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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 24,
Number 7, October,
pp. 648-650
Here is where the title stuff goes
An
Unusual Multiple Drug Intoxication Case Involving Citalopram
Kai Fu,
Robert J. Konrad, Robert W. Hardy, Robert M. Brissie, and C. Andrew Robinson
Department of Pathology and Laboratory Medicine, University of Alabama at Birmingham,
Birmingham, Alabama 35233-7331
A
47-year-old male with a history of drug abuse and suicide attempts was found
dead at home. The death scene investigation showed evidence of cocaine abuse
and multiple drug ingestion. Citralopram, a new selective serotonin reuptake
inhibitor, cocaine, oxycodone, promethazine, propoxyphene, and norpropoxyphene
were identified and quantitated in the postmortem samples by gas chromatographymass
spectrometry. The concentration of citalopram in the femoral blood was 0.88
mg/L. The heart blood concentration was 1.16 mg/L. Femoral blood concentrations
of the other drugs were as follows: cocaine, 0.03 mg/L; oxycodone, 0.06 mg/L;
promethazine, 0.02 mg/L; propoxyphene, 0.02 mg/L; and norpropoxyphene, 0.07
mg/L. Other tissue samples were also analyzed. The concentrations of cocaine,
oxycodone, promethazine, and propoxyphene in the blood, liver, brain, and gastric
contents did not suggest an intentional overdose. However, the possibility of
multiple drug interactions including citalopram was evident. In this case, the
citalopram concentrations were consistent with those reported in fatal cases
involving multiple drug use. Citalopram was present in urine at a concentration
of 0.9 mg/L.
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