Distribution of Trimipramine and Its Major Metabolites in a Fatal Overdose Case

A fatality following ingestion of the tricyclic antidepressant trimipramine (Surmontil) is described. Quantitation was performed by high-performance liquid chromatography. Trimipramine and desmethyltrimipramine concentrations were 4.8 and 2.1 mg/L, respectively, in postmortem blood. The concentration of trimipramine, desmethyltrimipramine, and their respective 2-hydroxy metabolites were also measured in liver and urine. Analysis of gastric contents revealed a tricyclic antidepressant drug. These findings are compared to previously published reports of trimipramine-related fatalities.