Post-mortem toxico-kinetics of trazodone

Area of Science:

• Forensic Toxicology
• Pharmacology
• Clinical Chemistry

Background:

• Trazodone, a bicyclic antidepressant, is noted for potentially lower toxicity in overdose compared to typical tricyclic antidepressants.
• Understanding drug distribution and redistribution is crucial in post-mortem toxicology for accurate interpretation of cause of death.

Observation:

• Two fatalities involving trazodone were analyzed for tissue distribution and post-mortem redistribution.
• Case 1 included comparison with trimipramine, a tricyclic antidepressant.
• Trazodone concentrations were measured in various tissues (muscle, lungs, myocardium, kidneys, liver, fat, brain) and blood over time.

Findings:

• Trazodone showed limited preferential concentration in solid organs.
• Post-mortem blood concentrations of trazodone remained relatively stable over 48 hours, indicating minimal redistribution.
• In contrast, trimipramine displayed more variable post-mortem blood concentrations.

Implications:

• The stable post-mortem blood levels of trazodone suggest a lower risk of redistribution artifacts in toxicological analysis.
• These findings highlight significant differences in the post-mortem toxicokinetics of trazodone compared to tricyclic antidepressants.
• This information is vital for accurate forensic interpretation and understanding trazodone's safety profile in overdose scenarios.