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Fatal cyclobenzaprine overdose with postmortem values.

Henry A Spiller¹, Letizia Cutino

¹Kentucky Regional Poison Control Center, Louisville, KY 40232-5070, USA. henry.spiller@nortonhealthcare.org

Journal of Forensic Sciences

|July 25, 2003

Summary

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This study presents two cases of fatal cyclobenzaprine overdose. Postmortem blood cyclobenzaprine concentrations of 0.8 mg/L or higher may indicate a fatal outcome in overdose cases.

Area of Science:

Forensic Toxicology
Clinical Pharmacology

Background:

Limited data exists on fatal cyclobenzaprine overdose.
Previous cases had confounding factors, hindering clear interpretation of cyclobenzaprine's role.

Purpose of the Study:

To report two additional cases of fatal cyclobenzaprine overdose.
To establish a potential blood concentration threshold associated with cyclobenzaprine fatalities.

Main Methods:

Case reports of two individuals with fatal cyclobenzaprine overdose.
Analysis of postmortem blood cyclobenzaprine concentrations.
Consideration of co-ingested substances and postmortem redistribution.

Main Results:

Two cases of fatal cyclobenzaprine overdose are detailed.

Related Experiment Videos

Postmortem blood cyclobenzaprine concentrations were 0.96 mg/L and 0.8 mg/L.

Co-ingested diazepam and ethanol were not at typically fatal levels, suggesting cyclobenzaprine as the primary cause.

Conclusions:

Postmortem blood cyclobenzaprine concentrations of ≥0.8 mg/L may be associated with fatal outcomes.
Femoral blood draws minimized concerns of postmortem redistribution.
Cyclobenzaprine is implicated as the primary agent in these fatalities.