Postmortem Distribution of Tramadol, Amitriptyline, and Their Metabolites in a Suicidal Overdose

A case report involving a 34-year-old white male who was found dead at home by his roommate is presented. At the time of his death, he was being treated with tramadol/acetaminophen, metaxalone, oxycodone, and amitriptyline. The decedent's mother stated that he had been taking increasing amounts...

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Bibliographic Details
Published in:Journal of analytical toxicology 2005-07, Vol.29 (5), p.401-406
Main Authors: Bynum, Nichole D., Poklis, Justin L., Gaffney-Kraft, Maryanne, Garside, Diana, Ropero-Miller, Jeri D.
Format: Article
Language:English
Subjects:
Adult
Amitriptyline - administration & dosage
Amitriptyline - blood
Amitriptyline - poisoning
Amitriptyline - urine
Analgesics, Non-Narcotic - blood
Analgesics, Non-Narcotic - poisoning
Analgesics, Non-Narcotic - urine
Analgesics, Opioid - blood
Analgesics, Opioid - poisoning
Analgesics, Opioid - urine
Analysis
Biological and medical sciences
Drug Combinations
Drug Overdose
Fatal Outcome
Gas Chromatography-Mass Spectrometry
General pharmacology
Humans
Kidney - chemistry
Liver - chemistry
Lung - chemistry
Male
Medical sciences
Nortriptyline - analysis
Pharmacology. Drug treatments
Suicide
Tissue Distribution
Tramadol - administration & dosage
Tramadol - blood
Tramadol - poisoning
Tramadol - urine
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Summary:A case report involving a 34-year-old white male who was found dead at home by his roommate is presented. At the time of his death, he was being treated with tramadol/acetaminophen, metaxalone, oxycodone, and amitriptyline. The decedent's mother stated that he had been taking increasing amounts of pain medication in order to sleep at night. There were no significant findings at autopsy; however, toxicology results supported a cause and manner of death resulting from suicidal mixed tramadol and amitriptyline toxicity. This case reports the tissue and fluid distribution of tramadol, amitriptyline, and their metabolites in an acutely fatal ingestion in an effort to document concentrations of these analytes in 12 matrices with respect to one another to assist toxicologists in difficult interpretations.
ISSN:0146-4760
1945-2403
DOI:10.1093/jat/29.5.401