A fatal case of trazodone and dothiepin poisoning: toxicological findings

Abstract

A fatal case of trazodone and dothiepin self-poisoning is presented. A multi-technique approach (EMIT, TLC, HPLC/DAD, and GC/MS) allowed the unequivocal identification of trazodone and dothiepin as toxicologically relevant substances. Both compounds were quantitatively determined in a number of postmortem samples. Blood and urinary trazodone concentrations (28.7 and 90.5 micrograms/mL, respectively) and dothiepin concentrations (2.1 and 9.7 micrograms/mL, respectively) were far above therapeutic concentrations (i.e., 1.5 and 0.05 microgram/mL for trazodone and dothiepin, respectively, in blood) and were clearly the cause of death in this particular case. These data confirm the high toxicity and the high mortality rate in trazodone intoxications, especially when co-ingestion of other substances is involved.