title: [Fatalities caused by anticholinergic antiparkinsonian drugs. Analysis of findings in a 11-year national material].
abstract: All autopsy samples received at the National Institute of Forensic Toxicology during the years 1986-1996 which contained anticholinergic antiparkinsonian drugs were reviewed. Of a total of 69 cases, orphenadrine was present in 57 (83%), biperiden in 8 (12%), procyclidine in 3 (4%), and trihexyphenidyl/benzhexol in 1 (1%) of the subjects. The measured concentrations were assessed in light of previously published data. Of 21 cases where causality between drug ingestion and death was classified as either highly probable (18/21) or possible (3/21), all subjects tested positive for orphenadrine. In the autopsy samples from these patients, orphenadrine concentrations in the 4.5-600 mumol/l range (mean 62.5 mumol/l, SD 126.5 mumol/l) were determined. Because of a low national autopsy rate, there is reason to believe that the actual numbers of drug-related deaths in this period may have been significantly higher. It is concluded that orphenadrine is responsible for a disproportionally high number of overdose deaths.
authors.affiliation: Psykiatrisk avdeling, Telemark sentralsjukehus, Skien.
authors.forename: P
authors.initials: P
authors.lastname: Gjerden
authors.forename: K S
authors.initials: KS
authors.lastname: Engelstad
authors.forename: G
authors.initials: G
authors.lastname: Pettersen
authors.forename: L
authors.initials: L
authors.lastname: Slørdal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000097:blood / Q000506:poisoning*; D001344:Autopsy; D062787:Drug Overdose; D006801:Humans; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000097:blood / Q000506:poisoning*; D009664:Norway / Q000453:epidemiology; D009966:Orphenadrine / Q000506:poisoning; D011041:Poisoning / Q000453:epidemiology*; D013405:Suicide
chemical_list: D000978:Antiparkinson Agents; D009125:Muscle Relaxants, Central; D009966:Orphenadrine
vernacular_title: Dødsfall forårsaket av antikolinerge antiparkinsonmedikamenter. Analysefunn i et nasjonalt 11-årsmateriale.