Published: Journal of Analytical Toxicology, Volume
23,
Number 6,
October 1999,
pp.544-548
Distribution of Mirtazapine (Remeron®) in Thirteen Postmortem Cases*
Daniel T. Anderson, Kristina L. Fritz, and
Joseph J. Muto
Mirtazapine is a new antidepressant agent that entered the United States market
in April 1996. To date, the literature provides limited information about therapeutic
blood concentrations and virtually no information about postmortem levels. The
Los Angeles County Coroner’s Toxicology Laboratory has encountered 13 cases
where postmortem tissue distributions of mirtazapine were determined. The analysis
of mirtazapine from postmortem specimens (2-mL sample size) consisted of an n-butylchloride
basic extraction procedure with identification and quantitation on a gas chromatograph–nitrogen-phosphorus
detector. Linearity was achieved from 0.025 mg/L to 3.0 mg/L with a limit of quantitation
of 0.025 mg/L. Confirmation of mirtazapine was performed on a gas chromatograph–mass
spectrometer by comparison with a pure analytical standard. The tissue distribution
of mirtazapine are in the following concentration ranges: heart blood 0.03–0.57
mg/L (13 cases), femoral blood 0.04–0.24 mg/L (9 cases), vitreous 0.06–0.10
mg/L (3 cases), liver 0.32–2.1 mg/kg (12 cases), bile 0.40–6.6 mg/L
(7 cases), urine 0.12–2.5 mg/L (11 cases), kidney 0.23 mg/kg (1 case), spleen
0.17 mg/kg (1 case), and gastric 0.001–2.7 mg total (9 cases). Mirtazapine
was not implicated in the cause of death in any of the 13 cases studied. These
cases are being presented to aid the forensic toxicologist in the evaluation of
postmortem mirtazapine levels.
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