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Postmortem tissue concentrations of venlafaxine.
K E Goeringer1, I M McIntyre, O H Drummer
1Department of Forensic Medicine, Victorian Institute of Forensic Medicine, Monash University, Southbank, Australia. kabrenae@vifp.monash.edu.au
Forensic Science International
|August 23, 2001
Summary
This study investigated 12 fatalities where venlafaxine was detected. No deaths were solely attributed to venlafaxine intoxication, though it was often found with other substances.
Area of Science:
- Pharmacology
- Forensic Toxicology
Background:
- Venlafaxine is a phenethylamine antidepressant inhibiting serotonin and norepinephrine reuptake.
- Its metabolite, O-desmethylvenlafaxine (ODV), also inhibits serotonin reuptake.
- Venlafaxine has a lower inhibitory effect on CYP 2D6 and 3A4 compared to SSRIs.
Purpose of the Study:
- To review and evaluate drug action mechanisms in 12 fatalities where venlafaxine was detected.
- To quantify venlafaxine and ODV concentrations in postmortem tissues.
- To assess potential drug interactions.
Main Methods:
- Liquid chromatography-mass spectrometry (LC-MS) with atmospheric pressure ionization (API) electrospray was used for identification.
- Analysis included postmortem blood, liver, vitreous humor, bile, urine, and gastric contents.
- Venlafaxine and ODV concentrations were determined in 12 cases.
Main Results:
- Venlafaxine and ODV concentrations varied across tissues (e.g., peripheral blood: 0.1-36 mg/l for venlafaxine, <0.05-3.5 mg/l for ODV).
- Venlafaxine was frequently detected alongside other drugs like alcohol and benzodiazepines.
- No fatalities were exclusively caused by venlafaxine overdose.
Conclusions:
- Over a 6-month period, no deaths were solely attributed to venlafaxine intoxication.
- Venlafaxine's presence in fatalities often involved co-ingestion with other substances.
- Further investigation into drug interactions is warranted.