Multiple effect crushing

A 34-year-old woman with a history of polysubstance dependence (alcohol, cannabis, and cocaine), depressive episodes associated with multiple suicide attempts, and borderline personality disorder, who had been incarcerated after conviction on charges of physical assault and possession of controlled substances, complained of difficulty in sleeping, poor impulse control, irritability, and depressed mood. She was given oral quetiapine 600 mg/day. On one occasion, she crushed two 300-mg tablets, dissolved them in water, boiled them, drew the solution through a cotton swab, and injected the solution intravenously. Apart from having the best sleep I ever had she described no dysphoric, euphoric, or other effects. She admitted to previous intranasal abuse of crushed quetiapine tablets. 

---