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Psychiatric Bulletin (2001) 25: 33. doi: 10.1192/pb.25.1.33
© 2001 The Royal College of Psychiatrists
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Psychiatric Bulletin (2001) 25: 33
© 2001 The Royal College of Psychiatrists

Correspondence

Urinary detection of olanzapine

Andrew Sander, Lecturer in Social and Community Psychiatry

Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Gower Street Campus, Wolfson Building, 45 Riding House Street, London W1N 8AA

Sir: Coates (Psychiatric Bulletin, August 2000, 24, 316) recently reported the value of urine testing to provide objective evidence of non-adherence with olanzapine by a patient appearing before a mental health review tribunal. While this test has its value in the entirely non-adherent patient, the method may have its limitations with the more canny patient wishing to mislead the tribunal. The half-life of olanzapine is 32.4 hours (Coates, 1999), which results in olanzapine being detectable in urine for about 6 days after ingestion. In the absence of quantitative testing patients can take olanzapine on an infrequent basis and still appear adherent. A serious concern is that patients might choose to mislead tribunals about their adherence by providing the evidence of positive tests for the presence of olanzapine in their urine by taking olanzapine on an infrequent non-therapeutic basis, in order to help effect their discharge.

References

COATES, J. W. (1999) Urinary detection of olanzapine — an aid to compliance. British Journal of Psychiatry, 175, 591-592.





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