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Polydrug fatality involving metaxalone.

Amy C Gruszecki1, Susan Kloda, Gary T Simmons

  • 1Department of Pathology and Laboratory Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA.

Journal of Forensic Sciences
|April 1, 2003
PubMed
Summary

This case report details a fatal overdose involving metaxalone, a muscle relaxant. High concentrations of metaxalone, combined with other substances, were identified as the primary cause of death in a young woman.

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Area of Science:

  • Forensic Toxicology
  • Clinical Pharmacology
  • Postmortem Analysis

Background:

  • A fatal overdose case involving polydrug abuse is presented.
  • The case highlights the potential toxicity of metaxalone when combined with other central nervous system depressants.

Observation:

  • A 29-year-old female with a history of depression was found deceased.
  • Postmortem analysis revealed significant concentrations of metaxalone, citalopram, ethanol, and chlorpheniramine.
  • Elevated metaxalone levels in femoral vein (39 mg/L) and heart blood (54 mg/L) were noted.

Findings:

  • Gas chromatography-mass spectrometry confirmed the presence and concentration of multiple substances.
  • Metaxalone concentrations were deemed toxic and potentially fatal.

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  • Citalopram levels were below those typically associated with fatal outcomes from citalopram alone.

    • Implications:

    • This case underscores the significant contribution of metaxalone overdose to mortality in polydrug abuse scenarios.
    • It represents the first documented instance where metaxalone overdose was a major factor in a fatality.
    • Findings emphasize the importance of considering metaxalone in postmortem toxicology, especially in cases of suspected overdose.