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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 24,
Number 7, October,
pp. 635-637
Here is where the title stuff goes
Lamotrigine Distribution
in Two Postmortem Cases
Barry
Levine, Rebecca A. Jufer, and John E. Smialek
Office of the Chief Medical Examiner, State of Maryland, 111 Penn Street,
Baltimore, Maryland 21201
Lamotrigine
(Lamictal®) is a new anticonvulsant drug recently approved for use in
the United States. Although a therapeutic range for lamotrigine has not been
definitively established, a range of between 2 and 14 mg/L has been reported.
Two cases are presented in which lamotrigine was identified in cases investigated
by the Office of the Chief Medical Examiner, State of Maryland. Lamotrigine
was identified by gas chromatographynitrogen-phosphorus detection following
an alkaline extraction. A DB-5 column provided analytical separation; no derivatization
was required. Confirmation was achieved by full scan electron ionization gas
chromatographymass spectrometry. In Case 1, primidone (11 mg/L) and
phenobarbital (5.5 mg/L) were found in the heart blood in addition to lamotrigine
(8.3 mg/L); in Case 2, no drugs other than lamotrigine (52 mg/L) were detected
in the heart blood. The peripheral blood concentration in Case 2 was 54 mg/L.
The liver lamotrigine concentrations in the two cases were 41 and 220 mg/kg.
The medical examiner ruled that the cause of death in Case 1 was seizure disorder
and the manner of death was natural. In Case 2, the medical examiner ruled
that the cause of death was lamotrigine intoxication and the manner of death
was undetermined.
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