• Kyle C Mangan, Brian P McKinzie, Lindsay P Deloney, Stuart M Leon, and Evert A Eriksson.
• Department of Pharmacy, Medical University of South Carolina, 150 Ashley Ave., Charleston, SC, USA; Department of Pharmacy, Detroit Receiving Hospital - Detroit Medical Center, 4201 St. Antoine Blvd., Detroit, MI, USA. Electronic address: kmangan511@gmail.com.
• J Crit Care. 2018 Oct 1; 47: 169-172.

PurposeDosing regimens of quetiapine to treat delirium in critically ill patients are titrated to effect, and may utilize doses higher than previously reported. This study aimed to assess the safety of quetiapine for this indication.Materials And MethodsA retrospective medical chart review was conducted, identifying 154 critically ill adults that were initiated on quetiapine to treat delirium and monitored for QTc prolongation.ResultsThe median average daily dose was 150 mg (79-234) and median max dose was 225 mg (100-350). The overall range was 25-800 mg daily. The time to peak dose was 3 days (1-8). Patients with QTc prolongation were significantly older (age 54 ± 11 vs 45 ± 17 years (p = 0.002)) and with higher baseline QTc (454 ± 33 vs 442 ± 30 (p = 0.045)). Regression analysis revealed only dose as a significant factor (OR = 1.006 (1.003-1.009) (p < 0.001)).ConclusionThe dose of quetiapine has very little correlation with QTc and change from baseline. A small number of side effects were observed. Overall, titrating quickly to large doses of quetiapine is safe for treating delirium.Copyright © 2018 Elsevier Inc. All rights reserved.

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