Hypotension Secondary to the Combination of Intramuscular Olanzapine and Intramuscular Lorazepam

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Sir: An intramuscular (IM) formulation of olanzapine was approved by the U.S. Food and Drug Administration (FDA) in March 2004 for the treatment of agitation associated with schizophrenia and bipolar I disorder.1 The package insert for IM olanzapine reports significant incidence of orthostatic hypotension in one third of nonagitated patients with schizophrenia who were treated with the maximum recommended dosage of olanzapine IM (three 10-mg doses administered 4 hours apart).1 Forty-nine adverse events, 29 of which were deemed serious and 8, fatal, were reported in Europe.2

J Clin Psychiatry 2005;66(12):1614-1615