To explore the diagnostic features of olanzapine-induced tardive dystonia (TDt).

The clinical data of an outpatient with olanzapine-induced TDt on April 11, 2018 at Linyi Municipal Mental Health Center were retrospectively analysed. Literatures of olanzapine-induced TDt were retrieved by PubMed and China National Knowledge Internet databases and reviewed.

The patient had no personal or family history of dystonia, she developed neck stiffness, torticollis, with the neck turning around to the left after 1.5 years of olanzapine treatment. According to medical history, physical examination and accessory examination, secondary dystonia due to other reasons was ruled out. The diagnosis of olanzapine-induced TDt was made. The olanzapine was gradually discontinued, and clozapine was initiated on a daily dose of 25 mg and was titrated to 125 mg daily. Eperisone hydrochloride tablets was given 50 mg three times a day. The psychotic symptoms were stable, but the cervical dystonia was not recovered. Of the 15 cases reported in literatures, there were 8 males and 7 females. Their mean age was (28.13±10.27) years (range 16-51 years). Their mean olanzapine dose was (13.33±5.23)mg daily (range 5-20 mg daily). The onset of TDt occurred 4 hours to 5 years after treatment with olanzapine, 12 cases developed TDt within one year. The dystonia was focal in 7 cases, segmental in 5cases, multifocal in 1case, generalized in 2 cases. After the development of TDt, 14 cases discontinued olanzapine.

Although olanzapine-induced TDt is uncommon, but therapeutic management is usually difficult. Effective measures should be taken to prevent the incidence of olanzapine-induced TDt. Careful assessments are required for tardive dystonia in patients receiving olanzapine, detecting timely and coping with timely.