A fatal intoxication due to doxepin

A fatal intoxication due to doxepin, a tricyclic antidepressant, is described. Concentrations of doxepin and its metabolite, desmethyldoxepin, were measured in blood, urine, myocardial, and other tissues using thin layer chromatography (TLC) and gas chromatography equipped with a flame-ionisation detector (GC/FID). The developed technique also permitted the quantitative determination of the cis and trans isomers of doxepin. A very remarkable concentration ratio of doxepin:desmethyldoxepin was observed in myocardial tissues. A detailed report on the possible significance is described.