Quetiapine (Seroquel) discontinuation syndrome.

[Argirios Argiriou]

The American journal of psychiatry.

2005, vol. 162, no5, pp. 1020-1020

KIM Deborah R. ; STAAB Jeffrey P.


Abstract

Ms. A, a 36-year-old woman with rapid-cycling bipolar II disorder and premenstrual mood exacerbation, was treated as an outpatient with lamotrigine, 400 mg at bedtime, and clonazepam, 0.5 mg t.i.d. Quetiapine, 100 mg at bedtime, was added for residual symptoms. Although the treatment was efficacious, Ms. A gained 20 lb in 6 months and asked to stop the medication. She was advised to decrease her quetiapine to 50 mg at bedtime. After 1 day, she reported nausea, dizziness, headache, and anxiety severe enough to preclude her normal daily activities. She was instructed to take quetiapine, 75 mg the next night, but her intolerable symptoms continued. They resolved when she returned to a dose of 100 mg at bedtime. A slower quetiapine taper of 12.5 mg every 5 days with the antiemetic ondansetron also failed. On a third attempt, prochlorperazine successfully reduced her discontinuation symptoms, although moderate nausea persisted for 2 days after the taper was completed. No other medications were changed, so quetiapine withdrawal was the most likely explanation for Ms. A's symptoms.

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