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Fatal intoxication with antidepressants: a case with many culprits.

TitleFatal intoxication with antidepressants: a case with many culprits.
Publication TypeJournal Article
Year of Publication2018
AuthorsGoulas, A., Raikos N., Krokos D., Mastrogianni O., Orphanidis A., Zisopoulos K., & Tsepa A.
JournalForensic Sci Med Pathol
Date Published2018 06
KeywordsAdult, Bipolar Disorder, Cardiomyopathy, Hypertrophic, Citalopram, Fluoxetine, Genotype, Heterozygote, Humans, Male, Pharmacogenomic Variants, Serotonin Plasma Membrane Transport Proteins, Serotonin Uptake Inhibitors

Serotonin-specific reuptake inhibitors (SSRIs) are generally considered safe drugs but fatal adverse effects do sometimes occur, often as a consequence of interactions with other serotonin active drugs. Polypharmacy is usually a problem that the elderly encounter, but it can also have dire consequences for young people, especially when an underlying heart condition is present. Thus, failure to diagnose heart disease and the use of contraindicated medications can be a lethal combination, irrespective of age. Here we present a case of a young adult suffering from bipolar disorder who used a combination of two SSRIs (citalopram and fluoxetine) and a monoamine oxidase inhibitor (MAO; moclobemide) with tragic consequences. The deceased also suffered from undiagnosed hypertrophic cardiomyopathy and was carrier of a genotype that may have predisposed him to increased sensitivity to SSRIs. The apparent difficulty in establishing the manner of death in this case is also discussed.

Alternate JournalForensic Sci Med Pathol
PubMed ID29488058
Grant List88228 / / Research Committee, Aristotle University of Thessaloniki / International


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