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Acute Quetiapine Intoxication: Relationship Between Ingested Dose, Serum Concentration and Clinical Presentation-Structured Literature Review and Analysis. | LitMetric

AI Article Synopsis

  • Quetiapine has become a widely used drug in cases of acute intoxication and a literature review was conducted to understand its effects and risks.
  • The study analyzed 134 cases of quetiapine ingestion, revealing a common median dose of 10 g and a peak serum concentration (c) of 4 mg/L, with a longer half-life during acute intoxication compared to therapeutic use.
  • Higher doses and concentrations of quetiapine were linked to more severe clinical symptoms like central nervous system depression and tachycardia, with doses above 3 g or concentrations above 2 mg/L indicating a high risk for severe complications.

Article Abstract

Over the past decade, quetiapine has become one of the most commonly used psychotropic drugs in acute intoxication events worldwide. A structured literature review and analysis were conducted to assess the relationship between the kinetic and dynamic profiles in acute quetiapine intoxication. The correlation between dose and peak serum concentration (c) was determined using Pearson's correlation coefficient. Binary logistic regression was used to evaluate dose and c as predictors of the most common clinical events, signs and symptoms. One hundred and thirty-four cases of acute quetiapine ingestion were included in the analysis, with a median ingested dose of 10 g and a median c of 4 mg/L. The typical half-life was estimated to be 16.5 h, significantly longer than at therapeutic doses. For the immediate-release formulation, a biphasic disposition could not be excluded. Dose and c demonstrated a weak but significant correlation (r = 0.256; N = 63; = 0.043). Central nervous system depression and tachycardia were the most common clinical signs. Higher doses and concentrations increased the risk of severe intoxication and were good predictors of intubation, tachycardia, hypotension, QT prolongation and seizures, but not QRS prolongation, arrhythmia, heart block, hypokalaemia or acidosis. The thresholds for dose and c that increased the risk for individual signs and symptoms varied widely. However, doses > 3 g or c > 2 mg/L can be considered as alert levels that represent a high risk for severe clinical course of acute quetiapine intoxication.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503392PMC
http://dx.doi.org/10.3390/jox14040085DOI Listing

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