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in postmortem cases.
Levine B, Zhang X, Smialek JE,
Kunsman GW, Frontz ME.
Office of the Chief Medical Examiner,
State of Maryland, Baltimore, USA.
This is a report of the
analytical findings in 13 cases investigated by either the Office of the
Chief Medical Examiner, State of Maryland or the Bexar County (San
Antonio, TX) Medical Examiner's Office in which citalopram, a highly
selective serotonin reuptake inhibitor used therapeutically as an
antidepressant, was identified. In 8 of the 9 cases in which both blood
and urine specimens were received, the urine citalopram concentration
exceeded the blood concentration, indicating that urine is an
appropriate specimen for screening citalopram use. The average liver to
blood citalopram concentration ratio was 6.5 (range 3.1-13, n = 6).
Three cases had blood concentrations less than 0.24 mg/L, which is in
the reported antemortem therapeutic range of the drug. Eleven cases had
blood concentrations less than 1.3 mg/L; in each of these cases,
citalopram was determined to be an incidental finding to the ultimate
cause of death. Quantitation of citalopram and the metabolite
desmethylcitalopram in these cases yielded an average
parent-to-metabolite ratio of 6.4.
PMID: 11599616 [PubMed - indexed for