title: Acute oxcarbazepine and atomoxetine overdose with quetiapine.
abstract: We present a case of acute oxcarbazepine and atomoxetine overdose combined with excess quetiapine in a 19-y-old male. The patient ingested approximately 36 g oxcarbazepine (514 mg/kg), 1.2 g atomoxetine (17 mg/kg), and 9 mg Quetiapine (128 mg/kg). Central nervous system (CNS) depression with initial unresponsiveness developed within 1 h of ingestion, necessitating intubation for airway protection. Despite aggressive therapy with whole bowel irrigation and charcoal administration, the patient's somnolence persisted for 4 d, punctuated by occasional violent outbursts. Prolonged QTc was noted initially, but normalized within 4 d. This case suggests that acute overdose of oxcarbazepine and atomoxetine combined with quetiapine is associated with rapid and prolonged CNS depression.
authors.affiliation: Department of Emergency Medicine, University of Rochester, NY 14642, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Barker
authors.forename: John G
authors.initials: JG
authors.lastname: Benitez
authors.forename: Sharon
authors.initials: S
authors.lastname: Ternullo
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Juhl
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000633:toxicity*; D000069445:Atomoxetine Hydrochloride; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000633:toxicity; D003937:Diagnosis, Differential; D003987:Dibenzothiazepines / Q000633:toxicity*; D062787:Drug Overdose / Q000175:diagnosis; D004638:Emergency Treatment; D006801:Humans; D008297:Male; D000078330:Oxcarbazepine; D011437:Propylamines / Q000633:toxicity; D000069348:Quetiapine Fumarate; D013406:Suicide, Attempted
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D011437:Propylamines; D000069348:Quetiapine Fumarate; D002220:Carbamazepine; D000069445:Atomoxetine Hydrochloride; D000078330:Oxcarbazepine