Gastric pharmacobezoars in quetiapine extended-release overdose: a case series

Rauber-Lüthy, Christine; Hofer, Katharina E; Bodmer, Michael; Kullak-Ublick, Gerd A; Kupferschmidt, Hugo; Ceschi, Alessandro (2013). Gastric pharmacobezoars in quetiapine extended-release overdose: a case series. Clinical toxicology, 51(10), pp. 937-940. Taylor & Francis 10.3109/15563650.2013.856442

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OBJECTIVE Although extended-release (XR) formulations are recognized to bear some risk of pharmacobezoar formation in overdose, there are no previously documented reports of this phenomenon with quetiapine. We describe nine cases of pharmacobezoar formation in acute quetiapine XR overdose. METHODS Observational case series of all patients who underwent gastroscopy after quetiapine XR overdose, which were reported by physicians to the Swiss Toxicological Information Centre between January 2010 and December 2012, with detailed analysis of cases with documented pharmacobezoar. RESULTS Gastric pharmacobezoars were detected in 9 out of 19 gastroscopic evaluations performed during the study period. All these patients ingested a large dose of quetiapine XR (10-61 tablets; 6-24.4 g quetiapine). All patients but one also coingested at least one other substance, and in three cases another XR drug formulation. Gastroscopic pharmacobezoar removal was achieved without complications in all patients, but was difficult due to the particular "gelatinous-sticky-pasty" consistency of the concretion. The subsequent clinical course was favorable. CONCLUSIONS The possibility of pharmacobezoar formation following a large quetiapine XR overdose should be considered, as this may influence acute patient management. Complete endoscopic pharmacobezoar removal may be a promising approach in selected cases, but further studies are needed to define its role.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Bodmer, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1556-9519

Publisher:

Taylor & Francis

Language:

English

Submitter:

Patricia Rajaonina

Date Deposited:

28 Mar 2014 15:23

Last Modified:

17 Oct 2017 10:56

Publisher DOI:

10.3109/15563650.2013.856442

PubMed ID:

24199644

URI:

https://boris.unibe.ch/id/eprint/47385

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