From the Research
Yes, an overdose of quetiapine can potentially cause renal failure, though it is not among the most common complications. Quetiapine is an atypical antipsychotic medication that, in excessive doses, can lead to multiple organ dysfunction including kidney damage. The mechanism involves several factors: severe hypotension (low blood pressure) from quetiapine's alpha-blocking effects can reduce blood flow to the kidneys; rhabdomyolysis (muscle breakdown) that sometimes occurs in overdose can release myoglobin that damages kidney structures; and direct toxic effects on renal cells may occur with extremely high concentrations of the drug. Acute kidney injury may develop hours to days after a significant overdose, particularly in cases where the patient experiences prolonged unconsciousness, severe cardiovascular effects, or seizures. Risk factors that increase the likelihood of renal complications include pre-existing kidney disease, dehydration, older age, and concurrent use of other nephrotoxic medications. Anyone suspected of quetiapine overdose should receive immediate medical attention, as early intervention with supportive care can help prevent or minimize kidney damage, as seen in a case where a patient was successfully treated with CytoSorb hemoperfusion in combination with continuous renal replacement therapy (CRRT) 1. Key considerations in managing quetiapine overdose include monitoring for signs of renal failure and providing supportive care to mitigate potential kidney damage, with the most recent study suggesting that quetiapine may lead to severe poisoning, particularly when used in combination with other medications 2. Some studies have investigated the pharmacokinetics of quetiapine in overdose and the effect of activated charcoal, finding that charcoal administration may be beneficial after quetiapine overdose by reducing fraction absorbed by 35% 3. However, the primary concern in quetiapine overdose remains the potential for severe neurological and cardiovascular effects, including the risk of acute kidney injury, which necessitates prompt medical evaluation and treatment 4, 5. Given the potential for renal complications, it is crucial to prioritize immediate medical attention for anyone suspected of quetiapine overdose.