A mexiletine intoxication

A case is presented of a 26-year-old white male with a history of depression and previous suicide attempts. No anatomic cause of death was determined at the autopsy. Comprehensive toxicological analysis of the blood and urine specimens identified mexiletine, a class 1B antiarrhythmic drug. Mexiletine was detected by gas chromatography and confirmed by gas chromatography-mass spectrometry. Quantitations were as follows: heart blood, 38 mg/L; subclavian blood, 14 mg/L; urine, 370 mg/L; liver, 190 mg/kg; kidney, 170 mg/kg; vitreous humor, 17 mg/L; and bile, 440 mg/L. The medical examiner ruled that the cause of death was mexiletine intoxication and the manner of death was suicide.