title: Acute massive pulmonary thromboembolism due to acute intoxication by duloxetine: a case report.
abstract: Duloxetine (Cymbalta) is a potent serotonin norepinephrine reuptake inhibitor used for the management of major depression and pain associated with diabetic peripheral neuropathy. Cymbalta delayed-release capsules contain Duloxetine HCl equivalent to 20, 30, 60 mg of Duloxetine. The ingestion of high quantities of Duloxetine may have serious outcomes such as venous thrombosis, causing cardiac respiratory arrest. The Authors outline a case report of an elderly woman, suffering from depression, found dead in her apartment. The cause of death was attributed to acute massive pulmonary thromboembolism due to acute intoxication of Duloxetine bought the day before. The thesis supported by the authors and confirmed by the data from other studies is that a massive intake of Duloxetine drug increases considerably the medication's side effects such as somnolence, dry mouth, fatigue, insomnia, dizziness, constipation, considerable increases in recumbent systolic and diastolic blood pressure, and a small decrease in heart rate.
authors.affiliation: Division of Forensic Toxicology, Department of Anatomy, Histology and Forensic Medicine, University of Florence, Largo Brambilla Street 3, 50134 Florence, Italy. francesco.mari@unifi.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Mari
authors.forename: Barbara
authors.initials: B
authors.lastname: Gualco
authors.forename: Regina
authors.initials: R
authors.lastname: Rensi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Bertol
mesh_terms: D000208:Acute Disease; D000368:Aged; D000928:Antidepressive Agents / Q000506:poisoning*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003866:Depressive Disorder / Q000188:drug therapy; D000068736:Duloxetine Hydrochloride; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000209:etiology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D013876:Thiophenes / Q000506:poisoning*
chemical_list: D000928:Antidepressive Agents; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride