title: Acute quetiapine poisoning.
abstract: Quetiapine (Seroquel) is a member of a new class of antipsychotic agents used in the treatment of schizophrenia. Its pharmacologic effect is primarily mediated via antagonistic binding to serotonergic (5HT2) and dopaminergic (D2) receptors. Presented is a case of acute quetiapine overdose in a patient with associated tachycardia, hypotension, prolonged QTc, and rapid progression to coma. Management included activated charcoal, i.v. saline, and intubation for airway protection. The patient's mental status rapidly improved within several hours of the ingestion, and the prolonged QTc and tachycardia resolved by the second and third days of hospitalization, respectively, without further intervention. This case illustrates the potential for hemodynamic instability and sudden deterioration in level of consciousness, warranting close monitoring and early intubation for airway protection. All patients with acute quetiapine overdose requiring hospitalization should be admitted to an intensive care unit setting.
authors.affiliation: Department of Emergency Medicine, The Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: F M
authors.initials: FM
authors.lastname: Hustey
mesh_terms: D000208:Acute Disease; D000328:Adult; D014150:Antipsychotic Agents / Q000506:poisoning*; D002606:Charcoal / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000506:poisoning*; D062787:Drug Overdose / Q000209:etiology / Q000628:therapy; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D015600:Glasgow Coma Scale; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007362:Intensive Care Units; D008297:Male; D000069348:Quetiapine Fumarate; D013610:Tachycardia / Q000139:chemically induced
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D002606:Charcoal; D000069348:Quetiapine Fumarate