Guidance on Seroquel Overdose Situation in ICU
Hello doctors, I am seeking some general insights on the type of inquiries we should be making and what to anticipate moving forward. My younger brother, who is 28 years old, was admitted to the emergency department in New Zealand after being discovered at home in a state of severe incapacitation, marked by significant tremors and dangerously low blood pressure. Upon assessment, he reluctantly revealed that he had taken "a considerable amount" of quetiapine in what appears to be a deliberate overdose. However, the specifics regarding the dosage and timing are somewhat ambiguous as he has provided inconsistent details. For context, he began monthly treatment with a long-acting injectable antipsychotic last November to manage his bipolar disorder type 1, following a lengthy manic episode during which he struggled with medication adherence. Consequently, the quetiapine tablets he ingested were remnants from prior prescriptions rather than his current main medication. Recently, he has experienced significant depressive symptoms. He typically goes through severe manic episodes almost annually, with last year's incident likely being his seventh such occurrence. I have been his main source of support throughout this time, though I distanced myself following the last episode where he treated both my mother and me harshly. Additionally, I now reside abroad and am contemplating when to return home. Regarding his current medical situation, based on what my mother has conveyed (which may not be entirely accurate): - He is now in the intensive care unit with concerns related to potential kidney damage; his urine was initially a dark red but has now lightened. - His C-reactive protein level was over 400 but has slightly decreased, while his white blood cell count is on the rise. - They are administering intravenous fluids to aid in his condition, and dialysis is under consideration should kidney function not show signs of recovery. - He is breathing independently, occasionally demonstrates clarity, and can consume food and drink with support, though the tremors continue. - There have been indications of sepsis, though this remains somewhat unclear. - Since I am overseas, my mother is the only one with him, and we are deeply worried about his prognosis. I have a few queries: - In cases of quetiapine overdose, what are the typical complications that necessitate ICU admission? - How significant are the tremors in this scenario, and what factors could affect his chances for a complete recovery? - Under what circumstances does dialysis become a requirement, and is kidney recovery generally anticipated in younger patients? - Are there any warning signs we should be vigilant about? Thank you for your time. I realize the information provided might be insufficient for a comprehensive assessment or reassurance, but any advice would be greatly valued. Initially, there was a misunderstanding at the ED, and they almost sent him home prematurely!
Answers (1)
2/15/2026, 2:30:42 PM
OpenHealth AI
I’m truly sorry to hear about your brother’s situation. It sounds very distressing for both him and your family. Here’s a structured overview addressing your queries about quetiapine overdose and what you can anticipate moving forward.
Key Points:
- ICU Admission Reasons: Quetiapine overdose can lead to serious complications, such as extreme sedation, altered mental status, low blood pressure, respiratory depression, seizures, and potential kidney damage due to muscle breakdown (rhabdomyolysis).
- Tremors and Recovery: Tremors can indicate neurological effects of the overdose or withdrawal-related symptoms, and their persistence can affect recovery; however, their significance will be assessed continuously by the medical team.
- Dialysis Necessity: Dialysis may be needed if kidney function worsens, especially if there are signs of acute kidney injury. Younger patients often have a better prognosis for recovery, but it will depend on the extent of kidney damage.
- Warning Signs: Monitor for further changes in urine color, increasing tremors, changes in mental status, and signs of infection such as fever, which could indicate worsening sepsis.
Detailed Explanation:
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Complications from Quetiapine Overdose: The overdose can lead to multiple organ system involvement, particularly affecting the heart (cardiac arrhythmias), central nervous system (sedation or agitation), and kidneys (dehydration and rhabdomyolysis).
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Tremors and Recovery Factors: The tremors your brother experiences could either be due to the overdose or a reaction to withdrawal from his regular medications. The prognosis will improve with gradual stabilization and monitoring. Recovery often depends on his overall health prior to the incident and how quickly the medical team can manage the symptoms.
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Dialysis Requirements: If his kidneys show signs of damage (e.g., elevated creatinine levels) alongside symptoms indicating metabolic distress, dialysis may be introduced. The timeline for recovery can vary; younger, healthier individuals can often recover function, but monitoring will be crucial.
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Warning Signs to Watch: It is important for your family to stay alert for changes in his condition. Keeping the medical team informed of any sudden changes, such as breathing difficulties, severe agitation, or persistent high fever, is vital.
Next Steps:
- Stay Informed: Ensure your mother has a clear line of communication with the medical team. Encourage her to ask questions about the treatment plan, expected outcomes, and any changes in his condition.
- Support System: Consider arranging regular updates between your mother and yourself or other family members, which can help in coping with this situation.
- Prepare for Next Steps: If you decide to return home, plan to support your mother, allowing her to adjust to the situation better while being present for your brother's recovery.
It’s understandable to feel overwhelmed, but navigating this one step at a time and staying proactive with communication can help manage the uncertainty. If you have other inquiries or need further information, just let me know.
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