Key result
Severe quetiapine poisoning presents with reversible ECG changes including tall aVR R waves and prolonged QRS.
Why the study?
Quetiapine shares sodium channel-blocking properties with tricyclic antidepressants, prompting the presentation of electrographic findings in severe quetiapine poisoning.
What are the electrocardiographic findings associated with severe quetiapine poisoning?
Case Report (n=2)
What are the electrocardiographic findings associated with severe quetiapine poisoning?
Severe quetiapine poisoning can cause specific electrocardiographic changes, including a tall R wave in aVR, deep S wave in lead I, and prolonged QRS duration, similar to tricyclic antidepressant toxicity.
Recognize quetiapine overdose ECG changes mimicking TCA toxicity; case report leaves open generalizability and management implications.
INTRODUCTION: Quetiapine shares sodium channel-blocking properties with tricyclic antidepressants. We present the electrographic findings in two patients with severe quetiapine poisoning. CASE SUMMARIES: Two patients poisoned with quetiapine presented with impaired consciousness, requiring mechanical ventilation and vasopressor support, with one also experiencing status epilepticus. Their peak serum quetiapine concentrations were 4.52 mg/L and 25.6 mg/L. IMAGES: On admission, electrocardiograms for both patients revealed a tall R wave in lead aVR, deep S wave in lead I, and QRS complex duration of 120 ms. These findings gradually resolved in parallel with the improvement in their symptoms. CONCLUSION: Severe quetiapine poisoning may cause electrographic changes. Further studies are needed to determine the utility of these electrocardiogram findings for predicting the severity of quetiapine poisoning.
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Inoue et al. (2024) conducted a case report in Severe quetiapine poisoning (n=2). Severe quetiapine poisoning was evaluated on Electrocardiographic changes. Severe quetiapine poisoning caused electrocardiographic changes, including a tall R wave in lead aVR, deep S wave in lead I, and QRS duration of 120 ms, which resolved with symptom improvement.
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