A report on autopsy cases involving amitriptyline and nortriptyline

Summary The concentration and distribution of amitriptyline and nortriptyline in different parts of the body of 55 autopsy cases are reported. The cases are grouped into three categories: i) cases in which poisoning by ami- or nortriptyline seemed to have been the only cause of death, (ii) cases of mixed poisoning by these two drugs and other compounds and/or ethanol, and finally (iii) deaths by physical means where ami- or nortriptyline was found but did not play a direct role in the lethal outcome.The severity of the intoxication by ami- or nortriptyline is best judged by the concentration of the drug (and its metabolites) in the liver, in a similar fashion as for the phenothiazine drugs discussed in an earlier paper.The autopsies reported in this paper have been performed by Drs. K. Boström, B. Falconer, P. Geertinger, H. Glaumann, S. Jacobsson, H. Knutson, B. Larsson, S. O. Lidholm, J. Lindberg, A. Lindgren, I. Lingmark, L. Rammer, T. Saldeen, Hj. Sjövall, G. Voigt, B. Zetterlund, and one of us (G.S.).