title: Disopyramide and mianserin intoxication: a unique fatal case--review of the literature.
abstract: Lethal occurrence is exceptional after disopyramide or mianserin poisoning. A case of intentional lethal intoxication with these drugs was reported, as well as a review of the literature. Pre- and postmortem blood concentrations of disopyramide or mianserin were assessed in a woman who died from acute cardiac failure after ingestion. The premortem blood concentration of disopyramide alone was considered lethal, and a toxic premortem concentration of mianserin was observed that may have increased cardiovascular failure induced by disopyramide because the metabolism of both drugs is mediated via cytochrome P450. Moreover, it was shown that the postmortem redistribution of disopyramide was limited, as pre- and postmortem concentrations were 48 and 65 mg/L, respectively. As regards mianserin, redistribution was observed after death with pre- and portmortem concentrations at 0.23 and 0.79 mg/L, respectively. This case illustrates that if postmortem blood concentration of disopyramide is known, the premortem concentration can be deduced.
authors: Department of Forensic Medicine, Rouen University Hospital-Charles Nicolle, 1 rue de Germont, 76031, Rouen-Cedex, France.
authors: Le Blanc-Louvry
authors: le BL
authors: Isabelle
authors: Franck
authors: F
authors: Clarot
authors: Emmanuelle
authors: E
authors: Vaz
authors: Jean Pierre
authors: JP
authors: Goullé
authors: Bernard
authors: B
authors: Proust
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000032:analysis / Q000493:pharmacokinetics / Q000506:poisoning*; D018687:Antidepressive Agents, Second-Generation / Q000032:analysis / Q000493:pharmacokinetics / Q000506:poisoning*; D001646:Bile / Q000737:chemistry; D004206:Disopyramide / Q000032:analysis / Q000493:pharmacokinetics / Q000506:poisoning*; D005260:Female; D053593:Forensic Toxicology; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D008803:Mianserin / Q000032:analysis / Q000493:pharmacokinetics / Q000506:poisoning*; D011180:Postmortem Changes; D013405:Suicide; D014018:Tissue Distribution; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents; D018687:Antidepressive Agents, Second-Generation; D008803:Mianserin; D004206:Disopyramide
keywords: autopsy; disopyramide; forensic sciences; forensic toxicology; lethal issue; mianserin; redistribution