Electrocardiographic changes in severe quetiapine poisoning
Fumiya Inoue1,2, Yuji Okazaki1, Toshihisa Ichiba1
1Department of Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima City Hiroshima, Japan.
Introduction:
Quetiapine shares sodium channel-blocking properties with tricyclic antidepressants. We present the electrographic findings in two patients with severe quetiapine poisoning.
Case Summaries:
Two patients poisoned with quetiapine presented with impaired consciousness, requiring mechanical ventilation and vasopressor support, with one also experiencing status epilepticus. Their peak serum quetiapine concentrations were 4.52 mg/L and 25.6 mg/L.
Images:
On admission, electrocardiograms for both patients revealed a tall R wave in lead aVR, deep S wave in lead I, and QRS complex duration of 120 ms. These findings gradually resolved in parallel with the improvement in their symptoms.
Conclusion:
Severe quetiapine poisoning may cause electrographic changes. Further studies are needed to determine the utility of these electrocardiogram findings for predicting the severity of quetiapine poisoning.
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