Analysis of citalopram and desmethylcitalopram in postmortem fluids and tissues using liquid chromatography-mass spectrometry.

Details

• Creators:
  Lewis, Russell J. ; Angier, Mike K. ; Johnson, Robert ; Rains, Brittany M. ; Nepal, Sarik
• Corporate Creators:
  Civil Aerospace Medical Institute ; University of Central Oklahoma
• Corporate Contributors:
  United States. Office of Aerospace Medicine
• Subject/TRT Terms:
  • Toxicology
  • Forensic medicine
  • Aviation medicine
  • Liquid chromatography
  • Mass spectrometry
  • Forensic Toxicology, Citalopram, Desmethylcitalopram,
  • Distribution, GC/MS, Selective Serotonin Reuptake
  • Inhibitor
• Publication/ Report Number:
  DOT/FAA/AM-11/17
• Resource Type:
  Tech Report
• Geographical Coverage:
  United States
• Corporate Publisher:
  United States. Office of Aerospace Medicine
• Abstract:
  "Citalopram is a selective serotonin reuptake inhibitor that is a commonly prescribed drug for the treatment of ; depression, obsessive-compulsive disorder, panic disorder, anxiety disorder, and post-traumatic stress disorder. ; While the use of citalopram is relatively safe, certain side effects could negatively affect a pilot’s performance ; and become a factor in an aviation accident. The side effects of this medication include nausea, tiredness, ; drowsiness, dizziness, and blurred vision. Due to the severity of aviation accidents, blood samples are often not ; available, so tissues must be relied upon for analysis. Therefore, understanding the distribution of a drug ; throughout postmortem fluids and tissues is important when trying to interpret drug impairment and/or ; intoxication. Our laboratory investigated the distribution of citalopram and its main active metabolite, ; desmethylcitalopram, in various postmortem tissues and fluids obtained from 15 fatal aviation accident cases. ; When available, 10 specimen types were analyzed for each case, including blood, urine, vitreous humor, liver, ; lung, kidney, spleen, muscle, heart, and brain. Whole blood citalopram concentrations obtained from these 15 ; cases ranged from 0.079 to 1.06 μg/mL. Distribution, expressed as specimen/blood ratio, for citalopram was ; 12 ± 19 in urine, 0.42 ± 0.21 in vitreous humor, 16 ± 8 in liver, 15 ± 15 in lung, 3.6 ± 2.5 in kidney, 8.1 ± 3.7 ; in spleen, 0.83 ± 0.40 in muscle, 2.3 ± 1.2 in brain, and 1.9 ± 1.0 in heart. Distribution coefficients obtained ; for citalopram had coefficient of variations (CV) ranging from 46-158%. With such large CV’s, the ; distribution coefficients have very little use in aiding in the interpretation of citalopram-positive tissue ; specimens. Furthermore, no consistent citalopram/desmethylcitalopram ratio was identified within any ; specimen group. This study suggests that citalopram likely undergoes postmortem concentration changes."
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• Format:
  PDF
• Funding:
  Task no. AM-B-11-TOX-204
• Download URL:
  https://rosap.ntl.bts.gov/view/dot/23566/dot_23566_DS1.pdf
• File Type:
  [PDF - 418.69 KB]
• Collection(s):
  FAA Civil Aerospace Medical Institute ; US Transportation Collection
• Main Document Checksum:
  urn:sha-512:e2d40f0ad64800172faa9e8dc617bf0063bc040d59947a26d2a761ab4c90bea1d49667676b86c618a55e3da1bc3e9df9e31a3e288bf6e7a5673bfdab0a651ecf