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Death of a female cocaine user due to the serotonin syndrome following moclobemide-venlafaxine overdose.

Abstract
To our knowledge, the majority of evidence supporting the relationship between the serotonin syndrome and medications that effect 5HT is based on case reports. The justification for taking up this subject has been a fatal outcome of a 21 year-old female following an administration of toxic doses of moclobemide (MAOI) and venlafaxine (SNRI). As a result of complex toxicological investigations including antemortem and postmortem material, antemortem clinical observations and postmortem examinations, the cause of death was identified as overdose with antidepressants--moclobemide and venlafaxine--in the mechanism of the clinically fully developed severe toxic serotonin syndrome. The analysis of a hair strand collected from the victim documented the use of the above-mentioned drugs simultaneously with cocaine in the period of at least 20 months preceding death. The fact is a matter of considerable interest in view of the employed pharmacotherapy, giving rise to suspicion that the woman had not developed the serotonin syndrome during the almost 2-year antemortem period until she took toxic doses of both medications.
AuthorsMałgorzata Kłys, Piotr Kowalski, Sebastian Rojek, Adam Gross
JournalForensic science international (Forensic Sci Int) Vol. 184 Issue 1-3 Pg. e16-20 (Jan 30 2009) ISSN: 1872-6283 [Electronic] Ireland
PMID19131198 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Cyclohexanols
  • Dopamine Uptake Inhibitors
  • Monoamine Oxidase Inhibitors
  • Serotonin Uptake Inhibitors
  • Venlafaxine Hydrochloride
  • Cocaine
  • Moclobemide
Topics
  • Cocaine (analysis)
  • Cocaine-Related Disorders (complications)
  • Cyclohexanols (analysis, poisoning)
  • Dopamine Uptake Inhibitors (analysis)
  • Drug Overdose
  • Female
  • Forensic Toxicology
  • Hair (chemistry)
  • Humans
  • Moclobemide (analysis, poisoning)
  • Monoamine Oxidase Inhibitors (analysis, poisoning)
  • Serotonin Syndrome (chemically induced)
  • Selective Serotonin Reuptake Inhibitors (analysis, poisoning)
  • Venlafaxine Hydrochloride
  • Young Adult

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