SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

C6
MEPROBAMATE OVERDOSE: A ONE-YEAR EVALUA TION OF REPORTS
Fabienne Pehourcq
Laboratoire de Pharmacologie, Universite Victor SegaJen, 33076 Bordeaux, France.
Meprobamate is a mild sedative-hypnotic drug used in therapy since the 1955s. An overdose with this drug,
even taken alone, may cause severe or even fatal respiratory depression, hypotension, shock, and heart
failure. This drug is widely known in France, particularly for use in suicide attempts.
One hundred and fifty-three cases of meprobamate intoxication were admitted to the emergency room of
our hospital during one year. In these patients, the plasma concentrations of meprobamate measured by gas
chromatography after liquid-liquid extractions were above the therapeutic level of 15 mgIL. Ninety-seven
intoxicated patients (63%) were female. The age of the patients studied was 14-75 years (mean ± SD, 42.2
± 12.7). The mean age for females (43.7 ± 13.1) was significantly greater than that for males (39.6 ± 11.6)
(p< 0.05). Most (58%) of the patients arrived in the emergency room during the time period 6:00 PM to
6:00 AM. Among these 153 hospitalized patients, meprobamate was detected 95 times at concentrations
above the toxic level of 50 mgIL. Thirty-two patients (21 %) presented with concentrations in the range of
100-200 mgIL; Six cases of overdose were described with meprobamate levels greater than 200 mgfL; and
among them, three voluntary intoxications were fatal (1.96%). One third of the cases turned out to be
combined intoxications, 82% of the patients also took benzodiazepines. Most poisonings took place in the
first quarter ofthe year.
In comparison with older studies, the pattern of meprobamate poisoning does not appear to have change in
France over the last 25. years. An overdose with this drug, even when taken alone, produces intoxication
that is often serious and sometimes fatal. The questionable efficacy of meprobamate as a selective antianxiety
agent and its potential for life-threatening intoxication are important drawbacks to the clinical use
ofthis drug.
Keywords: meprobamate, overdose, epidemiology
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