Postmortem citalopram concentrations: alone or along with other compounds.
Citalopram, an antidepressant whose use has become more widespread in Spain in recent years participates directly and indirectly in the lethal mechanism in voluntary and involuntary poisonings. There were 30 cases of autopsies in the Madrid region where citalopram and other psychoactive substances (psychotropic drugs, alcohol, opiates) were detected in the corpses. The postmortem citalopram levels in relation to the manner and mechanism of death were evaluated, and a significant difference between the toxic and nontoxic cases (p < 0.01) was found. We studied the citalopram blood levels alone and along with other psychoactive products, and these cases were then further divided into those where the compounds were at deadly levels and those which were not. We found a range of citalopram levels between 0.37 and 0.83 microg/mL in which some cases were associated with citalopram toxicity and others were not. Citalopram blood levels of less than 0.35 microg/mL did not lead to fatal poisoning when it was the sole substance detected.
Toxicology Laboratory, Instituto Anatómico Forense of Madrid, Ciudad Universitaria, Madrid, Spain. lseguraa@meditex.es
Luis J
LJ
Segura
Begoña
B
Bravo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018687:Antidepressive Agents, Second-Generation / Q000032:analysis* / Q000506:poisoning; D001569:Benzodiazepines / Q000032:analysis; D002423:Cause of Death; D002492:Central Nervous System Depressants / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D015283:Citalopram / Q000032:analysis* / Q000506:poisoning; D000431:Ethanol / Q000097:blood; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000032:analysis; D011619:Psychotropic Drugs / Q000032:analysis
D018687:Antidepressive Agents, Second-Generation; D002492:Central Nervous System Depressants; D009294:Narcotics; D011619:Psychotropic Drugs; D015283:Citalopram; D001569:Benzodiazepines; D000431:Ethanol