Report of a fluoxetine fatality.

Several fatalities due to fluoxetine combined with other drugs such as ethyl alcohol have been reported. We now report an apparent suicide in which fluoxetine was the only causative agent. Because this drug is widely described as having a wide safety margin, it is important to note concentrations in blood associated with overdose fatalities. The findings by GC/NPD and GC/MS in blood were as follows: fluoxetine 6,000 ng and demethylated metabolite 5,000 ng/mL. Parent compound and metabolite were 13,000 ng/mL each in bile. Details of the analytical method and data from 2,100 National Medical Services cases are also presented.