Quetiapine use-related ischemic brainstem stroke: a literature review with case report

Previous research suggests a link between atypical antipsychotic use and stroke. In the present paper, we report a case of ischemic pontine stroke that is closely related with the use of a second generation antipsychotic, quetiapine. A 42 year-old male patient -with a diagnosis of bipolar depression- who had been receiving quetiapine 300 mg/day over a period of 2 months, developed ischemic stroke involving pontine part of brainstem. Different pathophysiological pathways may be involved, ranging from the facilitation of thrombosis, reduced peripheral arterial compliance, orthostatic hypotension and a common diathesis for stroke of affective illness. This case report provides valuable support of previously published studies demonstrating that even brief exposure to antipsychotics can trigger stroke. Weighing the potential risks and benefits of antipsychotic treatment is particularly important for providers treating patients with multiple comorbid risk factors for stroke.