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Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics.
West J Emerg Med. 2017 Feb; 18(2):243-250.WJ

Abstract

INTRODUCTION

Case reports and poison center data have demonstrated that the second-generation antipsychotic quetiapine is being obtained and used for recreational abuse. The purpose of this study was to describe the relative rates of single-substance abuse for different atypical antipsychotics and compare their demographic and clinical features.

METHODS

We conducted a 10-year retrospective analysis of the National Poison Data System (NPDS) database (2003 - 2013). Trained nurses and pharmacists with specialty training in toxicology prospectively collect all NPDS data at poison control centers around the United States. We queried the NPDS for all cases of single-substance second-generation antipsychotic exposures coded as "intentional abuse." The data provided by the NPDS regarding rates and clinical features of quetiapine abuse and the abuse of all other second-generation antipsychotics were compared and described descriptively.

RESULTS

During the study period, 2,118 cases of quetiapine abuse and 1,379 cases of other second-generation antipsychotic abuse were identified. Quetiapine abuse was more common than the abuse of other second-generation antipsychotics, compromising 60.6% of all abuse cases during the study period. After quetiapine, the next most frequently abused medications were risperidone (530 cases, 15.2%) and olanzapine (246 cases, 7.0%). For all second-generation antipsychotics including quetiapine, central nervous system clinical effects were most common, including drowsiness, confusion, and agitation. Other serious clinical effects observed with second-generation antipsychotic abuse included hypotension, respiratory depression, and seizures.

CONCLUSION

Quetiapine abuse is relatively common, and is abused far more often than any other second-generation antipsychotic. Emergency physicians should be aware of the clinical effects that may occur after second-generation antipsychotic abuse.

Authors+Show Affiliations

Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota.Minnesota Poison Control System, Minneapolis, Minnesota.Hennepin County Medical Center, Department of Emergency Medicine, Minneapolis, Minnesota; Minnesota Poison Control System, Minneapolis, Minnesota.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28210359

Citation

Klein, Lauren, et al. "Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics." The Western Journal of Emergency Medicine, vol. 18, no. 2, 2017, pp. 243-250.
Klein L, Bangh S, Cole JB. Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics. West J Emerg Med. 2017;18(2):243-250.
Klein, L., Bangh, S., & Cole, J. B. (2017). Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics. The Western Journal of Emergency Medicine, 18(2), 243-250. https://doi.org/10.5811/westjem.2016.10.32322
Klein L, Bangh S, Cole JB. Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics. West J Emerg Med. 2017;18(2):243-250. PubMed PMID: 28210359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics. AU - Klein,Lauren, AU - Bangh,Stacey, AU - Cole,Jon B, Y1 - 2016/12/06/ PY - 2016/09/05/received PY - 2016/09/30/revised PY - 2016/10/15/accepted PY - 2017/2/18/entrez PY - 2017/2/18/pubmed PY - 2017/12/12/medline SP - 243 EP - 250 JF - The western journal of emergency medicine JO - West J Emerg Med VL - 18 IS - 2 N2 - INTRODUCTION: Case reports and poison center data have demonstrated that the second-generation antipsychotic quetiapine is being obtained and used for recreational abuse. The purpose of this study was to describe the relative rates of single-substance abuse for different atypical antipsychotics and compare their demographic and clinical features. METHODS: We conducted a 10-year retrospective analysis of the National Poison Data System (NPDS) database (2003 - 2013). Trained nurses and pharmacists with specialty training in toxicology prospectively collect all NPDS data at poison control centers around the United States. We queried the NPDS for all cases of single-substance second-generation antipsychotic exposures coded as "intentional abuse." The data provided by the NPDS regarding rates and clinical features of quetiapine abuse and the abuse of all other second-generation antipsychotics were compared and described descriptively. RESULTS: During the study period, 2,118 cases of quetiapine abuse and 1,379 cases of other second-generation antipsychotic abuse were identified. Quetiapine abuse was more common than the abuse of other second-generation antipsychotics, compromising 60.6% of all abuse cases during the study period. After quetiapine, the next most frequently abused medications were risperidone (530 cases, 15.2%) and olanzapine (246 cases, 7.0%). For all second-generation antipsychotics including quetiapine, central nervous system clinical effects were most common, including drowsiness, confusion, and agitation. Other serious clinical effects observed with second-generation antipsychotic abuse included hypotension, respiratory depression, and seizures. CONCLUSION: Quetiapine abuse is relatively common, and is abused far more often than any other second-generation antipsychotic. Emergency physicians should be aware of the clinical effects that may occur after second-generation antipsychotic abuse. SN - 1936-9018 UR - https://www.unboundmedicine.com/medline/citation/28210359/Intentional_Recreational_Abuse_of_Quetiapine_Compared_to_Other_Second_generation_Antipsychotics_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28210359/ DB - PRIME DP - Unbound Medicine ER -