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Postmortem forensic toxicology of trazodone
K E Goeringer1, L Raymon, B K Logan
1Washington State Toxicology Laboratory, Bureau of Forensic Laboratory Services, Washington State Patrol, Seattle 98134, USA.
Journal of Forensic Sciences
|July 29, 2000
Summary
Trazodone is generally safe, but fatalities are rare and usually involve massive overdoses or interactions with other drugs. High blood concentrations above 9 mg/L were linked to trazodone
Area of Science:
- Forensic Toxicology
- Pharmacology
Background:
- Trazodone, an antidepressant, has been available for about 30 years.
- It is known for its safety profile with few fatalities attributed solely to it.
Observation:
- A review of 37 deaths where trazodone was detected was conducted.
- Fatalities were rarely attributed solely to trazodone at blood concentrations below 9 mg/L, with the normal upper therapeutic level being around 2 mg/L.
Findings:
- In the reviewed cases, trazodone was not solely responsible for any death.
- Trazodone was frequently detected with other serotonergic drugs, like selective serotonin reuptake inhibitors.
- Three cases showed trazodone as the primary cause of death, with blood concentrations exceeding 9 mg/L.
Implications:
- Trazodone's toxicity can be influenced by co-administered drugs, especially those affecting serotonin.
- Patients with pre-existing heart conditions may be more susceptible to trazodone's toxic effects.
- The drug is relatively safe except in cases of massive overdose or specific drug interactions.