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Disopyramide and Mianserin Intoxication: A Unique Fatal Case-Review of the Literature

NCJ Number
Journal of Forensic Sciences Volume: 59 Issue: 3 Dated: May 2014 Pages: 850-853
Le Blanc-Louvry Isabelle; Franck Clarot M.D.; Emmanuelle Vaz M.D.; Goulle J. Pierre; Bernard Proust
Date Published
May 2014
4 pages
Lethal occurrence is exceptional after disopyramide or mianserin poisoning.
Lethal occurrence is exceptional after disopyramide or mianserin poisoning. A case of intentional lethal intoxication with these drugs was reported, as well as a review of the literature. Pre- and postmortem blood concentrations of disopyramide or mianserin were assessed in a woman who died from acute cardiac failure after ingestion. The premortem blood concentration of disopyramide alone was considered lethal, and a toxic premortem concentration of mianserin was observed that may have increased cardiovascular failure induced by disopyramide because the metabolism of both drugs is mediated via cytochrome P450. Moreover, it was shown that the postmortem redistribution of disopyramide was limited, as pre- and postmortem concentrations were 48 and 65 mg/L, respectively. As regards mianserin, redistribution was observed after death with pre- and portmortem concentrations at 0.23 and 0.79 mg/L, respectively. This case illustrates that if postmortem blood concentration of disopyramide is known, the premortem concentration can be deduced. Abstract published by arrangement with Wiley.