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Contributory and Incidental Blood Concentrations in Deaths Involving Citalopram

Authors

  • Shane Darke Ph.D.,

    Corresponding author
    • National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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  • Michelle Torok M.Soc.Sc.,

    1. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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  • Johan Duflou M.Med.Path. (Forens), F.R.C.P.A.

    1. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
    2. Department of Forensic Medicine, Sydney South West Area Health Service, School of Medical Sciences, University of New South Wales, Department of Pathology, University of Sydney, Sydney, NSW, Australia
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  • Funded by the Australian Government Department of Health and Ageing and the NSW Health Department.

Additional information and reprint requests:

Shane Darke, Ph.D.

National Drug and Alcohol Research Centre

University of New South Wales

Sydney, NSW 2052

Australia

E-mail: s.darke@unsw.edu.au

Abstract

All cases presenting to the New South Wales Department of Forensic Medicine between January 1, 2001 and December 31, 2010 in which citalopram was detected were retrieved. A total of 348 cases were identified. Citalopram contributed to death in 21.0%, and was incidental in 79.0%. Cases in which citalopram was contributory to death had significantly higher blood citalopram concentrations than incidental cases (0.50 mg/L vs. 0.30 mg/L). Citalopram concentrations varied significantly by contributory status: sole citalopram toxicity (median = 1.30 mg/L), citalopram/other drug toxicity (0.50 mg/L), and incidental cases (0.30 mg/L). Citalopram concentrations also varied by suicide status, with the highest concentration found in suicides where citalopram contributed to death (0.70 mg/L) compared with 0.50 mg/L for nonsuicide cases where citalopram contributed to death. In almost all contributory cases (69/73), other psychoactive substances were also detected, most commonly benzodiazepines (47.9%), alcohol (45.2%), and opioids (40.1%).

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