Akhgari Maryam, Jokar Farzaneh, Etemadi-Aleagha Afshar, Ghasemi Ali
Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
Department of Anaesthesiology & Critical Care, Tehran University of Medical Sciences, Tehran, Iran.
Sultan Qaboos Univ Med J. 2017 May;17(2):e213-e217. doi: 10.18295/squmj.2016.17.02.013. Epub 2017 Jun 20.
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.
反苯环丙胺是一种单胺氧化酶抑制剂类有效的抗抑郁药，其结构与苯丙胺相关。然而，关于反苯环丙胺在人体内代谢为苯丙胺和甲基苯丙胺的可能性，各报告的说法不一。我们报告一例25岁重度抑郁症女性，于2016年因过量服用反苯环丙胺致死。她前一天刚被开具反苯环丙胺处方，既往无自杀未遂或药物滥用史。尸体被转运至伊朗德黑兰的法医学部门进行尸检。用七氟丁酸衍生化后，通过气相色谱/质谱法检测发现尿液样本中反苯环丙胺、苯丙胺和甲基苯丙胺呈阳性。由于尿液样本中存在苯丙胺类物质，推测反苯环丙胺已通过代谢转化为苯丙胺类物质。因此，某些处方药的合法使用可能会使非法药物检测结果的解读变得复杂。
