Hyperventilation associated with quetiapine.
OBJECTIVE
To describe a case of hyperventilation associated with the administration of quetiapine.


METHODS
A 69-year-old African-American woman admitted to a psychiatric hospital for treatment of major depression with psychotic features was treated and successfully discharged with quetiapine, along with metronidazole and miconazole to treat bacterial/monilial vaginitis. Three days after discharge, the patient presented to a community hospital with shortness of breath and hyperventilation. The patient was admitted and treated for tachypnea and acute respiratory alkalosis. During this hospitalization, the patient was noted to have increased respiratory rate following the administration of quetiapine.


CONCLUSIONS
Hyperventilation was reported during the clinical trials of quetiapine; however, this is the first published report to date. Serotonin is involved both centrally and peripherally in the regulation of respiration. A contributing factor in this case may have been the concomitant administration of metronidazole, which inhibits the cytochrome P450 enzyme (CYP3A4) also responsible for the metabolism of quetiapine.


CONCLUSIONS
The development of hyperventilation and respiratory alkalosis was associated with the administration of quetiapine.
MEDS Program, Resources for Seniors, Raleigh, NC 27609, USA. pennys@rfsnc.org
P S
PS
Shelton
F L
FL
Barnett
S E
SE
Krick
D000368:Aged; D000472:Alkalosis, Respiratory / Q000097:blood / Q000139:chemically induced; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000994:Antitrichomonal Agents / Q000009:adverse effects; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D003987:Dibenzothiazepines / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000139:chemically induced*; D008795:Metronidazole / Q000009:adverse effects; D000069348:Quetiapine Fumarate
D014150:Antipsychotic Agents; D000994:Antitrichomonal Agents; D003987:Dibenzothiazepines; D008795:Metronidazole; D000069348:Quetiapine Fumarate