A case report of combined hemoperfusion and hemodiafiltration utilization in pediatric severe Quetiapine poisoning

Quetiapine is an atypical antipsychotic commonly used to manage psychotic and bipolar disorders. While quetiapine overdose is often associated with sedation, tachycardia, and QT interval prolongation on the ECG, severe hypotension and corrected QT interval (QTc) prolongation are relatively rare. There is limited information available regarding the safety of quetiapine overdose, particularly in the pediatric population. Here, we present the case of a 15-year-old girl who ingested quetiapine in a suicide attempt. A 15-year-old girl who ingested 1200 mg of quetiapine (22.6 mg/kg) in a suicide attempt. The overdose led to multiple severe symptoms, including tachycardia, agitation, hypotension, loss of consciousness, and QTc prolongation. To effectively eliminate quetiapine, we utilized a combination of hemoperfusion (HP) and continuous venovenous hemodiafiltration (CVVHDF) therapy. According to recent literature, this is the first reported pediatric case of severe quetiapine poisoning successfully treated with the combined use of HP and CVVHDF. In this report, we compare the clinical presentation with previous cases of quetiapine overdose in both pediatric and adult populations, review current treatment recommendations, and introduce a novel therapeutic approach for managing quetiapine poisoning.