A fatality involving clothiapine and clomipramine

A fatality resulting from the suicidal ingestion of clothiapine, clomipramine and biperiden is reported. Clomipramine, its metabolite N-desmethylclomipramine and clothiapine were quantified in blood, liver, kidney and gastric contents by HPLC and GC. Biperiden was detected only in the gastric content. Significant differences of drug levels were found in postmortem blood obtained from brain and from heart. Concentrations of clomipramine and N-desmethylclomipramine ranged from 0.48 to 1.61 mg/L and 0.26 to 1.32 mg/L, respectively, and clothiapine from 0.50 to 2.15 mg/L. This phenomenon may reflect a postmortem drug redistribution.