TY - JOUR

T1 - Postmortem Femoral Blood Reference Concentrations of Aripiprazole, Chlorprothixene, and Quetiapine

AU - Skov, Louise

AU - Johansen, Sys Stybe

AU - Linnet, Kristian

N1 - © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PY - 2015/1

Y1 - 2015/1

N2 - Postmortem femoral blood concentrations of the antipsychotic drugs aripiprazole, chlorprothixene and its metabolite, and quetiapine were determined by LC-MS-MS in 25 cases for aripiprazole and 60 cases each for chlorprothixene and quetiapine. For cases where the cause of death was not related to the considered drugs, the following blood concentration intervals (10-90 percentiles) were observed: 0.049-0.69 mg/kg for aripiprazole, 0.006-0.24 mg/kg for chlorprothixene, and 0.006-0.37 mg/kg for quetiapine. These concentration ranges largely correspond to therapeutic plasma levels observed in vivo suggesting no or only limited postmortem redistribution for aripiprazole, chlorprothixene with metabolite, and quetiapine in these cases. One fatality caused by chlorprothixene with a blood level of 0.90 mg/kg was recorded, and in six cases chlorprothixene was judged to be contributing to death with concentrations 0.43-0.91 mg/kg. No fatalities exclusively ascribed to the two other drugs were observed, but aripiprazole was considered to be contributing to death in one case (1.9 mg/kg) and quetiapine in seven cases with concentrations 0.35-10.0 mg/kg. The presented values may serve as a reference for judgment of postmortem cases with presence of these antipsychotics.

AB - Postmortem femoral blood concentrations of the antipsychotic drugs aripiprazole, chlorprothixene and its metabolite, and quetiapine were determined by LC-MS-MS in 25 cases for aripiprazole and 60 cases each for chlorprothixene and quetiapine. For cases where the cause of death was not related to the considered drugs, the following blood concentration intervals (10-90 percentiles) were observed: 0.049-0.69 mg/kg for aripiprazole, 0.006-0.24 mg/kg for chlorprothixene, and 0.006-0.37 mg/kg for quetiapine. These concentration ranges largely correspond to therapeutic plasma levels observed in vivo suggesting no or only limited postmortem redistribution for aripiprazole, chlorprothixene with metabolite, and quetiapine in these cases. One fatality caused by chlorprothixene with a blood level of 0.90 mg/kg was recorded, and in six cases chlorprothixene was judged to be contributing to death with concentrations 0.43-0.91 mg/kg. No fatalities exclusively ascribed to the two other drugs were observed, but aripiprazole was considered to be contributing to death in one case (1.9 mg/kg) and quetiapine in seven cases with concentrations 0.35-10.0 mg/kg. The presented values may serve as a reference for judgment of postmortem cases with presence of these antipsychotics.

U2 - 10.1093/jat/bku121

DO - 10.1093/jat/bku121

M3 - Journal article

C2 - 25342720

VL - 39

SP - 41

EP - 44

JO - Journal of Analytical Toxicology

JF - Journal of Analytical Toxicology

SN - 0146-4760

IS - 1

ER -