Acute quetiapine overdose is associated with risk of ectopic atrial rhythm

Abstract

Quetiapine overdose is commonly associated with coma, respiratory depression, hypotension, tachycardia, and QTc interval prolongation on the electrocardiogram. Although the arrhythmogenic effect of antipsychotics on ventricular arrhythmia has been established, their role in atrial arrhythmias is still not quite understood, specifically the ones caused by an ectopic atrial rhythm (EAR). We aim to present a case and review on the association between quetiapine and EAR. Data were obtained from clinical records and bibliographic research on PubMed. We present the case of a 57-year-old woman brought to the emergency room after a quetiapine overdose with a newly diagnosed EAR that reverted hours later. This association may be due to quetiapine’s increased risk of cardiac muscarinic receptors blockade that can lead to conduction abnormalities. Because of the possibility of degeneration to other more serious rhythm alterations, pacemaker implementation and increased mortality, there is a need for greater awareness of this correlation.