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OLANZAPINE AND CARBAMAZEPINE TREATMENT OF SCHIZOAFFECTIVE PSYCHOSIS - CASE REPORT

The utilization of atypic antipsychotics is not recommended in treatment of children and adolescents with regard of limited studies in that specific population. Newer studies confirmed favorable effects in certain diagnostic categories such as: autism, pervasive developmental disorder, uncontrolled agression, psychotic reactions etc. It is atypical antipsychotic and symptoms of overdose are: somnolence, mydriasis, blurred vision, respiratory depression, hypotension and extrapyramidal and anticholinergic effects. We displayed a case of self-intoxication with olanzapine in two adolescents, fourteen years old, after ingestion of five 10 mg olanzapine pills at once. Both boys are excellent scholars, with pronounced behavioral disorders and disturbed family dinamics (imprisoned mother because of drug trading, father convicted because of violent behaviour). One boy have stolen tablets from his mother, who is in treatment because of psychotic reaction. Motive for this act was wish for experimentation and proofing, because „they thought it is something for mood rising“. Previously we had a girl in age of twelve, who took mother's pills and have purposely ingested five 10 mg olanzapine pills. Adolescents were hospitalized on Pediatric clinic, and after stabilization of their condition, they were forwarded on psychiatric examination. In boys we recorded somnolence, hypotension, respiratory depression, sedation. Although the usual dose range for olanzapine is 5-15 mg/d, there are no standard reference values with respect to the expected concentration of olanzapine after therapeutic administration. In clinical studies, steady state concentration of olanzapine is complicated by tissue redistribution after death, which leads to higher concentration in postmortem blood samples. Olanzapine overdoses in children are generally associated with more significant adverse effects. Children therefore, require more active intervention than adults. It is very important carefully and directionally prescribe antipsychotics, and educating and warning parents about importance of controlling and storing the medications. Children and adolescents are very sensitive population, often influenced by society and surrounding, without sense for risk of uncritical taking of medicatons for adults. It is important to take into consideration family dinamics, as well as social component in preveting this unwished events.