Fatal acute topiramate toxicity.
A 44-year-old Caucasian female was found dead in bed. Qualitative screening detected ethanol, phenobarbital, and methotrimeprazine. However, none were sufficient to attribute as the cause of death. Additionally, high concentrations of topiramate, an antiepilieptic agent, were found. Analysis of available biological fluids and tissues was carried out with the following results: blood (central) 170 mg/L, liver 140 mg/kg, stomach contents greater than 300 mg, and vitreous fluid 65 mg/L. The cause of death was ascribed to topiramate overdose.
Langman
Loralie J
LJ
Provincial Toxicology Centre, Riverview Hospital, Port Coquitlam, BC, Canada. llangman@bcmhs.bc.ca
Kaliciak
Henry A
HA
Boone
Sharon A
SA
D000328:Adult; D000927:Anticonvulsants / Q000032:analysis / Q000493:pharmacokinetics / Q000506:poisoning*; D062787:Drug Overdose; D000431:Ethanol / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000032:analysis / Q000493:pharmacokinetics / Q000506:poisoning*; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D008099:Liver / Q000737:chemistry; D008728:Methotrimeprazine / Q000032:analysis; D010634:Phenobarbital / Q000032:analysis; D000077236:Topiramate; D014822:Vitreous Body / Q000737:chemistry
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose; D000431:Ethanol; D008728:Methotrimeprazine; D010634:Phenobarbital