Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatality

Tranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old wo...

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Main Authors: Maryam Akhgari, Farzaneh Jokar, Afshar Etemadi-Aleagha, Ali Ghasemi
Format: Article
Language:English
Published: Sultan Qaboos University 2017-05-01
Series:Sultan Qaboos University Medical Journal
Subjects:
Online Access:https://journals.squ.edu.om/index.php/squmj/article/view/2209
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author Maryam Akhgari
Farzaneh Jokar
Afshar Etemadi-Aleagha
Ali Ghasemi
author_facet Maryam Akhgari
Farzaneh Jokar
Afshar Etemadi-Aleagha
Ali Ghasemi
author_sort Maryam Akhgari
collection DOAJ
description Tranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old woman with severe depression who died due to a fatal tranylcypromine overdose in 2016. She had been prescribed tranylcypromine one day previously and had no history of previous suicide attempts or substance abuse. The body was transferred to a forensic medicine department in Tehran, Iran for the autopsy. A urine sample was positive for tranylcypromine, amphetamine and methamphetamine using gas chromatography/mass spectrometry after derivatisation with heptafluorobutyric acid. As amphetamines were present in the urine sample, it was assumed that the tranylcypromine had been converted to amphetamines metabolically. As such, it is possible that the legitimate use of certain prescription drugs may complicate the interpretation of test results for illegal drugs.
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spelling doaj.art-2c9a593844ed4d00ae2548fa386463e02022-12-22T01:57:04ZengSultan Qaboos UniversitySultan Qaboos University Medical Journal2075-051X2075-05282017-05-0117221321710.18295/squmj.2016.17.02.0132129Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatalityMaryam Akhgari0Farzaneh Jokar1Afshar Etemadi-Aleagha2Ali Ghasemi3Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, IranDepartment of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, IranDepartment of Anaesthesiology & Critical Care, Tehran University of Medical Sciences, Tehran, IranDepartment of Anaesthesiology & Critical Care, Tehran University of Medical Sciences, Tehran, IranTranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old woman with severe depression who died due to a fatal tranylcypromine overdose in 2016. She had been prescribed tranylcypromine one day previously and had no history of previous suicide attempts or substance abuse. The body was transferred to a forensic medicine department in Tehran, Iran for the autopsy. A urine sample was positive for tranylcypromine, amphetamine and methamphetamine using gas chromatography/mass spectrometry after derivatisation with heptafluorobutyric acid. As amphetamines were present in the urine sample, it was assumed that the tranylcypromine had been converted to amphetamines metabolically. As such, it is possible that the legitimate use of certain prescription drugs may complicate the interpretation of test results for illegal drugs.https://journals.squ.edu.om/index.php/squmj/article/view/2209tranylcypromineamphetaminemetabolismforensic toxicologysubstance abuse detectioncase reportiran.
spellingShingle Maryam Akhgari
Farzaneh Jokar
Afshar Etemadi-Aleagha
Ali Ghasemi
Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatality
Sultan Qaboos University Medical Journal
tranylcypromine
amphetamine
metabolism
forensic toxicology
substance abuse detection
case report
iran.
title Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatality
title_full Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatality
title_fullStr Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatality
title_full_unstemmed Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatality
title_short Discrimination Between Drug Abuse and Medical Therapy : Case report of a tranylcypromine overdose-related fatality
title_sort discrimination between drug abuse and medical therapy case report of a tranylcypromine overdose related fatality
topic tranylcypromine
amphetamine
metabolism
forensic toxicology
substance abuse detection
case report
iran.
url https://journals.squ.edu.om/index.php/squmj/article/view/2209
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AT afsharetemadialeagha discriminationbetweendrugabuseandmedicaltherapycasereportofatranylcypromineoverdoserelatedfatality
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