Randall C. Baselt

Olanzapine-related fatality.

A 43-year-old male psychiatric outpatient died within hours of ingesting as much as 600 mg of olanzapine, a newer antipsychotic agent related to clozapine. Analysis of postmortem blood and urine by gas chromatography with nitrogen-selective detection yielded olanzapine concentrations of 1238 and 6987 micrograms/L, respectively, greatly in excess of levels expected following therapeutic administration of the drug. Based on the toxicology findings, the decedents known history of suicide attempts, and the circumstances surrounding the death, this case was ruled a suicide by olanzapine overdosage.

Blood Codeine Concentrations in Fatalities Associated with Codeine

The toxicologic findings in eight cases of death due primarily to codeine overdosage are presented. Blood codeine concentrations ranged from 1.4 to 5.6 mug/ml as determined by gas-liquid chromatography. Morphine was found in only two of the blood samples, at concentrations of 0.2 and 0.6 mug/ml, and may have resulted from heroin usage rather than codeine metabolism. A case of death of a codeine user by violent means is also presented in which the blood codeine concentration was 2.6 mug/ml.

Commentary on Wu AHB, Hill DW, Crouch D, Hodnett CN, McCurdy HH. Minimal standards for the performance and interpretation of toxicology tests in legal proceedings. J Forensic Sci 1999;44(3):516-522.

Commentary on Wu AHB, Hill DW, Crouch D, Hodnett CN, McCurdy HH. Minimal Standards for the Performance and Interpretation of Toxicology Tests in Legal Proceedings. J Forensic Sci 1999;44(3):516-522