Hunfeld N G M, Westerman E M, Boswijk D J, de Haas J A M, van Putten M J A M, Touw D J
Central Hospital Pharmacy, The Hague, The Netherlands.
Ther Drug Monit. 2006 Apr;28(2):185-9. doi: 10.1097/01.ftd.0000185770.44502.51.
Data on quetiapine overdosage are only sparsely available in the literature. This study provides additional data on the pharmacokinetics and clinical effects of intoxication with this atypical antipsychotic drug. The authors performed a retrospective analysis of all quetiapine intoxications reported to and screened by the toxicological laboratory of the Central Hospital Pharmacy The Hague between January 1999 and December 2003. Cases with known suggested amount of intake and medical outcome were included. From the patient's medical record and from the toxicological laboratory findings, patient demographic characteristics (gender, age), details of quetiapine intoxication (estimated time of ingestion, estimated amount of ingestion, and coingested drugs) and clinical parameters were obtained. Severity of intoxication was graded by the Poisoning Severity Score (PSS). Individual pharmacokinetic parameter values were calculated using a one-compartment open model and a Bayesian fitting procedure. Out of a total of 21 intoxications with quetiapine, 14 fulfilled the inclusion criteria. The ingested dose ranged from 1200 to 18,000 mg. The blood concentration ranged from 1.1 to 8.8 mg/L with a lag time of 1 to 26.2 hours between time of ingestion and blood sampling at the emergency ward. The most frequent findings were somnolence and tachycardia. The PSS was minor in 6 patients (43%), moderate in 5 patients (36%), and severe in 3 patients (21%). Severity of intoxication was not associated with a higher amount of quetiapine intake. The authors found no correlation between the serum concentration of quetiapine and the amount ingested. Elimination t(1/2) was not prolonged. It can be concluded that quetiapine intoxications appear to proceed mildly. Tachycardia and somnolence were the main clinical symptoms in our case series. No fatalities occurred. The severity of clinical symptoms was not associated with either a high serum concentration or the suggested amount ingested of quetiapine.
有关喹硫平过量用药的数据在文献中仅零散可见。本研究提供了关于这种非典型抗精神病药物中毒的药代动力学和临床效应的更多数据。作者对1999年1月至2003年12月期间向海牙中央医院药房毒理学实验室报告并经其筛查的所有喹硫平中毒病例进行了回顾性分析。纳入已知摄入剂量建议和医疗结局的病例。从患者的病历和毒理学实验室检查结果中，获取患者人口统计学特征（性别、年龄）、喹硫平中毒细节（估计摄入时间、估计摄入量和同时摄入的药物）以及临床参数。中毒严重程度通过中毒严重程度评分（PSS）进行分级。使用一室开放模型和贝叶斯拟合程序计算个体药代动力学参数值。在总共21例喹硫平中毒病例中，14例符合纳入标准。摄入剂量范围为1200至18000毫克。血药浓度范围为1.1至8.8毫克/升，摄入时间与急诊病房采血时间之间的延迟时间为1至26.2小时。最常见的表现是嗜睡和心动过速。6例患者（43%）的PSS为轻度，5例患者（36%）为中度，3例患者（21%）为重度。中毒严重程度与喹硫平摄入量较高无关。作者发现喹硫平血清浓度与摄入量之间无相关性。消除半衰期未延长。可以得出结论，喹硫平中毒似乎进展较为轻微。心动过速和嗜睡是我们病例系列中的主要临床症状。未发生死亡病例。临床症状的严重程度与喹硫平的高血清浓度或建议摄入量均无关。
