Mental status change, myoclonus, electrocardiographic changes, and acute respiratory distress syndrome induced by quetiapine overdose.

A 41-year-old man with bipolar disorder came to the emergency department with mental status changes, prolonged rate-corrected QT interval, and myoclonus after ingesting 4500 mg of quetiapine, an atypical antipsychotic drug. Within 24 hours, respiratory failure ensued, requiring intubation and mechanical ventilation. Chest radiograph demonstrated bilateral infiltrates consistent with acute respiratory distress syndrome (ARDS). To our knowledge, this is the first report of ARDS resulting from quetiapine overdose. Clinicians should be aware that in cases of large overdoses of quetiapine, patients should be closely monitored if mental status changes, electro-cardiographic changes, or hypoxia occur, preferably in an intensive care unit.