Suicide by Gabapentin Overdose
2011; Wiley; Volume: 56; Issue: 5 Linguagem: Inglês
10.1111/j.1556-4029.2011.01798.x
ISSN1556-4029
Autores Tópico(s)Epilepsy research and treatment
ResumoJournal of Forensic SciencesVolume 56, Issue 5 p. 1373-1375 CASE REPORTPATHOLOGY/BIOLOGY; TOXICOLOGY Suicide by Gabapentin Overdose Owen Middleton M.D., Owen Middleton M.D. Hennepin County Medical Examiner’s Office, 530 Chicago Avenue, Minneapolis, MN 55415.Search for more papers by this author Owen Middleton M.D., Owen Middleton M.D. Hennepin County Medical Examiner’s Office, 530 Chicago Avenue, Minneapolis, MN 55415.Search for more papers by this author First published: 06 May 2011 https://doi.org/10.1111/j.1556-4029.2011.01798.xCitations: 39 Additional information and reprint requests:Owen Middleton, M.D.Hennepin County Medical Examiner’s Office530 Chicago AvenueMinneapolis, MN 55415E-mail: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract Abstract: Gabapentin is an antiepileptic drug that is prescribed for both FDA-approved and multiple off-label conditions, and has a relatively safe side-effect profile. Rare cases of overdose-related adverse effects have been reported in the literature. Described herein are the circumstances and autopsy findings of a 62-year-old woman with a history of depression, whose death was caused by intentional ingestion of excess gabapentin. The postmortem peripheral blood gabapentin concentration as determined by high-performance liquid chromatography/tandem mass spectroscopy was 88 μg/mL. Previously reported cases of individuals surviving gabapentin overdoses are discussed and compared with this case. Based on a review of the available literature, this appears to be the first published report of a death due solely to gabapentin toxicity. References 1 Baselt RC. Gabapentin. In: Disposition of toxic drugs and chemicals in man, 8th edn. Foster City, CA: Biomedical Publications, 2008; 677–8. 2 FDA Label and Approval History for gabapentin. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory (accessed July 26, 2010). 3 Mack A. Examination of the evidence for off-label use of gabapentin. J Manag Care Pharm 2003; 9(6): 559–68. 4 Verma A, St Clair EW, Radtke RA. A case of sustained massive gabapentin overdose without serious side effects. Ther Drug Monit 1999; 21(6): 615–7. 5 Jones H, Aguila E, Farber HW. Gabapentin toxicity requiring intubation in a patient receiving long-term hemodialysis. Ann Intern Med 2002; 137(1): 74. 6 Bookwalter T, Gitlin M. Gabapentin-induced neurologic toxicities. Pharmacotherapy 2005; 25(12): 1817–9. 7 Dogukan A, Aygen B, Berilgen MS, Dag S, Bektas S, Gunal AI. Gabapentin-induced coma in a patient with renal failure. Hemodial Int 2006; 10(2): 168–9. 8 Hung TY, Seow VK, Chong CF, Wang TL, Chen CC. Gabapentin toxicity: an important cause of altered consciousness in patients with uraemia. Emerg Med J 2008; 25(3): 178–9. 9 Fischer JH, Barr AN, Rogers SL, Fischer PA, Trudeau VL. Lack of serious toxicity following gabapentin overdose. Neurology 1994; 44(5): 982–3. 10 Fernández MC, Walter FG, Petersen LR, Walkotte SM. Gabapentin, valproic acid, and ethanol intoxication: elevated blood levels with mild clinical effects. J Toxicol Clin Toxicol 1996; 34(4): 437–9. 11 Spiller HA, Dunaway MD, Cutino L. Massive gabapentin and presumptive quetiapine overdose. Vet Hum Toxicol 2002; 44(4): 243–4. 12 Stopforth J. Overdose with gabapentin and lamotrigine. S Afr Med J 1997; 87(10): 1388. 13 Patorno E, Bohn RL, Wahl PM, Avorn J, Patrick AR, Liu J, et al. Anticonvulsant medications and the risk of suicide, attempted suicide, or violent death. JAMA 2010; 303(14): 1401–9. 14 Klein-Schwartz W, Shepherd JG, Gorman S, Dahl B. Characterization of gabapentin overdose using a poison center case series. J Toxicol Clin Toxicol 2003; 41(1): 11–5. 15 Litovitz TL, Klein-Schwartz W, White S, Cobaugh DJ, Youniss J, Drab A, et al. 1999 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2000; 18(5): 517–74. 16 Litovitz TL, Klein-Schwartz W, White S, Cobaugh DJ, Youniss J, Omslaer JC, et al. 2000 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2001; 19(5): 337–95. 17 Litovitz TL, Klein-Schwartz W, Rodgers GC Jr, Cobaugh DJ, Youniss J, Omslaer JC, et al. 2001 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2002; 20(5): 391–452. 18 Watson WA, Litovitz TL, Rodgers GC Jr, Klein-Schwartz W, Youniss J, Rose SR, et al. 2002 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2003; 21(5): 353–421. 19 Watson WA, Litovitz TL, Klein-Schwartz W, Rodgers GC Jr, Youniss J, Reid N, et al. 2003 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2004; 22(5): 335–404. 20 Watson WA, Litovitz TL, Rodgers GC Jr, Klein-Schwartz W, Reid N, Youniss J, et al. 2004 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med 2005; 23(5): 589–666. 21 Lai MW, Klein-Schwartz W, Rodgers GC, Abrams JY, Haber DA, Bronstein AC, et al. 2005 Annual Report of the American Association of Poison Control Centers’ national poisoning and exposure database. Clin Toxicol (Phila) 2006; 44(6-7): 803–932. 22 Bronstein AC, Spyker DA, Cantilena LR Jr, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS). Clin Toxicol (Phila) 2007; 45(8): 815–917. 23 Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Heard SE. 2007 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 25th Annual Report. Clin Toxicol (Phila) 2008; 46(10): 927–1057. 24 Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL. 2008 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 26th Annual Report. Clin Toxicol (Phila) 2009; 47(10): 911–1084. 25 Yarema MC, Becker CE. Key concepts in postmortem drug redistribution. Clin Toxicol (Phila) 2005; 43(4): 235–41. 26 Pélissier-Alicot AL, Gaulier JM, Champsaur P, Marquet P. Mechanisms underlying postmortem redistribution of drugs: a review. J Anal Toxicol 2003; 27(8): 533–44. 27 Shields LB, Hunsaker DM, Hunsaker JC 3rd, Ward MK. Toxicologic findings in suicide: a 10-year retrospective review of Kentucky medical examiner cases. Am J Forensic Med Pathol 2006; 27(2): 106–12. Citing Literature Volume56, Issue5September 2011Pages 1373-1375 ReferencesRelatedInformation
Referência(s)