Quetiapine-Induced Acute Pancreatitis in a 78-Year-Old Woman

Quetiapine-induced pancreatitis is a rare but serious adverse effect of second-generation antipsychotics, often linked to metabolic derangements such as hypertriglyceridemia and diabetic ketoacidosis. We report a 78-year-old woman found unresponsive at home, with a history of nausea and vomiting in the preceding days. Laboratory evaluation revealed significantly elevated lipase and liver enzymes, and imaging confirmed acute pancreatitis. She had experienced multiple prior episodes of pancreatitis during long-term quetiapine therapy. Common causes, including alcohol use, gallstones, hypertriglyceridemia, hypercalcemia, and autoimmune disease, were rigorously excluded. Medication review revealed long-term quetiapine use. Quetiapine was discontinued during hospitalization, leading to rapid clinical improvement, and no other medications or risk factors were implicated. The temporal relationship between quetiapine use and symptom onset, along with resolution upon drug withdrawal, suggests probable quetiapine-induced pancreatitis. The recurrence during prolonged therapy highlights the potential for cumulative or direct drug toxicity, independent of metabolic derangements, and underscores the importance of monitoring for adverse effects in high-risk populations. Clinicians should be aware that quetiapine can rarely cause recurrent acute pancreatitis, possibly via direct toxicity, and maintain vigilance in elderly patients or those on long-term therapy.