SPECIAL ISSUE ON NOVEL PSYCHOACTIVE SUBSTANCES Olanzapine as the ideal “trip terminator”? Analysis of online reports relating to antipsychotics’ use and misuse following occurrence of novel psychoactive substance-related psychotic symptoms

Objective The pharmacological self-management of novel psychoactive substance (NPS)-induced psychopathological consequences represents a fast growing phenomenon. This is facilitated by the frequent sharing of NPS intake experiences online and by the ease of access to a range of psychotropic medications from both the online and street market. Olanzapine is anecdotally reported by Web users to be the most frequent selfprescribed medication to cope with NPS-induced psychoses. Hence, we aimed here at better assessing olanzapine use/misuse for this purpose. Methods Exploratory qualitative searches of 163 discussion fora/specialized websites have been carried out in four languages (English, German, Spanish, and Italian) in the time frame November 2012–2013. Results Most NPS-users allegedly self administer with olanzapine to manage related psychotic crises/“bad trips”. This may be typically taken only for a few days, at a dosage range of 5–50mg/day. Conclusions Only a few research studies have formally assessed the effectiveness of olanzapine and indeed of other second-generation antipsychotics to treat NPS-induced psychosis. Olanzapine was suggested here from a range of pro drug websites as being the “ideal”molecule to terminate “bad trips”. Health professionals should be informed about the risks related to olanzapine misuse. Copyright © 2015 John Wiley & Sons, Ltd.