The Role of Low-Dose Quetiapine in the Treatment of Somatic Symptom Disorder: A Case Report

Somatic symptom disorder (SSD) involves physical symptoms like palpitations, pain, weakness, dizziness, and pseudo-neurological symptoms. These symptoms are accompanied by excessive thoughts, emotions, and behaviors related to the symptom, causing significant distress and impairment lasting at least six months. They may not be explained by any underlying medical conditions. SSD can be resistant to standard treatment modalities like Cognitive Behavioral Therapy (CBT), Selective Serotonin Reuptake Inhibitors (SSRIs), and Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs). Antipsychotics, in particular second generations, have also been used to treat SSD but not as frequently. This case report shows the improvement in symptomatology of SSD after low-dose quetiapine was used for its management. This case is a 41-year-old Hispanic male with a diagnosis of SSD who presented to the outpatient clinic for severe somatic symptoms. The use of low-dose second-generation antipsychotic (SGA), in particular quetiapine, to successfully improve symptoms and patient functionality after just four weeks on quetiapine as the patient and wife both reported significant normalization of intrusive thoughts and health-related behaviors. To the best of our knowledge, this is the first case demonstrating symptom improvement in SSD following the addition of low-dose quetiapine to SNRI treatment.