quetiapine-fumarate and Pancreatitis

Pancreatitis is a very rare adverse effect of quetiapine treatment, with only 5 cases of quetiapine-associated pancreatitis reported in the English literature to date. Herein, we report one patient who developed severe hypertriglyceridemia (>1000 mg/dL) after quetiapine administration, resulting in acute pancreatitis. An analysis of the underlying pathogenic mechanisms and a review of relevant literature are also presented. Clinicians should be aware of the potentially life-threatening metabolic disturbances and/or pancreatitis associated with quetiapine therapy.

Topics: Acute Disease; Bipolar Disorder; Dibenzothiazepines; Humans; Hypertriglyceridemia; Pancreatitis; Quetiapine Fumarate

Topics: Acute Disease; Antipsychotic Agents; Drug Synergism; Humans; Pancreatitis; Quetiapine Fumarate

Topics: Antipsychotic Agents; Bipolar Disorder; Child; Female; Humans; Pancreatitis; Quetiapine Fumarate

Second-generation antipsychotics have well-known metabolic side effects such as hyperlipidaemia and hyperglycaemia. A middle-aged man presented with epigastric and flank pain associated with nausea, and was noted to have elevated triglycerides (3590 mg/dL or 40.53 mmol/L), lipase and glucose. Haematological parameters revealed neutropenia with pancytopaenia. The patient was started on conservative management for acute pancreatitis, and on intravenous insulin and oral gemfibrozil for lowering of his triglycerides. He gradually improved and was transitioned to oral atorvastatin and fenofibrate. His triglycerides, glucose and leucocyte counts normalised at discharge and he was transitioned to ziprasidone. The combination of hypertriglyceridaemia, worsening hyperglycaemia and neutropenia made us suspect quetiapine as the causative agent. Medications cause only 0.1-7% of acute pancreatitis cases, with quetiapine implicated in only five-reported cases. Hypertriglyceridaemia (>600 mg/dL or 6.77 mmol/L) is frequently reported with quetiapine use, but severe hypertriglyceridaemia (>1000 mg/dL or 11.29 mmol/L) has been reported in <10 patients.

Topics: Acute Disease; Antipsychotic Agents; Bipolar Disorder; Humans; Hypertriglyceridemia; Male; Middle Aged; Pancreatitis; Quetiapine Fumarate; Treatment Outcome

Topics: Acute Disease; Antipsychotic Agents; Dibenzothiazepines; Dose-Response Relationship, Drug; Humans; Male; Middle Aged; Pancreatitis; Quetiapine Fumarate; Schizophrenia; Time Factors

We report a case of fatal acute pancreatitis caused by severe hypertriglyceridaemia in a 27-year-old male who was treated with quetiapine. The blood samples were milk-like with markedly elevated triglycerides (> 55 mmol/l). Computer tomography revealed a severe pancreatitis without bile stones or cholestasis. In spite of treatment the patient's condition rapidly worsened and he died 48 hours after admission. We discuss the option of treating hypertriglyceridaemia-induced pancreatitis with apheresis.

Topics: Adult; Antipsychotic Agents; Fatal Outcome; Humans; Hypertriglyceridemia; Male; Pancreatitis; Quetiapine Fumarate; Tomography, X-Ray Computed

Topics: Adult; Dibenzothiazepines; Female; Humans; Middle Aged; Pancreatitis; Quetiapine Fumarate