|SOFT - TIAFT 1998||Poster Session 3||Thursday October 8, 1998|
POSTMORTEM TISSUE DISTRIBUTION OF MIRTAZAPINE (REMERON®)|
Daniel T. Anderson
Los Angeles County Department of Coroner, 1104 North Mission Road, Los Angeles, CA 90033, U.S.A.
|Mirtazapine is a new anti-depressant agent which entered the United States market in April 1996. To date, the literature provides limited information about therapeutic blood concentrations and no information about postmortem levels. During 1998, the Los Angeles County Coroner's Toxicology Laboratory encountered five cases where postmortem tissue distributions of mirtazapine were determined.
The analysis of mirtazapine from postmortem specimens (2 ml sample size) consisted of an n-butylchloride basic extraction procedure with screening and quantitation on a GC/NPD. Linearity was achieved from 0.05 mg/L to 3.0 mg/L with limit of quantitation being 0.05 mg/L. Confirmation of mirtazapine was performed on a GC/MS by comparison with an analytical standard.
The tissue distribution of mirtazapine are in the following concentration ranges: Heart blood 0.10 - 0.32 mg/L, Femoral blood 0.13 - 0.24 mg/L, Vitreous 0.06 - 0.10 mg/L, Liver 0.53 - 2.1 mg/kg, Bile 1.2 - 6.6 mg/L, Urine 0.43 - 2.5 mg/L, and Gastric 0.012 - 2.7 mg total. In all five cases, the concentration of mirtazapine was not directly linked to the cause of death. However, these cases represent the first reported fatalities involving the anti-depressant, mirtazapine, and can be used for postmortem comparisons.