Olanzapine (Zyprexa) is one of the novel atypical antipsychotics that act as a serotonin-dopamine receptor antagonist. Its use is increasing in frequency among psychiatrists to treat both the positive and negative symptoms of schizophrenia. It is also becoming a commonly prescribed antipsychotic because of its low association with dystonia and other extrapyramidal side effects. More commonly, sedation, weight gain, and transient, nondose-dependent, symptomatic elevations in liver enzymes are seen with the use of this drug [1,2,3]. This is a case of a patient who had elevation of transaminases, the appearance of dependent pitting edema of both feet, as well as transient elevations of both systolic and diastolic blood pressures following the administration of olanzapine for psychotic symptoms. This patient was also chronically on albuterol and theophylline for bronchial asthma. There was a complete resolution of edema and normalization of transaminase levels when olanzapine was discontinued.
