title: Comprehensive Duloxetine Analysis in a Fatal Overdose.
abstract: Duloxetine is a second-generation selective serotonin and norepinephrine reuptake inhibitor used primarily for the treatment of depression. Relatively few fatalities have been reported in association with its use. Similarly, there are no known reports that provide a comprehensive analysis of blood, fluid and tissue samples in an overdose setting. Herein we present a fatal case of duloxetine toxicity with both the highest reported post-mortem blood concentration and a comprehensive toxicological analysis of duloxetine in femoral blood, vitreous humor, liver tissue, urine and gastric contents. In doing so, we hope to provide data that can assist both toxicologists and forensic pathologists with assessing duloxetine toxicity in the future.
authors.affiliation: Medical Examiner's Office, Onondaga County Health Department, Syracuse, NY, USA kellyscanlon@ongov.net.
authors.forename: Kelly Ann
authors.initials: KA
authors.lastname: Scanlon
authors.affiliation: Medical Examiner's Office, Onondaga County Health Department, Syracuse, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Stoppacher
authors.affiliation: NMS Labs, Willow Grove, PA, USA.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Blum
authors.affiliation: Medical Examiner's Office, Onondaga County Health Department, Syracuse, NY, USA.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Starkey
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications; D000639:Amitriptyline / Q000031:analogs & derivatives / Q000032:analysis; D003863:Depression / Q000188:drug therapy; D004155:Diphenhydramine / Q000032:analysis; D062787:Drug Overdose / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D000068736:Duloxetine Hydrochloride / Q000032:analysis* / Q000506:poisoning*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000032:analysis* / Q000506:poisoning*
chemical_list: D000639:Amitriptyline; D004155:Diphenhydramine; D000068736:Duloxetine Hydrochloride; D017367:Selective Serotonin Reuptake Inhibitors; C004704:cyclobenzaprine