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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...
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Suicide due to cyclizine overdose.

Marianne Arnestad1, Kari Beate Boye Eldor, Arne Stray-Pedersen

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Cyclizine, an over-the-counter antihistamine, may pose risks when abused. A case study found high cyclizine levels in a fatal overdose, questioning its perceived safety.

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Area of Science:

  • Toxicology
  • Pharmacology
  • Forensic Science

Background:

  • Cyclizine is an antihistamine commonly used for motion sickness, often considered safe and available over-the-counter.
  • Limited data exists on cyclizine's toxicity, though abuse has been noted in specific populations.

Observation:

  • A 22-year-old female was found deceased, with suspected drug and alcohol intoxication.
  • Autopsy revealed high concentrations of cyclizine (16 mg/L) and ethanol (0.16 g/dL) in femoral blood, along with meclozine.

Findings:

  • Cyclizine was identified as the principal drug in a fatal overdose case.
  • The combination of cyclizine, meclozine, and ethanol contributed to the fatality.

Implications:

  • This case highlights the potential for cyclizine toxicity and fatal overdose.
  • It questions the current safety profile of cyclizine, especially in overdose scenarios.
  • Further research into cyclizine's toxicological effects and safe dosage limits is warranted.