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Fatal intoxication with a selective serotonin reuptake inhibitor, lorazepam, and codeine
Emily R Filter1, Laura Gorczynski, John R Fernandes
1Department of Pathology and Molecular Medicine, Hamilton Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada.
The American Journal of Forensic Medicine and Pathology
|November 29, 2007
Summary
Selective serotonin reuptake inhibitors (SSRIs) are linked to severe side effects and fatalities, especially when combined with other drugs. This case highlights a fatal outcome from coingesting sertraline, lorazepam, and codeine.
Area of Science:
- Pharmacology
- Toxicology
- Clinical Medicine
Background:
- Selective serotonin reuptake inhibitors (SSRIs) emerged in 1987 as treatments for depression and anxiety.
- Increased SSRI use correlates with more severe adverse events and fatalities.
- Fatalities often involve coingestion with other serotonergic agents or substances.
Observation:
- A case report details a fatality involving a patient who coingested sertraline, lorazepam, and codeine.
- This combination represents a specific instance of polypharmacy with potentially lethal consequences.
Findings:
- The coingestion of sertraline, lorazepam, and codeine led to a fatal outcome.
- The presumed mechanism of death is discussed in relation to the combined pharmacological effects.
Implications:
- Highlights the critical risk of polypharmacy involving SSRIs and central nervous system depressants/serotonergic agents.
- Underscores the importance of careful patient monitoring and medication review when prescribing SSRIs.
- Emphasizes the need for awareness regarding drug-drug interactions that can potentiate toxicity.
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