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Title: Increasing rates of quetiapine overdose, misuse, and mortality in Victoria, Australia.
Austin Authors: Lee, Julia;Pilgrim, Jennifer;Gerostamoulos, Dimitri;Robinson, Jeff;Wong, Anselm 
Affiliation: Melbourne Medical School, University of Melbourne, Parkville, Australia
Department of Forensic Medicine, Drug Harm Prevention Unit, Monash University, Southbank, VIC, Australia
Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
Victorian Poisons Information Centre, Austin Health, Heidelberg, Victoria, Australia
Department of Emergency Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, School of Clinical Sciences, Monash University, Victoria, Australia
Department of Medicine and Department of Surgery, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 7-Apr-2018 2018
Publication information: Drug and alcohol dependence 2018; 187: 95-99
Abstract: Quetiapine is misused due to its anxiolytic and hedonic effects and has been associated with deliberate self-harm. This study analyzed quetiapine-related calls to the Victorian Poisons Information Centre (VPIC), coronial data from Victorian Institute of Forensic Medicine (VIFM) and prescribed data from the Pharmaceutical Benefits Scheme (PBS) to determine current trends in overdose, misuse and mortality. This was a retrospective review of multiple databases. Calls to VPIC and coronial data from the VIFM were reviewed from 2006 to 2016. PBS prescription data from 2000 to 2015 was obtained from the Australian Statistics on Medicines website. VPIC data indicated a 6-fold increase in the number of quetiapine-related calls over the 11-year period of which most were overdose-related (77%). Overdose and misuse calls increased by 6-fold and 6.6-fold, respectively. Coronial data also indicated a rise in quetiapine-related harm; a 7.4-fold increase in quetiapine-related deaths was recorded for the same period. Similarly, Australian PBS data showed that quetiapine prescriptions increased 285-fold since 2000. There was a significant positive correlation between the increase in prescribing and overdose (r = 0.75, p < 0.001), and prescribing and mortality (r = 0.82, p < 0.01). This study revealed an increasing trend of misuse, non-fatal and fatal overdoses in Victoria over the last decade. The increasing rates of prescriptions in Australia and thus increased quetiapine availability are likely to have contributed to increased poisoning and mortality. Further research is warranted to explore the reasons behind increased prescribing, including off-label use.
DOI: 10.1016/j.drugalcdep.2018.03.002
ORCID: 0000-0002-6817-7289
PubMed URL: 29655032
Type: Journal Article
Subjects: Abuse
Antipsychotic poisoning
Appears in Collections:Journal articles

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