Related Experiment Video
Updated: Jun 16, 2026
11:14
Rapid High-throughput Species Identification of Botanical Material Using Direct Analysis in Real Time High Resolution Mass Spectrometry
Published on: October 2, 2016
Deaths involving serotonergic drugs
J L Pilgrim1, D Gerostamoulos, Olaf H Drummer
1Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University, Victoria, Australia.
Forensic Science International
|February 23, 2010
Summary
Serotonin-active drugs like tramadol and MDMA are frequently detected in Victorian fatalities. Investigations suggest these substances, particularly tramadol, contribute to deaths, sometimes via serotonin toxicity.
Area of Science:
- Forensic Toxicology
- Clinical Pharmacology
Background:
- Serotonin-active drugs are frequently detected in fatal cases in Victoria.
- A significant number of deaths involve drugs such as tramadol, venlafaxine, fluoxetine, sertraline, citalopram, paroxetine, and MDMA.
Purpose of the Study:
- To determine the contribution of serotonin-active drugs to the cause of death.
- To investigate the potential role of serotonin toxicity in these fatalities.
Main Methods:
- Review of pathology, toxicology, and police reports for 1123 fatalities.
- Focus on 28 cases with target drugs and circumstances suggesting serotonin toxicity.
- Analysis of drug combinations and their association with toxicity.
Main Results:
- Tramadol was the most commonly detected drug, often with antidepressants.
- MDMA was also frequently detected, notably with moclobemide in 4 confirmed serotonin toxicity cases.
- 5 cases had reported serotonin toxicity, and 23 were suspected, with tramadol being prominent.
Conclusions:
- Serotonin-active drugs, especially tramadol, are implicated in a notable number of Victorian deaths.
- Serotonin toxicity is a potential mechanism of death in these cases, often involving drug combinations.
- Further research into the toxicological profiles and interactions of these drugs is warranted.
Related Concept Videos
01:23Antidepressant Drugs: MAOIs and Other Agents
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
01:28Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
01:23Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
01:00Drug Toxicity: Overview
Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
01:26Pharmaceutical Poisoning: Potential Scenarios
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
01:21Drugs Affecting Neurotransmitter Release or Uptake
Certain drugs can affect how neurotransmitters called catecholamines, are released or taken back up in the adrenergic neuron. They can have different effects on the body's sympathetic transmission. Reserpine, a natural compound found in the Rauwolfia shrub, blocks a transporter called vesicular monoamine transporter (VMAT), which leads to a buildup of catecholamines in the cell and reduces sympathetic transmission. Another drug called guanethidine works in multiple ways, including blocking...