824. Urticaria Associated with Polypharmacy Involving Quetiapine and Vortioxetine - A Case Report

Abstract

Abstract Background Advancing brain health together emphasises collaborative, patient-centred psychiatric care, particularly in the context of increasing psychotropic polypharmacy. Although combination therapy may enhance symptom control, it also increases the risk of adverse drug reactions. Cutaneous hypersensitivity reactions such as urticaria are uncommon but clinically significant and may compromise treatment adherence and patient safety. Aims & Objectives To analyse the hypersensitivity reaction due combination of Vortioxetine and Quetiapin Method We report a clinical case of suspected adverse drug reaction following combined vortioxetine and quetiapine therapy. Clinical history, medication timeline, physical findings, laboratory results, and treatment response were reviewed. Causality was assessed using the Naranjo Adverse Drug Reaction Probability Scale. Results A 16-year-old with major depressive disorder was treated with vortioxetine 10 mg daily. Due to persistent insomnia and mood instability, quetiapine 25 mg nightly was added. After having combination therapy, she developed generalised pruritic wheals consistent with acute urticaria, without angioedema or systemic involvement. There was no prior allergy history or recent exposure to new environmental triggers. Laboratory investigations, including complete blood count and liver function tests, were within normal limits. Both medications were discontinued, and topical and oral antihistamines were initiated, resulting in complete resolution within 7 days. Drug rechallenge was declined. The Naranjo scale indicated a probable adverse drug reaction related to polypharmacy. Discussion & Conclusions This case highlights a potential hypersensitivity reaction associated with combined quetiapine and vortioxetine use. Advancing brain health together requires interdisciplinary collaboration, careful medication review, and early recognition of adverse effects to optimise patient safety and therapeutic outcomes.