Surgical Sciences, Anesthesia, Intensive Care Medicine, Blå Stråket 5, Sahlgrenska University Hospital, Gothenburg, Sweden.
Clin Toxicol (Phila). 2012 Apr;50(4):258-61. doi: 10.3109/15563650.2012.665456. Epub 2012 Mar 1.
Quetiapine is a second-generation antipsychotic drug, used mainly in the treatment of psychotic disorders. Overdose is associated with sedation, tachycardia and a prolonged QT-interval on the ECG. Cardiovascular symptoms are uncommon but in severe cases profound cardiovascular depression may occur.
To report a case where extracorporeal circulatory support (ECCS) was used successfully in severe quetiapine overdose.
A 40-year-old woman was admitted to the emergency department (ED) with reduced consciousness apparently due to intoxication. She had a history of schizophrenia and was treated with 900 mg of quetiapine daily. In the ED, she presented with immeasurable low blood pressure, irregular bradycardia, hypothermia and a Glasgow Coma Scale (GCS) of 8. An immunoassay test for tricyclic antidepressive agents (TCA) was positive. Despite resuscitation with intravenous fluids, intensive vasopressor treatment and renal replacement therapy (CRRT) the patient's condition deteriorated. The patient was quickly moved to an intensive care unit where ECCS could be instituted. The patient subsequently recovered after 4 days in the ICU without any residual symptoms. Further laboratory analysis did not confirm the immunoassay finding.
Severe poisoning with quetiapine may imitate tricyclic antidepressant poisoning, and drug screening methods may be falsely positive for TCA. In case of cardiovascular collapse due to quetiapine overdose, ECCS may be life saving.
喹硫平是一种第二代抗精神病药物，主要用于治疗精神障碍。药物过量会导致镇静、心动过速和心电图 QT 间期延长。心血管症状并不常见，但在严重情况下可能会出现严重的心血管抑制。
报告 1 例成功应用体外循环支持（ECCS）治疗严重喹硫平药物过量的病例。
一名 40 岁女性因意识不清而被送入急诊部（ED），据推测是由于中毒。她患有精神分裂症，每天服用 900 毫克喹硫平治疗。在 ED，她表现出无法测量的低血压、不规则心动过缓、低体温和格拉斯哥昏迷量表（GCS）评分为 8 分。三环类抗抑郁药（TCA）的免疫测定呈阳性。尽管通过静脉补液、强化升压治疗和肾脏替代疗法（CRRT）进行复苏，但患者的病情仍在恶化。患者迅速被转移到重症监护病房，以便进行 ECCS。患者在重症监护病房治疗 4 天后康复，没有任何残留症状。进一步的实验室分析并未证实免疫测定结果。
严重的喹硫平中毒可能模仿三环类抗抑郁药中毒，药物筛选方法可能对 TCA 呈假阳性。在喹硫平药物过量导致心血管衰竭的情况下，ECCS 可能是救命的。
