Valproate and quetiapine overdose with benign outcome: A case report

We describe a case of intoxication with 16 000 mg of valproate (VPA) and 20 000 mg of quetiapine (QUE). This is the first case of mixed intoxication with QUE and VPA. The ingested dose of QUE is the highest reported in the literature. The overdose induced coma and prolonged tachycardia. However, QT did not change significantly and blood pressure remained stable. The outcome was benign. Three days after the overdose, the patient's medical status improved significantly. Despite the overdosage of QUE (25 times the recommended maximum daily dosage and 100 times the patient's previous daily dosage), only mild tremor and minimal akinesia were present, whereas akathisia, rigidity and dystonia were absent. In accordance with previous reports on QUE overdosage, this case shows that intoxication with high doses of QUE rapidly induces severe deterioration in level of consciousness requiring transfer to an intensive care unit. (Int J Psych Clin Pract 2002; 6: 173-174 ).