Massive intoxication involving unusual high concentration of amitriptyline

Amitriptyline is a tricyclic antidepressant widely used in the treatment of depression. Antidepressant drugs are among the most commonly encountered causes of self-poisoning, as illustrated by several published cases in the literature. This investigation reports a case of massive amitriptyline intox...

Full description

Saved in:
Bibliographic Details
Published in:Human & experimental toxicology 2007-08, Vol.26 (8), p.667-670
Main Authors: Margalho, Cláudia, Barroso, Mário, Gallardo, Eugenia, Monsanto, Paula, Vieira, Duarte Nuno
Format: Article
Language:English
Subjects:
Adult
Amitriptyline - blood
Amitriptyline - poisoning
Antidepressants
Antidepressive Agents, Tricyclic - blood
Antidepressive Agents, Tricyclic - poisoning
Biological and medical sciences
Depression - drug therapy
Diazepam - blood
Drug intoxications. Doping
Drunkenness
Female
Forensic Toxicology - methods
Gas Chromatography-Mass Spectrometry
Humans
Medical sciences
Nordazepam - blood
Nortriptyline - blood
Pharmacology. Drug treatments
Spectrometry, Mass, Electrospray Ionization
Suicide
Toxicology
Citations: Items that this one cites
Items that cite this one
Online Access:Request full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Amitriptyline is a tricyclic antidepressant widely used in the treatment of depression. Antidepressant drugs are among the most commonly encountered causes of self-poisoning, as illustrated by several published cases in the literature. This investigation reports a case of massive amitriptyline intoxication, involving a 44-year old female found dead in bed. The presence of this tricyclic antidepressant was revealed by a routine screening procedure. The concentration was calculated by gas chromatography/ electron ionization-mass spectrometry in the selected ion monitoring mode after solid-phase extraction using proadifen as internal standard and was in the post-mortem whole blood sample 85.9 μg/mL. This value was much higher than the reported toxic values ever found in the literature, and may therefore have caused the victim's death. Nortriptyline was also detected in the toxic concentration range, as well as therapeutic levels of diazepam and nor-diazepam. Taking into account both the available circumstantial information and toxicological results, it is very likely that death was caused by self-poisoning. Human & Experimental Toxicology (2007) 26, 667—670
ISSN:0960-3271
1477-0903
DOI:10.1177/0960327107076813