Abstract
BackgroundAlthough the benefits of antipsychotic pharmacotherapy can be pronounced, many patients develop unwanted adverse effects including a variety of movement disorders. Compared with the traditional antipsychotics, the atypical antipsychotics have a decreased risk for associated movement disorders. Drug-induced movement disorders can occur, however, and the risk of adverse events can increase significantly when medications are abused.Case presentationWe describe the case of a 13-year-old male who presented to an emergency department with acute movement disorders after nasal insufflation of crushed quetiapine. The patient was admitted and successfully treated for neuroleptic toxicity with intravenous antihistamine pharmacotherapy. His primary care provider and psychiatrist were notified of the abuse, quetiapine was discontinued, and the patient was discharged and referred to a drug and alcohol awareness and abuse program.ConclusionsThe abuse of quetiapine has unfortunately become more common. This unique case report of acute movement disorders following nasal insufflation of quetiapine highlights the need for heightened vigilance when prescribing quetiapine and for increased awareness and education regarding medication-abuse.
Highlights
The benefits of antipsychotic pharmacotherapy can be pronounced, many patients develop unwanted adverse effects including a variety of movement disorders
This sudden substantial exposure is likely responsible for the acute episodes of dyskinesia, myoclonus and akathisa described in this case
We report a case of acute movement disorders in an adolescent that likely resulted from quetiapine abuse
Summary
We report a case of acute movement disorders in an adolescent that likely resulted from quetiapine abuse (nasal insufflation of crushed tablets). Quetiapine tablets can be crushed into powder, and many abusers will either insufflate the powder or will solubilize the powder and inject it intravenously. Consent Written informed consent was obtained from the patient’s legal guardian and from the patient for publication of this case report. Authors’ contributions MG, MH, AC, and SS were responsible for the medical care of the patient and assisted in the literature review and drafting of the Case Report. LK and JPK were responsible for the literature review and drafting of the Case Report.
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