NCJ Number
212938
Journal
Journal of Forensic Sciences Volume: 51 Issue: 1 Dated: January 2006 Pages: 179-182
Date Published
January 2006
Length
4 pages
Annotation
This paper presents three case studies in which atomoxetine (a drug used in the treatment of attention-deficit/hyperactivity disorder) was detected in two individuals who died from causes unrelated to the drug and a third person who died from the intentional ingestion of atomoxetine and other drugs.
Abstract
Two cases demonstrate the distribution of atomoxetine in postmortem fluids and tissue in deaths unrelated to atomoxetine. The distribution data for atomoxetine was in the recommended dosage range for treatment of the individuals, so the drug was found to be incidental to the cause of death. Both decedents had intrinsic morphologic abnormalities of the heart. The amphetamine and atomoxetine prescribed for attention deficit/hyperactivity disorder (ADHD) in the two decedents may have exacerbated a natural heart disease even though the drugs were ingested in compliance with recommended dosages. In the third case, the elevated blood concentrations of atomoxetine showed an overdose of the drug that suggests suicide, a conclusion also supported by the high concentration of venlafaxine in the decedent's blood. The concentration of each of the drugs was so high that one of the drugs alone could have caused death. Little is known through clinical trials or literature reports about the toxicity of atomoxetine in overdose; even less is known about postmortem toxicology. Atomoxetine can be considered nontoxic at whole blood and liver concentrations below 1.3 mg/L and 5 mg/kg, respectively. Atomoxetine may undergo postmortem redistribution with a central-to-peripheral ratio that ranges from 1.5 to 5.6. 2 tables, 1 figure, and 7 references