title: Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics.
abstract: BACKGROUND
  Case reports and poison center data have demonstrated that the second-generation antipsychotic quetiapine is being obtained and used for recreational abuse. The purpose of this study was to describe the relative rates of single-substance abuse for different atypical antipsychotics and compare their demographic and clinical features.
  
  
  METHODS
  We conducted a 10-year retrospective analysis of the National Poison Data System (NPDS) database (2003 - 2013). Trained nurses and pharmacists with specialty training in toxicology prospectively collect all NPDS data at poison control centers around the United States. We queried the NPDS for all cases of single-substance second-generation antipsychotic exposures coded as "intentional abuse." The data provided by the NPDS regarding rates and clinical features of quetiapine abuse and the abuse of all other second-generation antipsychotics were compared and described descriptively.
  
  
  RESULTS
  During the study period, 2,118 cases of quetiapine abuse and 1,379 cases of other second-generation antipsychotic abuse were identified. Quetiapine abuse was more common than the abuse of other second-generation antipsychotics, compromising 60.6% of all abuse cases during the study period. After quetiapine, the next most frequently abused medications were risperidone (530 cases, 15.2%) and olanzapine (246 cases, 7.0%). For all second-generation antipsychotics including quetiapine, central nervous system clinical effects were most common, including drowsiness, confusion, and agitation. Other serious clinical effects observed with second-generation antipsychotic abuse included hypotension, respiratory depression, and seizures.
  
  
  CONCLUSIONS
  Quetiapine abuse is relatively common, and is abused far more often than any other second-generation antipsychotic. Emergency physicians should be aware of the clinical effects that may occur after second-generation antipsychotic abuse.
authors.affiliation: Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota.
authors.forename: Lauren
authors.initials: L
authors.lastname: Klein
authors.affiliation: Minnesota Poison Control System, Minneapolis, Minnesota.
authors.forename: Stacey
authors.initials: S
authors.lastname: Bangh
authors.affiliation: Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota; Minnesota Poison Control System, Minneapolis, Minnesota.
authors.forename: Jon B
authors.initials: JB
authors.lastname: Cole
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001007:Anxiety / Q000188:drug therapy* / Q000523:psychology; D004636:Emergency Service, Hospital; D055416:Evidence-Based Emergency Medicine; D005260:Female; D006801:Humans; D008297:Male; D011039:Poison Control Centers; D017410:Practice Guidelines as Topic; D063487:Prescription Drug Misuse / Q000009:adverse effects*; D000069348:Quetiapine Fumarate / Q000009:adverse effects*; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D000069348:Quetiapine Fumarate