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Fatal unintentional intoxications with tramadol during 1995-2005.
Forensic Sci Int. 2007 Dec 20; 173(2-3):107-11.FS

Abstract

Tramadol is an extensively used centrally acting analgesic and is considered a safe drug devoid of many serious adverse effects of traditional opioids. However, recently, toxicity and an abuse potential of tramadol have been reported. This study examined fatal unintentional tramadol intoxications among Swedish forensic autopsy cases between 1995 and 2005. All fatal intoxications were selected, in which toxic concentrations of tramadol (>1 microg/g femoral blood) had been detected, and where the forensic pathologist considered the intoxication unintentional and the fatal outcome at least partly explained by tramadol. Toxicology analyses, police reports, autopsy protocols and medical records were scrutinized. A total of 17 cases (eleven men and six women) of fatal unintentional tramadol intoxications were identified. For these cases the median age was 44 years (range 18-78 years) and the median tramadol concentration was 2.0 microg/g (range 1.1-12.0 microg/g). Other pharmaceutical substances, illicit drugs or ethanol were detected in addition to tramadol in all of these cases. In fact, intoxication with multiple drugs was considered the cause of death in 10 (59%) cases. However, in seven cases tramadol was the only substance present in toxic concentrations. A history of substance abuse was identified in 14 (82%) subjects and a present tramadol abuse in 8 (47%). These results suggest that fatal intoxications with tramadol may occur unintentionally and that subjects with a history of substance abuse may be at certain risk. Precaution is therefore warranted when prescribing tramadol in such patients.

Authors+Show Affiliations

Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17350197

Citation

Tjäderborn, Micaela, et al. "Fatal Unintentional Intoxications With Tramadol During 1995-2005." Forensic Science International, vol. 173, no. 2-3, 2007, pp. 107-11.
Tjäderborn M, Jönsson AK, Hägg S, et al. Fatal unintentional intoxications with tramadol during 1995-2005. Forensic Sci Int. 2007;173(2-3):107-11.
Tjäderborn, M., Jönsson, A. K., Hägg, S., & Ahlner, J. (2007). Fatal unintentional intoxications with tramadol during 1995-2005. Forensic Science International, 173(2-3), 107-11.
Tjäderborn M, et al. Fatal Unintentional Intoxications With Tramadol During 1995-2005. Forensic Sci Int. 2007 Dec 20;173(2-3):107-11. PubMed PMID: 17350197.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fatal unintentional intoxications with tramadol during 1995-2005. AU - Tjäderborn,Micaela, AU - Jönsson,Anna K, AU - Hägg,Staffan, AU - Ahlner,Johan, Y1 - 2007/03/09/ PY - 2006/11/03/received PY - 2007/02/02/revised PY - 2007/02/04/accepted PY - 2007/3/14/pubmed PY - 2008/1/1/medline PY - 2007/3/14/entrez SP - 107 EP - 11 JF - Forensic science international JO - Forensic Sci Int VL - 173 IS - 2-3 N2 - Tramadol is an extensively used centrally acting analgesic and is considered a safe drug devoid of many serious adverse effects of traditional opioids. However, recently, toxicity and an abuse potential of tramadol have been reported. This study examined fatal unintentional tramadol intoxications among Swedish forensic autopsy cases between 1995 and 2005. All fatal intoxications were selected, in which toxic concentrations of tramadol (>1 microg/g femoral blood) had been detected, and where the forensic pathologist considered the intoxication unintentional and the fatal outcome at least partly explained by tramadol. Toxicology analyses, police reports, autopsy protocols and medical records were scrutinized. A total of 17 cases (eleven men and six women) of fatal unintentional tramadol intoxications were identified. For these cases the median age was 44 years (range 18-78 years) and the median tramadol concentration was 2.0 microg/g (range 1.1-12.0 microg/g). Other pharmaceutical substances, illicit drugs or ethanol were detected in addition to tramadol in all of these cases. In fact, intoxication with multiple drugs was considered the cause of death in 10 (59%) cases. However, in seven cases tramadol was the only substance present in toxic concentrations. A history of substance abuse was identified in 14 (82%) subjects and a present tramadol abuse in 8 (47%). These results suggest that fatal intoxications with tramadol may occur unintentionally and that subjects with a history of substance abuse may be at certain risk. Precaution is therefore warranted when prescribing tramadol in such patients. SN - 1872-6283 UR - https://www.unboundmedicine.com/medline/citation/17350197/Fatal_unintentional_intoxications_with_tramadol_during_1995_2005_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0379-0738(07)00092-8 DB - PRIME DP - Unbound Medicine ER -