Fatal fluoxetine ingestion with postmortem blood concentrations.
A 37-year-old male ingested 12 gm of fluoxetine approximately 2 hours prior to arrival at an emergency department. The patient developed tonic-clonic seizures, which resolved with diazepam and midazolam therapy. The patient then developed profound bradycardia that progressed to ventricular fibrillation and asystole. A postmortem toxicology analysis reported a fluoxetine concentration of 4500 mcg/L and diazepam of 500 mcg/L. No other drugs were detected. We report an unusual case of massive fluoxetine ingestion resulting in neurological and cardiovascular toxicity resulting in death.
Compton
Russel
R
Lewis-Gale Medical Center, Salem, Virginia, USA.
Spiller
Henry A
HA
Bosse
George M
GM
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000097:blood* / Q000506:poisoning*; D001919:Bradycardia / Q000139:chemically induced; D002675:Child, Preschool; D003975:Diazepam / Q000627:therapeutic use; D004562:Electrocardiography / Q000187:drug effects; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced / Q000188:drug therapy; D017809:Fatal Outcome; D005473:Fluoxetine / Q000097:blood* / Q000506:poisoning*; D018757:GABA Modulators / Q000627:therapeutic use; D006323:Heart Arrest / Q000139:chemically induced; D006801:Humans; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D009765:Obesity / Q000150:complications; D014693:Ventricular Fibrillation / Q000139:chemically induced
D000927:Anticonvulsants; D018687:Antidepressive Agents, Second-Generation; D018757:GABA Modulators; D005473:Fluoxetine; D003975:Diazepam; D008874:Midazolam