Hypotension Secondary to the Combination of Intramuscular Olanzapine and Intramuscular Lorazepam

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