Valproate and high dosage of zotepine induced acute delirium: a case report

Zotepine, one of the second generation antipsychotics, is widely used in the treatment of schizophrenia and bipolar disorder in Asia and Europe. Within the dosage range of 50–450 mg, a significant reduction of positive as well as negative symptoms was noted in patients with schizophrenia. Delirium is characterized by an alteration of consciousness with reduced ability to focus, sustain and shift attention. It is associated with increased morbidity and mortality, persistent functional and cognitive decline, a longer hospital stay, higher rates of nursing home placement and increased healthcare costs. Antipsychotics are used for delirium management. There are several case reports on second generation antipsychotic-induced delirium, but no related report on zotepine-induced delirium. Herein, we present the case of a male patient who developed delirium after a high-dosage prescription of zotepine.