A fatality due to alprazolam intoxication

J Anal Toxicol. 1997 May-Jun;21(3):218-20. doi: 10.1093/jat/21.3.218.

Abstract

Alprazolam is one of the most widely prescribed benzodiazepines in the United States. It is generally considered a safe and effective drug for the treatment of anxiety disorders and panic attacks. Few overdoses that are due to the sole ingestion of alprazolam have been reported. This paper documents a fatality due to alprazolam intoxication and describes the distribution of alprazolam and an active metabolite, alpha-hydroxyalprazolam, in tissues obtained at autopsy. Qualitative identification of the drugs was achieved by full-scan gas chromatography-mass spectrometry, and quantitative analysis was performed by high-performance liquid chromatography. High concentrations of alprazolam were found in all specimens analyzed, but the metabolite was detected only in subclavian blood, urine, bile, and liver. A postmortem heart blood alprazolam concentration of 2.1 mg/L is the highest reported in the literature to date.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alprazolam / analogs & derivatives*
  • Alprazolam / analysis
  • Alprazolam / blood
  • Alprazolam / pharmacokinetics
  • Alprazolam / poisoning*
  • Alprazolam / urine
  • Anti-Anxiety Agents / analysis
  • Anti-Anxiety Agents / pharmacokinetics
  • Anti-Anxiety Agents / poisoning*
  • Bile / metabolism
  • Chromatography, High Pressure Liquid
  • Drug Overdose / diagnosis
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Heart / drug effects
  • Humans
  • Kidney / drug effects
  • Kidney / metabolism
  • Liver / drug effects
  • Liver / metabolism
  • Myocardium / metabolism
  • Suicide
  • Tissue Distribution
  • Vitreous Body / drug effects
  • Vitreous Body / metabolism

Substances

  • Anti-Anxiety Agents
  • alpha-hydroxyalprazolam
  • Alprazolam