SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

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IT'S ONLY JUST BEGUN A POSTMORTEM TISSUE DISTRIBUTION OF STRATTERA® OR
A TOMOXETINE IN TWO FATALITIES
Dan Anderson"', Kristina Fritz, Michelle Sandberg, Jamie Lintemoot, Sara Kegler, and Joseph J. Muto
Los Angeles County Dept. a/Coroner, 1104 N. Mission Road, Los Angeles, CA 90033
Stratterl~ or Atomoxetine is a selective norephinephrine reuptake inhibitor approved by the Food and Drug
Administration in December 2002. It is considered the first non-stimulant treatment of attention deficit
hyperactivity (ADHD) in both children and adults. Atomoxetine is prescribed in lO, 18,25,40, and 60-mg
dose capsules. Since Strattera® has entered the market, the Los Angeles County Dept. of Coroner
Toxicology Laboratory has only encountered two cases where atomoxetine was detected. Presented are the
case histories, cause and manner of death, the postmortem tissue distribution of atomoxetine, all designed
to aid the forensic toxicologist with the interpretation of their own casework.
The analysis of atomoxetine from postmortem specimens consisted of a basic, Iiquid/liquid (nbutylchloride)
extraction procedure with screening and quantitation by GC/NPD. Linearity was achieved
from 0.05 to 5.0 mgIL with the limit of quantitation at 0.05 mgIL. Confirmation of atomoxetine was
determined using a GCIMS by comparison with an analytical standard.
The tissue distribution of atomoxetine was as follows:
...
Atomoxetine ._._,.-->-' (mg/L r:-:-- or mg/kg) _.,...__.__._-- ---,
Chest Blood Femoral Blood Vitreous Liver Gastric Bile Urine
I Case No. 1 0.08 0.04 --­ -­ --­ --­ 0.16
I Case No.2 1.3 0.23 0.34 4.2 1.2 or 0.17 mg total 1.5 0.62
It's the author's belief that these are one of the first cases of atomoxetine being detected and reported from
postmortem specimens.
Keywords: Atomoxetine; Tissue Distribution, Postmortem
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