Distribution of Fluvoxamine and Identification of the Main Metabolite in a Fatal Intoxication
Distribution of Fluvoxamine and Identification of the Main Metabolite in a Fatal Intoxication
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DOI：
10.1093/jat/bkaa084
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发表时间：
2021-05-01
影响因子：
2.5
通讯作者：
Morini, Luca
中科院分区：
文献类型：
--
作者：
Vignali, Claudia;Moretti, Matteo;Morini, Luca
氟伏沙明是一种选择性血清素再摄取抑制剂，半衰期约为 30 小时，通常用于治疗抑郁症和强迫症。尽管与三环类抗抑郁药相比，其不良反应更有利，但过量服用可能会导致严重的中枢神经系统抑制。我们特此报告一名患有精神疾病的 48 岁女性，她在她所居住的受保护社区死亡。死后 9 天进行尸检，发现多器官充血和胃内容物误吸。收集股骨和心脏血液、尿液和胆汁用于毒理学分析。对血液样本进行 GC-MS、LC-MS-MS 和 LC-HRMS 筛查。分析确定了以下药物：氟伏沙明、氯硫平、7-氨基氯硝西泮、普萘洛尔、加巴喷丁和氟哌啶醇。通过经过验证的 LC-MS-MS 分析程序对血液中检测到的药物进行定量，得到以下结果：氟伏沙明 (2.20 mg/L)、加巴喷丁 (41.00 mg/L)、7-氨基氯硝西泮 (0.24 mg/L)、氯硫平 (0.07 mg/L)、氟哌啶醇 (
Fluvoxamine is a selective serotonin reuptake inhibitor, with a half-life of about 30 hours, that is commonly prescribed in the treatment of depression and obsessive and compulsive disorders. Though its more favorable adverse effect profile in comparison to tricyclic antidepressants, overdosages could lead to severe central nervous system depression. We hereby report the case of a 48-year-old woman with psychiatric disorders, who died in the Protected Community where she lived. An autopsy, during which multiorgan congestion and aspiration of gastric content were found, was performed 9 days after the death. Femoral and cardiac blood, urine and bile were collected for toxicological analysis. GC-MS, LC-MS-MS and LC-HRMS screenings were performed on blood samples. The analysis allowed to identify the following drugs: fluvoxamine, clotiapine, 7-aminoclonazepam, propranolol, gabapentin and haloperidol. Quantification of the detected drugs in blood was performed by means of a validated LC-MS-MS analytical procedure, and the following results were achieved: fluvoxamine (2.20 mg/L), gabapentin (41.00 mg/L), 7-aminoclonazepam (0.24 mg/L), clotiapine (0.07 mg/L), haloperidol (