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Sertraline concentrations and postmortem redistribution.

Iain M McIntyre1, Phyllis Mallett

  • 1Forensic Toxicology Division, County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA. Iain.McIntyre@sdcounty.ca.gov

Forensic Science International
|November 8, 2012
PubMed
Summary
This summary is machine-generated.

Sertraline, a common antidepressant, can redistribute after death, leading to higher concentrations in the liver than in peripheral blood. This postmortem redistribution may contribute to fatalities when combined with other substances.

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Area of Science:

  • Forensic Toxicology
  • Pharmacology
  • Clinical Chemistry

Background:

  • Sertraline is a widely used selective serotonin reuptake inhibitor (SSRI) for depression and anxiety.
  • Understanding drug distribution in postmortem cases is crucial for accurate interpretation of toxicological findings.

Purpose of the Study:

  • To compare sertraline and its metabolite, norsertraline, concentrations in central blood, peripheral blood, and liver tissue.
  • To evaluate the potential for postmortem redistribution of sertraline.

Main Methods:

  • Analysis of nine medical examiner cases involving sertraline.
  • Initial screening using GC-FID, ELISA, and GC/MS.
  • Confirmation and quantification of sertraline using GC-NPD.

Main Results:

  • Sertraline concentrations varied across peripheral blood, central blood, and liver.
  • Central to peripheral blood ratios averaged 1.22.
  • Liver to peripheral blood ratios averaged 97, indicating significant postmortem redistribution.

Conclusions:

  • Sertraline exhibits marked postmortem redistribution, with liver concentrations substantially higher than peripheral blood.
  • The high liver to peripheral blood ratio suggests a propensity for redistribution.
  • Sertraline, especially when co-ingested with other substances, may be a contributing factor in deaths.