Management of Olanzapine Overdose

Specific Interventions

Benzodiazepines, such as lorazepam 0.5-2 mg IV every 6 hours, may be used to manage agitation and delirium in patients with olanzapine-induced anticholinergic toxicity, as recommended by the National Comprehensive Cancer Network 1
Avoid dopamine antagonists, such as metoclopramide, phenothiazines, and haloperidol, to prevent excessive dopamine blockade in patients with olanzapine overdose, as suggested by the National Comprehensive Cancer Network 2

For patients taking therapeutic doses of olanzapine who experience breakthrough nausea/vomiting, consider alternative antiemetics such as 5-HT3 antagonists, benzodiazepines, or dexamethasone, as recommended by the National Comprehensive Cancer Network 1
Avoid other dopamine antagonists when possible to prevent excessive dopamine blockade in patients with olanzapine-induced nausea/vomiting, as suggested by the National Comprehensive Cancer Network 2