 mg/day (rectal temperature 34° C). She was therefore given dixyrazine 150 mg/day and alimemazine 20 mg at night, and had no more episodes of hypothermia. 

ANTIPSYCHOTICS-CHLORPROMAZINE, CLOZAPINE, HALOPERI-DOL, OLANZAPINE, PERPHENAZINE, RISPERIDONE, SERTINDOLE, THIORIDAZINE, ZUCLOPENTHIXOL H2 RECEPTOR BLOCKERS -CIMETIDINE t plasma concentrations of these antipsychotics, with risk of associated adverse effects Cimetidine is an inhibitor of CYP3A4 (sertindole, haloperidol, risperidone), CYP2D6 (chlorpromazine, risperidone, zudopenthixol, thioridazine, perphenazine) and CYP1A2 (clozapine, olanzapine, sertindole, haloperidol) Avoid concomitant use. Choose an alternative acid suppression, e.g. H2 antagonist... 

A literature review identified FGAs (amisulpride, flupenthixol, haloperidol, pimozide, promazine, levoproma-zine, sulpiride, prochorperazine, thioridazine, thioxanthenes, zuclopenthixol) and SGAs at higher dose (aripiprazole, olanzapine, risperidone) as high risk of inducing Parkinsonism [43. Ziprasidone was identified as intermediate risk. 

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