• Lisa J Rosenthal, Victor Kim, and Deborah R Kim.
• University of Pennsylvania Department of Psychiatry, Philadelphia, PA, USA. lisa.rosenthal@uphs.upenn.edu
• Crit. Care Med. 2007 Oct 1; 35 (10): 2417-9.

ObjectiveTo report the use of a second-generation antipsychotic agent to assist weaning from prolonged mechanical ventilation in an anxious patient.DesignCase report.SettingMedical intensive care unit at the Hospital of the University of Pennsylvania.PatientA 39-yr-old white female whose severe anxiety prohibited weaning from prolonged mechanical ventilation.InterventionsInitiation of quetiapine as treatment for severe anxiety that was unresponsive to sedative hypnotics.Measurements And Main ResultsOnce a therapeutic dose of quetiapine was reached, ventilator support was removed within 24 hrs.ConclusionsA 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.(C) 2007 Lippincott Williams & Wilkins, Inc.

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