title: Weaning from prolonged mechanical ventilation using an antipsychotic agent in a patient with acute stress disorder.
abstract: OBJECTIVE
  To report the use of a second-generation antipsychotic agent to assist weaning from prolonged mechanical ventilation in an anxious patient.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Medical intensive care unit at the Hospital of the University of Pennsylvania.
  
  
  METHODS
  A 39-yr-old white female whose severe anxiety prohibited weaning from prolonged mechanical ventilation.
  
  
  METHODS
  Initiation of quetiapine as treatment for severe anxiety that was unresponsive to sedative hypnotics.
  
  
  RESULTS
  Once a therapeutic dose of quetiapine was reached, ventilator support was removed within 24 hrs.
  
  
  CONCLUSIONS
  A second-generation antipsychotic agent was successfully used to facilitate weaning in a very anxious patient, possibly secondary to anxiolysis or direct effect on respiratory drive. Further investigations of pharmacologic intervention should be done to inform practice guidelines in difficult-to-wean patients suffering from severe anxiety.
authors.affiliation: University of Pennsylvania Department of Psychiatry, Philadelphia, PA, USA. lisa.rosenthal@uphs.upenn.edu
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Rosenthal
authors.forename: Victor
authors.initials: V
authors.lastname: Kim
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Kim
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000069348:Quetiapine Fumarate; D015300:Ventilator Weaning
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate