title: Death following acute poisoning by moclobemide.
abstract: A fatality due to ingestion of a reversible inhibitor of monoamine-oxidase A (MAO-A) is reported. Moclobemide is generally considered as a safe drug far less toxic than tricyclic anti-depressants. However, severe intoxications may result from interactions with other drugs and food such as selective serotonin reuptake inhibitors (SSRIs), anti-Parkinsonians of the MAOI-type (e.g. selegiline) or tyramine from ripe cheese or other sources. In the present case, high levels of moclobemide were measured in peripheral blood exceeding toxic values reported so far in the scientific literature. The body fluid concentrations of moclobemide were of 498 mg/l in peripheral whole blood, 96.3 mg/l in urine while an amount of approximately 33 g could be recovered from gastric contents. The other xenobiotics were considered of little toxicological relevance. The victim (male, 48-year-old) had a past history of depression and committed one suicide attempt 2 years before death. Autopsy revealed no evidence of significant natural disease or injury. It was concluded that the manner of death was suicide and that the unique cause of death was massive ingestion of moclobemide.
authors.affiliation: Laboratoire de Toxicologie et de Chimie Forensiques, Institut Universitaire de Médecine Légale, rue du Bugnon 21, CH-1005 Lausanne, Switzerland. christian.giroud@hospvd.ch
authors.forename: Christian
authors.initials: C
authors.lastname: Giroud
authors.forename: Beat
authors.initials: B
authors.lastname: Horisberger
authors.forename: Chin
authors.initials: C
authors.lastname: Eap
authors.forename: Marc
authors.initials: M
authors.lastname: Augsburger
authors.forename: Annick
authors.initials: A
authors.lastname: Ménétrey
authors.forename: Pierre
authors.initials: P
authors.lastname: Baumann
authors.forename: Patrice
authors.initials: P
authors.lastname: Mangin
mesh_terms: D000928:Antidepressive Agents / Q000737:chemistry / Q000378:metabolism / Q000506:poisoning*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000378:metabolism; D002492:Central Nervous System Depressants / Q000097:blood; D062787:Drug Overdose; D000431:Ethanol / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D020912:Moclobemide / Q000737:chemistry / Q000378:metabolism / Q000506:poisoning*; D015394:Molecular Structure
chemical_list: D000928:Antidepressive Agents; D002492:Central Nervous System Depressants; D001569:Benzodiazepines; D000431:Ethanol; D020912:Moclobemide