Høiseth Gudrun, Bramness Jørgen G, Christophersen Asbjørg S, Mørland Jørg
Division of Forensic Toxicology and Drug Abuse, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403 Oslo, Norway.
Int J Legal Med. 2007 Sep;121(5):403-9. doi: 10.1007/s00414-006-0139-1. Epub 2006 Nov 18.
Carisoprodol is commonly prescribed as a centrally acting muscle relaxant, but it is also subject to abuse. The literature describing fatal intoxications with the drug is limited to a relatively small number of cases, and there are inconsistencies with regard to which concentration levels that are toxic. We therefore investigated all forensic autopsies at the Norwegian Institute of Public Health during the period 1992-2003 where carisoprodol was detected. The median concentrations of carisoprodol in intoxication with carisoprodol only or with only minor other analytical findings was 36 mg/l (range 8-65 mg/l; n=5). In the rest of the intoxications, the relevance of carisoprodol relative to the other drugs detected was variable (n=93). When the number of intoxications with carisoprodol each year were divided by the number of defined daily doses (DDD) sold, a fatal toxicity index between 5.6 and 6.9 deaths/1 million DDD was obtained. The total number of cases where carisoprodol was detected increased during the period studied, which correlated to sales figures for the drug. We conclude that carisoprodol can be fatal in concentrations below those indicated in some of the previously published literature. There were, however, only a small number of cases where the cause of death can be attributed to use of carisoprodol alone.
卡立普多通常被用作中枢性肌肉松弛剂，但它也容易被滥用。描述该药物致命中毒情况的文献仅限于相对少数的病例，而且关于何种浓度水平有毒存在不一致之处。因此，我们调查了1992年至2003年期间挪威公共卫生研究所所有检测到卡立普多的法医尸检情况。仅卡立普多中毒或仅有少量其他分析结果的情况下，卡立普多的中位浓度为36毫克/升（范围8 - 65毫克/升；n = 5）。在其余中毒情况中，卡立普多相对于其他检测到的药物的相关性各不相同（n = 93）。当每年卡立普多中毒的病例数除以售出的限定日剂量（DDD）数时，得出的致命毒性指数为每100万DDD有5.6至6.9例死亡。在所研究的期间内，检测到卡立普多的病例总数有所增加，这与该药物的销售数字相关。我们得出结论，卡立普多在低于一些先前发表的文献中所指出的浓度时也可能致命。然而，仅有少数病例的死亡原因可归因于单独使用卡立普多。
