{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T21:53:34Z","timestamp":1784325214503,"version":"3.55.0"},"reference-count":39,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxics"],"abstract":"<jats:p>The administration of intravenous lipid emulsion (ILE) is a proven antidote used to reverse local anesthetic-related systemic toxicity. Although the capacity of ILE to generate blood tissue partitioning of lipophilic drugs has been previously demonstrated, a clear recommendation for its use as an antidote for other lipophilic drugs is still under debate. Venlafaxine (an antidepressant acting as a serotonin\u2013norepinephrine reuptake inhibitor (SNRI)) and quetiapine (a second-generation atypical antipsychotic) are widely used in the treatment of psychotic disorders. Both are lipophilic drugs known to induce cardiotoxicity and central nervous depression. We report the case of a 33-year-old man with a medical history of schizoaffective disorder who was admitted to the emergency department (ED) after having been found unconscious due to a voluntary ingestion of 12 g of quetiapine and 4.5 g of venlafaxine. Initial assessment revealed a cardiorespiratory stable patient but unresponsive with a GCS of 4 (M2 E1 V1). In the ED, he was intubated, and gastric lavage was performed. Immediately after the admission to the intensive care unit (ICU), his condition quickly deteriorated, developing cardiovascular collapse refractory to crystalloids and vasopressor infusion. Junctional bradycardia occurred, followed by spontaneous conversion to sinus rhythm. Subsequently, frequent ventricular extrasystoles, as well as patterns of bigeminy, trigeminy, and even episodes of non-sustained ventricular tachycardia, occurred. Additionally, generalized tonic\u2013clonic seizures were observed. Alongside supportive therapy, antiarrhythmic and anticonvulsant therapy, intravenous lipid emulsion bolus, and continuous infusion were administered. His condition progressively improved over the following hours, and 24 h later, he was tapered off the vasopressor. On day 2, the patient repeated the cardiovascular collapse and a second dose of ILE was administered. Over the next few days, the patient\u2019s clinical condition improved, and he was successfully weaned off ventilator and vasopressor support. ILE has the potential to become a form of rescue therapy in cases of severe lipophilic drug poisoning and should be considered a viable treatment for severe cardiovascular instability that is refractory to supportive therapy.<\/jats:p>","DOI":"10.3390\/toxics11110917","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T10:19:27Z","timestamp":1699525167000},"page":"917","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Biodetoxification Using Intravenous Lipid Emulsion, a Rescue Therapy in Life-Threatening Quetiapine and Venlafaxine Poisoning: A Case Report"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1142-7427","authenticated-orcid":false,"given":"Cristian","family":"Cobilinschi","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Mirea","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosmin-Andrei","family":"Andrei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Ungureanu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Maria","family":"Cotae","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana","family":"Avram","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care Toxicology, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2687-2611","authenticated-orcid":false,"given":"Sebastian","family":"Isac","sequence":"additional","affiliation":[{"name":"Department of Physiology, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Marina","family":"Grin\u021bescu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu","family":"\u021aincu","sequence":"additional","affiliation":[{"name":"Department of Clinical Toxicology, Carol Davila University of Medicine, and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Anesthesiology and Intensive Care Toxicology, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/BF02245606","article-title":"Risperidone compared with new and reference antipsychotic drugs: In vitro and in vivo receptor binding","volume":"124","author":"Schotte","year":"1996","journal-title":"Psychopharmacology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.annemergmed.2008.03.016","article-title":"Acute Quetiapine 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