Reactions 1080 - 3 Dec 2005

O SImipramine overdose

Death: case reportA 57-year-old woman with depression died after ingesting

an imipramine overdose [dosage and time to reaction onsetnot stated].

The woman, who had received antidepressive therapy forapproximately 2 years, was found in a deep coma in her roomby her husband; there were a lot of empty drug packets in herroom. On arrival to hospital, she had a heart arrest. She wasinitially resuscitated, but died approximately 11 hours afteradmission. Autopsy was conducted 7 hours after her death.Since only imipramine was detected in her stomach contents,it was concluded that she ingested imipramine alone. In herfemoral venous blood, the imipramine concentration(6.90 µg/mL) and the combined concentration of imipramineand the active metabolite desipramine (8.67 µg/mL), werewithin the fatal range. It was estimated that she ingested atleast 5.7g of imipramine; however, the ingested amount mayhave been greater than this estimated amount because shesurvived for 11 hours after being found, during which timedrug metabolism would have occurred and decontaminationby emergency treatment was conducted.Kinoshita H, et al. An autopsy case of imipramine poisoning. American Journal ofForensic Medicine and Pathology 26: 271-274, No. 3, Sep 2005 -Japan 801026047

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Reactions 3 Dec 2005 No. 10800114-9954/10/1080-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved