Hands down it's EEEEE EEE EEEE by Tao Lin
Great book, but slightly crazy.

http://i41.tinypic.com/2u6foud.jpg

A few passages from the book:
"He is embarrassed for the pizza box. He folds it. ‘Shit-eating grin.’ He needs to stop. He needs to use his face to convey emotions to other humans in order to move sincerely through life - laughing in groups of three or four; expressing gratitude, concern, or disapproval about people, the weather, or food; and manipulating members of either sex to get them to love him, like him, or respect him. That is what a face is for."

"She never thinks about Andrew; hasn’t ever e-mailed or called. Andrew never e-mails or calls either, really, just has imaginary conversations with her almost constantly; his idea of her. Maybe he will e-mail her tonight. She will respond with a form letter. We thank you for your submission but are unable to see your work at this time."

http://www.readysteadybook.com/BookReview.aspx?isbn=1933633255
http://www.amazon.com/exec/obidos/ASIN/1933633255/artandlies-20
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Someone Comes To Town, Someone Leaves Town by Cory Doctorow is one crazy weird book. I enjoyed it but its not for everyone.

"Unbeknownst to most of the other characters, Alan and his brothers are not quite human. Their father is a mountain and their mother is a washing machine. Alan's eldest brother can see the future, his second-eldest is an island, his third-eldest is undead, and his three youngest brothers are a set of Russian nesting dolls. Alan is the most normal-seeming of his family. Outwardly, he looks human, but he heals at an incredible rate, and if part of him is cut off, it will grow back, and the cut off part will begin to form a new copy of him, much like an earthworm does." http://media.scifi.com/sfw/issue422/someonecomestotown.jpg
Source(s):
http://www.amazon.com/Someone-Comes-Town-Leaves/dp/0765312808/ref=sr_1_1?ie...
http://en.wikipedia.org/wiki/Someone_Comes_to_Town,_Someone_Leaves_Town

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House of Leaves by Mark Danielewski - the entire book is written and printed in the weirdest fashion - some pages mirror each other, some have only one word, some pages have one word over and over and over, some pages read literally in a spiral, some pages are just written in the spine of the book, some pages are printed in an X pattern...
It's a little hard to read, but tells a very paranoid story at the same time. You feel like you're reading something a serial killer might write...
It's very disconcerting, but somehow devilishly enjoyable.
Source(s):
http://en.wikipedia.org/wiki/House_of_Leaves_(novel)

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The Box Man by Kōbō Abe

http://www.iblist.com/book25195.htm

it's got everything you want for a weird book. nurses and onanism.

first runner up:
The Wasp Factory was the first novel by Scottish writer Iain Banks. It was published in 1984.

http://en.wikipedia.org/wiki/The_Wasp_Factory
if you want to read the book, read it ... not the wiki page that has a huge spoiler.

second runner up:
Bedlam Burning by Geoff Nicholson
http://www.amazon.com/Bedlam-Burning-Geoff-Nicholson/dp/1585674532

a writer joins the staff of an asylum, but his past catches up with him.
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