Rhabdomyolysis Secondary to Quetiapine and Olanzapine Intoxication

Introduction: Rhabdomyolysis is a rare and potentially serious adverse drug reaction to antipsychotic medicines. We present a case that developed rhabdomyolysis following the intake of 200 mg olanzapine and 6 gr quetiapine for a suicide attempt. Case Report: A 49-year-old male patient was submitted to the emergency department with complaint of taking an excessive amount of olanzapine (10 mg) and quetiapine (300 mg) in order to commit suicide. As to the laboratory analysis, Creatine Kinase (CK): 7761 U/L, Creatine Kinase Myocardial Band (CKMB): 178 U/L, pH 7.44, HCO3 : 22.9 mmol/L, lactate: 0.50 mmol/L, and the urine myoglobin test was positive. The other parameters were within the normal limits. The patient had been using the medicines for 2 years and has not been come across that high level for enzymes which had not previously been detected. On the second day, the results were CK: 4008 U/L and CKMB: 100 U/L; on the third day, CK: 1924 U/L and CKMB: 86 U/L; and on the fourth day, CK: 1510 U/L and CKMB: 80 U/L. During hospitalization, no renal function disorder or metabolic acidosis occurred. On the fifth day, the patient was discharged. Conclusion: After taking an excessive amount of atypical antipsychotic drugs, patients should necessarily be followed for the risk of developing of rhabdomyolysis.