Acute Quetiapine Intoxication: Relationship Between Ingested Dose, Serum Concentration and Clinical...

Area of Science:

• Pharmacology
• Clinical Toxicology

Background:

• Quetiapine is frequently used in acute intoxication cases globally.
• Understanding quetiapine's pharmacokinetic and pharmacodynamic profile in overdose is crucial.

Purpose of the Study:

• To analyze the relationship between dose, serum concentration, and clinical outcomes in acute quetiapine intoxication.
• To identify predictive factors for severe clinical events.

Main Methods:

• Structured literature review and analysis of 134 acute quetiapine ingestion cases.
• Pearson's correlation for dose-cmax relationship.
• Logistic regression for predicting clinical events.

Main Results:

• Median ingested dose: 10g; median cmax: 4mg/L; estimated half-life: 16.5h.
• Weak but significant correlation between dose and cmax (r=0.256).
• Higher doses/concentrations predicted CNS depression, tachycardia, hypotension, QT c prolongation, seizures, and intubation.

Conclusions:

• Dose and peak serum concentration are weak predictors but significant for severe outcomes in quetiapine overdose.
• Alert levels: >3g dose or >2mg/L cmax indicate high risk for severe intoxication.
• Specific clinical events like QRS prolongation or arrhythmias were not reliably predicted.