Olanzapine pamoate is marketed in the UK as Zypadhera™. The SPC warns of PIDSS following administration of olanzapine pamoate in approximately 2% of patients with most cases occurring within an hour of injection, therefore patients are recommended to be observed in a healthcare facility by appropriately qualified personnel for at least 3 hours for signs and symptoms consistent with olanzapine overdose. However, in this report the patients died three to four days after receiving an appropriate dose, well after the 3-hour post-injection monitoring period required under the Zyprexa Relprevv Risk Evaluation and Mitigation Strategy (REMS).