Death from asthma associated with sertraline overdose

The authors report a case of a young woman for whom autopsy confirmed the cause of death to be due to an acute asthma attack. In addition, she had high serum levels of sertraline hydrochloride (Zoloft). The decedent had a recent prescription for sertraline filled, from which most of the pills were missing, suggesting a large consumption of medication. She was found dead at home, immersed in a bath. Autopsy revealed anatomic evidence of a severe recent asthma attack. Quantitative blood assay for sertraline was very high (620 ng/ml). Fatalities from sertraline alone are virtually nonexistent. The effects of sertraline on asthma, however, are not well-studied. Why the patient ingested so much sertraline is unclear. However, it is possible that, in a variant of the serotonin syndrome, a large dose of a selective serotonin reuptake inhibitor participated in precipitating an asthma attack or prevented her from being aware of the evolution of such an exacerbation. Additional observations in the future will be useful in assessing the role of this class of drugs in patients with asthma.