Volume 45, Issue 2 (March 2000)

    Olanzapine Concentrations in Clinical Serum and Postmortem Blood Specimens—When Does Therapeutic Become Toxic?

    (Received 23 April 1999; accepted 2 July 1999)

    CODEN: JFSOAD

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    Abstract

    The concentration of olanzapine (Zyprexa®) was determined in 1653 clinical serum specimens during routine drug monitoring, and in 58 postmortem whole blood specimens as part of routine toxicological analysis. The analysis of olanzapine was performed by the solid-phase extraction of 1.0 mL of buffered serum or blood, followed by gas chromatography separation with nitrogen-phosphorus detection. The analysis of the clinical serum samples showed that 86% of positive serum values were within the range of 5 to 75 ng/mL, with a mean and median of 36 and 26 ng/mL, respectively. These data suggest that the concentrations of olanzapine expected during therapy may be higher than those previously reported. In 58 postmortem whole blood specimens the mean olanzapine concentration was 358 ng/mL with a range of 10 to 5200 ng/mL. Further, investigation of deaths involving olanzapine suggest that potential toxicity should be considered at concentrations above 100 ng/mL. Although the majority of the olanzapine-related deaths were associated with many other drugs, death primarily due to olanzapine toxicity was determined at concentrations in postmortem blood as low as 160 ng/mL.


    Author Information:

    Robertson, MD
    Forensic toxicologist and director of clinical toxicology, National Medical Services, Inc., Willow Grove, PA

    McMullin, MM
    Forensic toxicologist and director of clinical toxicology, National Medical Services, Inc., Willow Grove, PA


    Stock #: JFS14697J

    ISSN: 0022-1198

    DOI: 10.1520/JFS14697J

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    Author
    Title Olanzapine Concentrations in Clinical Serum and Postmortem Blood Specimens—When Does Therapeutic Become Toxic?
    Symposium , 0000-00-00
    Committee E30