Monica Fui-Chien Yam, Chai-Fung Kiew, Chee-Ping Chong
Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
Abstract
Quetiapine is an atypical antipsychotic agent which is being increasingly prescribed for psychotic disorders because it has fewer side effects than other antipsychotics. Consequently, overdoses of quetiapine have gained attention, given its widespread use. We report a 31-year-old man with schizophrenia who allegedly ingested 4 g of immediate-release quetiapine. He presented with common manifestations of quetiapine overdose such as sinus tachycardia, dry mouth and mucosa, hypotension, and coma. He also had hyperglycemia and late onset seizures (>24 hours post ingestion) which are not frequently reported. The patient was given activated charcoal while hypotension was managed with fluid resuscitation and intravenous noradrenaline. Intravenous diazepam and phenytoin were given for the seizure. The patient recovered without residual complications. Although a quetiapine overdose can result in serious medical complications, it can be managed by early intervention, mainly supportive care and close monitoring.
Keywords
Hyperglycemia; Late-onset seizure; Quetiapine overdose; Quetiapine poisoning
