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Fatal acute topiramate toxicity.
Loralie J Langman1, Henry A Kaliciak, Sharon A Boone
1Provincial Toxicology Centre, Riverview Hospital, Port Coquitlam, BC, Canada. llangman@bcmhs.bc.ca
Journal of Analytical Toxicology
|August 12, 2003
Summary
A fatal overdose of topiramate, an antiepileptic drug, was identified as the cause of death in a 44-year-old female. Postmortem toxicology revealed high topiramate concentrations in blood and tissues.
Area of Science:
- Forensic toxicology
- Clinical pharmacology
Background:
- A case study investigating the toxicological findings in a deceased individual.
- Assessing the role of multiple substances, including ethanol, phenobarbital, and methotrimeprazine, in a fatality.
Observation:
- A 44-year-old female was found deceased.
- Qualitative screening detected ethanol, phenobarbital, and methotrimeprazine, but these were insufficient to determine the cause of death.
- Significantly elevated concentrations of topiramate were quantified in biological samples.
Findings:
- Central blood: 170 mg/L
- Liver: 140 mg/kg
- Stomach contents: >300 mg
- Vitreous fluid: 65 mg/L
- The cause of death was attributed to topiramate toxicity.
Implications:
- Highlights the potential for topiramate toxicity, even at levels not initially considered lethal.
- Underscores the importance of comprehensive toxicological analysis in postmortem investigations.
- Provides critical data for understanding topiramate pharmacokinetics and overdose scenarios.