A fluvoxamine-related fatality: Case report with postmortem concentrations

Jenna Otter; Iain M McIntyre; Jacquelyn Morhaime; Lee Cantrell

doi:10.1016/j.forsciint.2019.02.047

A fluvoxamine-related fatality: Case report with postmortem concentrations

Forensic Sci Int. 2019 Jul:300:e31-e33. doi: 10.1016/j.forsciint.2019.02.047. Epub 2019 Mar 1.

Authors

Jenna Otter¹, Iain M McIntyre², Jacquelyn Morhaime³, Lee Cantrell⁴

Affiliations

¹ University of California San Diego, USA. Electronic address: jnotter@ucsd.edu.
² Department of the Medical Examiner, County of San Diego, USA. Electronic address: Iain.McIntyre@sdcounty.ca.gov.
³ County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA. Electronic address: Jacquelyn.Morhaime@sdcounty.ca.gov.
⁴ University of California San Diego, USA; University of California San Francisco, USA. Electronic address: lcantrell@calpoison.org.

PMID: 30871740
DOI: 10.1016/j.forsciint.2019.02.047

Abstract

Fluvoxamine is a selective serotonin reuptake inhibitor that has been considered relatively safe in overdose. At therapeutic and supratherapeutic concentrations, fluvoxamine affects cardiac conduction, prolongs QTc interval, causes hypotension, obtundation, and can increase propensity for seizures. A man in his 60s was found dead at his home with a postmortem fluvoxamine peripheral blood concentration of 4.9 mg/L, and a liver concentration of 440 mg/kg. His cause of death was determined to be acute fluvoxamine toxicity.

Keywords: Fluvoxamine; Overdose; Postmortem concentration; SSRI.

Publication types

Case Reports

MeSH terms

Drug Overdose
Fluvoxamine / analysis
Fluvoxamine / poisoning*
Gas Chromatography-Mass Spectrometry
Humans
Limit of Detection
Liver / chemistry
Male
Middle Aged
Selective Serotonin Reuptake Inhibitors / analysis
Selective Serotonin Reuptake Inhibitors / poisoning*

Substances

Serotonin Uptake Inhibitors
Fluvoxamine