Cyprus Turkish Journal of Psychiatry & Psychology Vol.7 Issue.4

Doi:10.35365/ctjpp.25.4.13

CASE REPORT / OLGU SUNUMU 

Hyperactive Delirium and Short-Term Quetiapine Treatment: A Pediatric Case

Hiperaktif Deliryum ve Kısa Dönem Ketiapin Tedavisi: Bir Pediatrik Vaka

 

Feride Burcu Taflan1, Melis Elif Elçi2, Miraç Barış Usta3

Abstract:

Pediatric delirium is an acute neuropsychiatric syndrome that differs from adult presentations and is often underrecognized in clinical settings. In children and adolescents, delirium may develop due to various etiological factors such as drug or substance toxicity, infections, autoimmune or neurological disorders, trauma, metabolic abnormalities, or multiorgan failure. Recognition during childhood is challenging because symptoms vary by age, communication may be restricted, and physical illnesses often mask psychiatric findings. This case report aims to examine the effectiveness of quetiapine in the presentation of hyperactive delirium in a 17-year-old male patient after surgical intervention, in which multiple factors played a role. Postoperatively, the patient received midazolam (265 mg/day for 3 days) and morphine (27 mg/day for 1 day). At consultation, ongoing treatments included piperacillin/tazobactam, teicoplanin, terlipressin, morphine, vitamin K1, and intravenous hydration. Laboratory results showed hyponatremia (Na: 130 mmol/L) and elevated C-reactive protein (CRP: 225 mg/L). The initial Delirium Rating Scale score was 23, and quetiapine 25 mg/day was started with the option to increase to 50 mg/day. After treatment initiation and correction of underlying factors, the score decreased to 6 at one-week follow-up, showing marked and significant improvement. This case suggests that short-term, low-dose quetiapine can be an effective, safe, and well-tolerated option for hyperactive delirium associated with hyponatremia, inflammation, and sedative or analgesic exposure. Moreover, it highlights the crucial importance of greater awareness, early recognition, careful assessment of biological and iatrogenic factors, and coordinated multidisciplinary collaboration for effective clinical management in pediatric delirium.

Keywords: Delirium, Quetiapine, Pediatric patients.

1Research Asisst., 19 Mayis University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Türkiye, E-mail: [email protected], Orcid Id: 0009-0004-2790-0970

2Research Asisst, 19 Mayis University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Türkiye E-mail: [email protected], Orcid Id: 0000-0001-8866-6525

3Assoc. Prof. Dr., 19 Mayis University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Türkiye E mail: [email protected], Orcid Id: 0000-0002-1573-3165

Address of Correspondence/Yazışma Adresi: Feride Burcu Taflan, 119 Mayis University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kurupelit Campus 55200 Atakum /Samsun, Türkiye, E-Mail: [email protected]

Date of Received/Geliş Tarihi: 24.11.2024, Date of Revision/Düzeltme Tarihi: 04.11.2025, Date of Acceptance/Kabul Tarihi: 17.11.2025, Date of Online Publication/Çevirimiçi Yayın Tarihi: 15.12.2025

Citing/Referans Gösterimi: Taflan, F. B., Elçi, M. E. & Usta, M. B. (2025). Hyperactive Delirium and Short-Term Quetiapine Treatment: A Pediatric Case. Cyprus Turkish Journal of Psychiatry & Psychology, 7(4), 438-445.

© 2025 The Author(s). Published by Cyprus Mental Health Institute / Cyprus Turkish Journal of Psychiatry and Psychology (www.ktppdergisi.com). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 license which permits use, sharing, adaptation, distribution and reproduction in any medium or format, provided the original work is properly cited and is not used for commercial purposes. https://creativecommons.org/licenses/by-nc-sa/4.0/