Cyclizine is an
antihistamine with
sedative effect used to treat
motion sickness. A few studies have reported on
cyclizine abuse among teenagers, and
cyclizine abuse has been reported among
opioid dependants receiving
methadone, with the combination having been reported to produce strong psychoactive effects. Few reports exist on the possible toxic effects of
cyclizine, and it is regarded as a safe
drug most often sold as a non-prescription/
over-the-counter drug. Very few cases of fatalities resulting from
cyclizine overdose can be found in the literature. We present a case where a 22-year-old female was found unconscious and intoxication with drugs and alcohol was suspected. Whole blood from the femoral vein, urine and stomach content were collected during autopsy and screened for drugs of abuse and medicinal drugs. GC-MS screening of the stomach contents revealed presence of
cyclizine and
meclozine.
Cyclizine and
meclozine concentrations in blood were determined using a UPLC-MS-MS method. Quantification of femoral blood revealed a high concentration of
cyclizine (16 mg/L), a low concentration of
meclozine (0.2 mg/L) and
ethanol 0.16 g/dL. No other medicinal drugs or drugs of abuse were detected. We report on a case of suicide where
cyclizine was found to be the principal
drug and question the safety of this
drug.