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Quetiapine poisoning: a case series.

Corrine R Balit1, Geoffrey K Isbister, L Peter Hackett

  • 1New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Sydney, Australia.

Annals of Emergency Medicine
|November 25, 2003
PubMed
Summary
This summary is machine-generated.

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Quetiapine overdose can cause central nervous system depression and sinus tachycardia. Doses under 3g in non-drowsy patients may predict shorter hospital stays, avoiding ICU admission.

Area of Science:

  • Toxicology
  • Pharmacology
  • Emergency Medicine

Background:

  • Quetiapine is an atypical antipsychotic used to treat schizophrenia and bipolar disorder.
  • Overdose cases require understanding of clinical effects and management strategies.

Purpose of the Study:

  • To describe the clinical effects and outcomes of quetiapine overdose.
  • To identify factors predicting the need for intensive care unit (ICU) admission and prolonged hospitalization.

Main Methods:

  • Prospective data collection from a regional toxicology service database.
  • Inclusion of 45 quetiapine poisoning cases, with detailed extraction of ingestion, clinical features, investigations (ECG), and outcomes.
  • Correlation analysis between ingested dose, peak drug concentration, and clinical outcomes.

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Main Results:

  • 18 patients with quetiapine assay results were analyzed.
  • Median length of stay was 35 hours, with 9 patients admitted to the ICU.
  • Seizures, delirium, and need for mechanical ventilation were observed; no deaths or arrhythmias occurred.
  • Ingested dose correlated with peak concentrations, ICU admission, and length of stay.
  • A reported dose <3g and Glasgow Coma Scale score ≥15 predicted shorter stays and no ICU admission.

Conclusions:

  • Quetiapine overdose primarily causes CNS depression and sinus tachycardia.
  • Large overdoses may necessitate intubation and ventilation.
  • Prolonged QTc interval's clinical significance is uncertain due to tachycardia overcorrection.
  • A reported dose <3g in non-drowsy patients without co-ingestion predicts favorable outcomes.