However, this dose is markedly above 300 mg/day, a dose that is common in patients with mood disorders. Patients have survived 20-24 g overdoses with quetiapine a dose of 2 g/day, therefore, is not large in comparison. Three weeks later, all liver function tests were normal. Quetiapine was abruptly withdrawn and oxazepam (30 mg nightly) was introduced to manage possible withdrawal symptoms the other medications were continued. Quetiapine levels could not be assessed because the facilities for the assay were unavailable. With the exception of Serum glutamic oxaloacetic transaminase (SGOT) and Serum glutamic pyruvic transaminase (SGPT), which were elevated to a little above twice the laboratory reference range, hematology, liver function, renal function, serum electrolyte, and electrocardiogram (ECG) test results were within normal limits. Cognition for everyday functions was unaffected. Mental status and physical examination findings were within normal limits. He had continued quetiapine 2 g nightly (along with his other medications) for the next 2 months without apparent detriment. He explained that his sleep had been poor after raising the dose of quetiapine, his sleep had normalized in duration and restorative quality. He did not report for follow-up until 3 months later, when it was found that on his own initiative and during the first month after remission, he had gradually increased the dose of quetiapine from 100 mg to 2,000 mg at night. After the first episode of mania, he was treated to remission and then maintained on lithium (800 mg/day), haloperidol (5 mg/day), trihexyphenidyl (4 mg/day), and quetiapine (100 mg at night). is a 30-year-old male with no past history of substance abuse.
Herein, we report a patient who self-administered two and a half times the maximum dose each day for 2 months.Ī. The maximum licensed dose of quetiapine across diagnostic indications is 800 mg/day in mood disorders, however, doses around 300 mg/day are usual.
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