Deaths involving contraindicated and inappropriate combinations of serotonergic drugs

摘要: In the Australian state of Victoria, all fatalities that were recorded from 2002 through to 2008 involving use certain serotonin active drugs (tramadol, venlafaxine, fluoxetine, sertraline, citalopram and paroxetine), reviewed assess incidence contraindicated or ill advised drug combinations. More than 1,000 identified which 326 cases formed basis this study. These involved inappropriate combinations can lead adverse reactions (ADRs) subsequent fatal toxicity. Of these, 46% drug-related, 35% a result natural disease 13% classified as external injury cases. The remaining those where cause death (COD) was unascertained. Tramadol most common drug, usually detected alongside serotonergic antidepressant (in 20% cases). Twenty-five (8%) while remainder (301 cases, 92%) are associated with interactions ranging minor major severity. these Coroner determined 166 (51%) be acts intentional self-harm misuse, unascertained attributed disease. Very few post-mortem reports Coroners’ findings made mention possible ADRs when such actually present. majority comprising combined five (24%) at time death. A combination three in inadvisable Combined toxicity COD, heart co-morbidity.