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Postmortem Metaxalone (Skelaxin®) Data from North Carolina.

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Summary

Postmortem toxicology studies reveal metaxalone concentrations in overdose cases are significantly higher than therapeutic levels. These findings aid in determining the cause and manner of death in complex forensic cases.

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Area of Science:

  • Forensic Toxicology
  • Postmortem Analysis
  • Pharmacology

Background:

  • Metaxalone is a muscle relaxant.
  • Postmortem drug screening is crucial for death investigations.
  • Understanding drug concentrations in fatalities is essential.

Purpose of the Study:

  • To analyze metaxalone concentrations in postmortem cases.
  • To differentiate between overdose and non-overdose scenarios.
  • To assess metaxalone's contribution to the cause of death.

Main Methods:

  • Retrospective analysis of 61 postmortem cases (2002-2014).
  • Cases categorized by manner of death (natural, accident, suicide, undetermined).
  • Subgroup analysis for attributed (contributing to death) and unattributed cases.

Main Results:

  • Mean metaxalone concentration in attributed deaths: 14.2 mg/L (additive) and 36.7 mg/L (primary).
  • Mean metaxalone concentration in unattributed cases: 3.4 mg/L.
  • 34% of cases had concentrations at or below the therapeutic level (≤4 mg/L).

Conclusions:

  • Elevated metaxalone levels are associated with overdose fatalities.
  • Distinguishing between additive and primary roles of metaxalone is important.
  • Case studies provide valuable insights for postmortem interpretation of metaxalone toxicity.