Citation

Rhyee SH, Pedapati EV, Thompson J. Pediatr. Emerg. Care 2010; 26(10): 754-756.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0b013e3181f39d5b

PMID

20930599

Abstract

Quetiapine is an atypical antipsychotic agent increasingly used to treat schizophrenia and bipolar disorder in pediatric patients. Few published data exist concerning quetiapine's effects in therapeutic settings or short-term overdose in pediatric and adolescent populations. In this report, we describe a 15-year-old adolescent girl who experienced continued delirium 5 days after an overdose of quetiapine, trazodone, and clonidine. The patient initially presented with sedation and stable vital signs. After 3 days of gradual improvement, she experienced episodes of delirium coinciding with an increase in resting heart rate. On the basis of suspicion for quetiapine-associated antimuscarinic effects, the patient was administered intravenously with physostigmine on the fifth day after ingestion. Treatment resulted in a brief resolution of symptoms. Serum quetiapine levels measured 1 day and 5 days after ingestion were 3400 and 4800 ng/mL, respectively. The use of physostigmine and interpretation of serum levels are discussed further.

Language: en

Keywords

Humans; Female; Adolescent; Depression; Time Factors; Drug Interactions; Self-Injurious Behavior; Suicide, Attempted; Emergencies; Delirium; Hypotension; Antipsychotic Agents; Dibenzothiazepines; Cytochrome P-450 CYP3A; Trazodone; Clonidine; Physostigmine; Tachycardia; Quetiapine Fumarate; Cholinergic Antagonists; Heart Block