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Mirtazapine/morphine Death secondary to drug toxicity: case report

In a case series of 5 patients, a 33-year-old woman was described, who died due to mixed-drug toxicity during treatment with mirtazapine and morphine for borderline personality disorder. The woman was found deceased at home. Her medical history was significant for diabetes, asthma, borderline personality disorder, pneumonia and asthma. She had beeing receiving lorazepam, salbutamol, mirtazapine and morphine [dosages and routes not stated]. The post-mortem sampling was performed two days after her death. At the post-mortem, there was no anatomical cause of death reported. Unpreserved blood taken from the femoral vein contained etizolam, flubromazolam, clozapine, cocaine and metabolites, lamotrigine, gabapentin, morphine (total) 91 µg/L and morphine (free) 56 µg/L, mirtazapine and 7-amino clonazepam. Each of these drugs was also found in urine sample. Her cause of death was considered to be due to mixed-drug toxicity and it was suggested that the flubromazolam either was taken as a mixture of drugs* or was present as a contaminant of other illicit compounds such as heroin or etizolam [duration of treatments to reaction onset not stated]. * Only therapeutically taken toxicologically detected drugs were considered as valid suspect drugs. Rest of the detected drugs were excluded considering possiblity of illicit drugs mixture use. Abdul K, et al. Flubromazolam: Detection in five post-mortem cases. Medicine, science, and the law : 24 Aug 2020. Available from: URL: http:// doi.org/10.1177/0025802420950273

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Reactions 26 Sep 2020 No. 1823