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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 45, Number 7, September,
pp.409-414
The Distribution of Fluoxetine in Human Fluids
and Tissues
Robert D. Johnson, Russell J. Lewis,
and Mike K. Angier
Civil Aerospace Medical Institute, Federal Aviation Administration,
Analytical Toxicology and Accident Research Laboratory, AAM-610,
CAMI Building, RM 356G, 6500 S. MacArthur Blvd., Oklahoma City,
Oklahoma 73169-6901
Fluoxetine is a selective serotonin reuptake inhibitor
(SSRI) that was introduced in 1986. Certain side effects of this
medication—drowsiness, dizziness, abnormal vision, diarrhea,
and headache—could affect pilot performance and become a
factor in an aviation accident. Our laboratory has determined
the distribution of fluoxetine and its desmethyl metabolite, norfluoxetine,
in various postmortem tissues and fluids from 10 fatal aviation
accident cases. When available, 11 specimen types were analyzed
for each case, including blood, urine, vitreous humor, bile, liver,
kidney, skeletal muscle, lung, spleen, heart muscle, and brain.
Blood fluoxetine concentrations in these 10 cases ranged from
21 to 1480 ng/mL. The distribution coefficients for both fluoxetine
and norfluoxetine, expressed as specimen/blood ratios, were determined.
The distribution coefficients for fluoxetine were determined to
be 0.9 ± 0.4 for urine, 0.10 ± 0.03 for vitreous
humor, 9 ± 1 for bile, 38 ± 10 for liver, 60 ±
17 for lung, 9 ± 3 for kidney, 20 ± 5 for spleen,
2.2 ± 0.3 for muscle, 15 ± 3 for brain, and 10 ±
2 for heart. To our knowledge, this is the first report presenting
the distribution of fluoxetine in humans at therapeutic concentrations.
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